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Duhan Plastic Surgery Clinic · 두한성형외과 DUHANISM · March 6, 2020
#Gangnam under-eye fat #Gangnam under-eye fat repositioning #Gangnam under-eye fat removal #male upper eyelid fat removal #male under-eye wrinkles #male under-eye fat #male under-e...
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This page is an English translation of a Korean Naver Blog archive entry. For exact wording and source context, verify against the Korean archive original and the original Naver post.
Clinic: Duhan Plastic Surgery Clinic
Original post date: March 6, 2020
Translated at: April 25, 2026 at 8:33 AM
Medical note: This translation does not guarantee medical accuracy or suitability for treatment decisions.
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The eyelids contain a structure called "orbital fat."
If there is only an appropriate amount of orbital fat, it helps maintain the contour of the eyelids, protects the eyeball, and acts as a lubricant for eyelid movement. However, if there is too much, the under-eye area or upper eyelids may protrude and look swollen.
Removing this unnecessary excess fat is what eyelid fat removal is.
The lower eyelid usually has three fat pads: one on the inner side of the eye, one in the middle, and one on the outer side.
Among them, the middle fat pad is the largest, so the middle fat is usually removed first, and depending on the case, the inner fat may also be removed.
How many areas of fat are removed and how much are removed depends on the individual, so it is important to remove the right amount for each person.
Excessive fat removal can cause hollowness under the eyes, so it is important to remove the appropriate amount after an accurate examination.
● Indications for under-eye fat removal procedures
① A protruding under-eye area caused by forward displacement of orbital fat
② Eyes that easily become puffy in the morning
③ Cases where wrinkle lines are visible around the protruding under-eye area
⑤ Cases with red dark circles under the eyes
The upper eyelid usually has two fat pads: one on the inner side of the eye and one on the outer side.
Because the outer fat pad is about twice the volume of the inner one, the common method is usually to remove the outer fat pad.
● Indications for upper eyelid fat removal procedures
① An eyelid line that looks swollen
② Eyes that easily become puffy in the morning
③ Cases where the eyelids feel heavy
④ Cases where you want to remove only the fat without touching the double eyelid line
| 01. It can correct swollen-looking eyelids. |
|---|
| 02. In the case of under-eye fat removal, it helps restore a smoother eye line and corrects hollowness and wrinkle lines under the eyes. |
| 03. It can improve red dark circles under the eyes. |
| 04. It helps restore a more youthful eye line. |
If there is a double eyelid, the design is made along the double eyelid line.
Only a small amount is needed for anesthesia, so swelling caused by the anesthetic is minimal.
The incision is only about 2–3 mm long, so there is almost no scar.
In the case of an eyelid with a double eyelid, the incision line passes along the double eyelid line, so the scar is hidden in the crease and is not visible.
The fat is accumulated behind the orbital septum, so the septum must be opened first, and then the fat is pulled out enough to bring out an adequate amount.
Good hemostasis is important to prevent swelling and bruising.
The thread can be removed after 2–3 days.
Daily life is possible immediately after surgery, and swelling and bruising are usually minimal.
▷ Use the cold compress pack provided by the hospital for about 3 days after fat removal.
▷ Remove the stitches on the second day after surgery.
▷ Washing the face and applying makeup are possible from the day after surgery.
▷ Swelling and bruising are mild, so normal daily life is possible right away.
① If the skin or orbicularis oculi muscle is thick and the area looks swollen, the effect of fat removal may be limited.
② When fat is removed from an eye with a double eyelid, the double eyelid line may become slightly wider.
③ Excessive fat removal can make the eyes look sunken, so do not remove too much fat.
④ If the skin or orbicularis oculi muscle of the upper eyelid is thick and makes the area look swollen, the effect of fat removal may be limited.
⑤ Upper eyelid fat removal is more difficult in eyes that have already had double eyelid surgery.
The effect of upper eyelid fat removal is to improve morning puffiness and reduce the volume of swollen-looking eyes.
Upper eyelid fat removal surgery
involves making a 2 mm incision on the outer side of the eyelid
and removing fat about the size of a kidney bean.
After fat removal,
you may see an effect that makes the eyes look slightly deeper-set.
Once removed, the fat does not grow back.
The surgery takes about 20 minutes,
and daily life is possible immediately.
You can go home right after surgery.
Swelling and bruising are almost absent.
Stitches are removed after 2–3 days.
Almost no scar remains.
Director Shin Duhan
Restoration to a smoother eye line, along with correction of #under-eyewrinkles
Correction of red dark circles under the eyes
Restoration to a more youthful eye line
No scar and a natural result
Minimal bruising and swelling, allowing immediate return to daily life
The area of fat to be removed is determined according to the distribution and amount of fat, and then the design is made.
Although a laser is sometimes used, lasers have weaker hemostatic effects and can cause heavy bleeding during surgery, so an electric coagulator is generally used more often.
The electric coagulator reduces bleeding and minimizes swelling and bruising.
Excessive fat removal can cause hollowness and wrinkles under the eyes, so it is appropriate to remove only the amount that comes out when pulled.
If hemostasis is insufficient, bleeding may occur from inside after surgery, causing more swelling and bruising, so proper hemostasis is important.
Because the dissolvable thread disappears within 7–15 days, there is no need to visit the clinic later to have stitches removed.
Contact lenses can also be worn starting the day after surgery.
To prevent swelling and inflammation after surgery, antibiotic and anti-inflammatory eye drops are prescribed.
○ Use the cold compress pack provided by the hospital for about 3 days after fat removal.
○ On the day of surgery, sleep with your head elevated about 30 degrees to reduce bruising and swelling.
○ To reduce swelling and bruising, avoid lying down as much as possible and stay seated on the day of surgery.
○ Washing the face and applying makeup are possible from the next day.
○ Contact lenses may be worn starting the day after surgery.
○ Use the eye drops prescribed by the hospital for about one week.
○ The conjunctiva is closed with dissolvable thread, so there is no need to remove stitches.
○ Swelling and bruising are minor and usually subside within about a week.
Excessive fat removal can make the under-eye area look sunken, so be careful not to remove too much fat.
If the skin is loose and under-eye fat removal is performed, the skin may sag and wrinkles may increase.
If you have had LASIK, wait at least 3 months before undergoing under-eye fat removal; if you have had LASEK, wait at least 1 month.
Under-eye fat removal may worsen dark circles in some cases, so if dark circles could worsen, the procedure should not be performed.
The most common side effects include hollowness under the eyes due to excessive fat removal caused by an inaccurate assessment of the fat amount by an inexperienced surgeon, more fine wrinkles than before surgery, and the appearance or worsening of dark circles.
It is better not to have cosmetic surgery at a dermatology clinic or other department without a plastic surgery specialist, especially if the surgeon has limited experience.
If hollowness under the eyes occurs after excessive fat removal, it can be corrected and restored with micro fat grafting.
To avoid side effects, it is important to carefully determine the indications for fat removal through an accurate preoperative examination and remove the appropriate amount of fat.
If the skin lacks elasticity and is prone to fine wrinkles, or if dark circles may worsen or appear, fat removal should not be performed.
To avoid side effects, the rule is not to undergo surgery by a non-specialist in plastic surgery.
Depending on the skin type under the eyes, there are roughly three types of color changes after fat removal.
There may be almost no color change, the color may become slightly darker, or it may become lighter.
If there are dark circles under the eyes, the color often becomes darker after fat removal.
Conversely, if the color is red, the redness may decrease.
Depending on the skin type and current color, the color change after fat removal must be predicted in advance and handled accordingly.
If fat removal is performed for the purpose of improving dark circles, the condition may actually worsen, so the indication for the procedure must be carefully determined.
In cases where fat is removed for the purpose of improving dark circles, additional fat grafting below the area of fat removal may be needed later.
If the orbital fat under the eyes protrudes and looks bulging,
the symptoms can be relieved through fat removal.
Under-eye fat removal is performed as a scarless surgery through the conjunctiva.
A 3 mm incision is made through the conjunctiva
and the excess orbital fat is removed.
Anesthesia is performed with painless sleep sedation and local anesthesia.
Therefore, you do not need to worry about pain.
The surgery takes about 30–40 minutes,
and daily life is possible immediately.
You can go home right after surgery.
Although it varies from person to person, swelling and bruising are usually not severe.
Because the stitches are closed with dissolvable thread,
you do not need to come in to have them removed.
Treatment ends with a single procedure.
Director Shin Duhan
Q. What is the best method for under-eye fat removal?
A. For under-eye fat removal, no incision is made in the skin.
If the skin is cut externally, a scar remains, so a scarless operation through the conjunctiva is usually performed.
Q. How much swelling and bruising occurs after fat removal?
A. There will be some swelling and bruising, but they will usually 거의 disappear within about a week.
Q. Do I not need to remove stitches?
A. Since the conjunctiva is incised, the fat is removed, and the area is closed with dissolvable thread, there is no need to remove stitches.
Q. Does the fat grow back?
A. Once removed, fat does not regenerate.
Fat removal has a permanent effect.
This refers to a method of moving the protruding orbital fat under the eyes to the lower recessed area and spreading it there instead of removing it.
This is a method intended to correct both the protruding area and the sunken area at the same time.
It was devised to compensate for the disadvantage of fat removal, which can address protrusion but not hollowness.
The problem with under-eye fat repositioning is that it is difficult to obtain the desired result properly.
Because the surgery is performed through the conjunctiva, visibility is limited and the operation is not performed properly. Also, there are not many people for whom fat repositioning is actually a perfect fit.
A simple example is when the ground has a hill and a pit, and the goal is to level the entire area by removing soil from the hill to fill the pit. If the hill is not that large, even after shaving off all the soil from the hill, it may still not be enough, and after filling the pit, the hill can actually become a sunken area.
This is a phenomenon in which, when there is not much fat and it is forcibly pulled and repositioned, the originally protruding area becomes sunken instead.
In another case, the pit is larger than the hill, so even after removing all the soil from the hill to fill the pit, the pit only becomes slightly shallower and still remains a pit.
This refers to a case where a small amount of fat is pulled and repositioned, but the hollow area is not corrected well and remains sunken.
In yet another case, the hill is large, and even after filling the pit, the hill only becomes slightly smaller and still remains a hill.
This means there is so much protruding fat that even after repositioning, fat remains and the under-eye bulging is still present.
When the amount of fat is insufficient, the protruding area where the fat used to be may actually become sunken after repositioning.
When there is a large amount of fat, the original protruding area may still look protruded even after repositioning.
After repositioning, the original sunken area may instead appear protruded.
When the amount of fat is small, the original sunken area may not be properly filled even after repositioning and may still look sunken and shadowed.
Therefore, if fat repositioning is performed, the surgery must be done by carefully selecting the appropriate shape and indications in order to achieve satisfactory results. If the case is not suitable, fat repositioning may become an ambiguous operation.
Also, because more tissue must be dissected than with fat removal, swelling and bruising are much more severe.
If the case is not suitable, fat removal can produce a clearer result than fat repositioning, and if needed, micro fat grafting can additionally fill only the sunken area after fat removal.
It can be improved with under-eye fat repositioning surgery, which moves the protruding fat to the hollow area.
The exact method of surgery can be determined during an in-person consultation.
Rather than removing the fat under the eyes, the fat is moved to the area that needs volume.
The surgery is performed through the conjunctiva of the lower eyelid without an incision, and the advantage is that there is almost no scar or swelling.
Usually, many patients come back to our clinic for grafting after repositioning at another hospital.
For those with severe under-eye grooves, simple repositioning alone is not enough to fill the grooves completely with existing under-eye fat.
At our clinic, based on more than 20 years of rich clinical experience and know-how, we additionally fill the deficient parts of the sunken areas with grafting.
Because the hollow area is fully improved, satisfaction is higher.
Under-eye repositioning is not a surgery that requires separate treatment after surgery.
Therefore, you only need to come on the day of surgery and then return for a follow-up after 3 months.
The dark circle surgery is determined according to the shape of the patient’s under-eye area.
If the under-eye area is sunken, fat grafting is performed.
If it is protruding, removal is performed.
If there is both protrusion and hollowness under the eyes,
the condition can be improved with under-eye fat repositioning surgery,
which moves the protruding fat to the hollow area.
Repositioning does not remove the fat under the eyes;
it moves the fat to the area that needs volume.
The surgery is performed without an incision,
through the conjunctiva of the lower eyelid,
and the advantage is that there is almost no scar or swelling.
Usually, many patients come back to our clinic
after repositioning at another hospital for grafting.
For those with severe under-eye grooves,
simple repositioning alone is not enough
to fill the grooves completely with existing under-eye fat.
Therefore, at our clinic, the 부족한 parts of the hollow areas
are additionally filled with grafting.
Because the sunken areas are fully improved, satisfaction is higher.
The fat is harvested through an incision at the navel.
Because no tape is applied after surgery,
normal daily life is possible immediately,
and washing the face and applying makeup are possible from the very next day.
Bruising and swelling occur for about 1–2 weeks,
but they can be sufficiently covered with concealer or makeup.
Director Shin Duhan
■ When fat removal is performed with a laser
There are hospitals that perform fat removal with a laser, but there is something you should know.
Even if most hospitals have a laser, they do not actually perform surgery with it.
The word "laser" sounds flashy and convincing, but it can be misleading.
Some people also mistakenly think that a laser is a universal and best surgical method.
When a laser is used to make an incision for under-eye fat removal, the problem is that there is a lot of bleeding after the incision.
The heat generated by the laser can stop bleeding in fine capillaries on its own, but in the case of slightly larger blood vessels, hemostasis does not occur, so if surgery is performed only with a laser, bleeding may prevent the surgery from being done at all.
To operate with a laser, you must also use an electric coagulator.
If there is bleeding, you must stop the laser and continue the surgery while controlling bleeding with the electric coagulator.
Therefore, there is no reason to perform surgery this way.
If surgery is performed from the beginning with an electric coagulator, hemostasis works properly and the procedure can proceed faster.
Despite several disadvantages, some hospitals still use lasers.
There is only one reason.
It is simply to gain promotional effect by using the word "laser."
By suggesting that using a laser will make the surgery seem better, they try to create a sense of confidence and stimulate demand.
The laser used for fat removal is a carbon dioxide laser for making incisions.
Among the various lasers used today, the carbon dioxide laser is the least expensive.
Pigment lasers used to remove Ota nevus or tattoos can cost tens of millions of won, but the carbon dioxide laser is the least expensive type and is usually used to remove moles, freckles, and age spots.
Having a carbon dioxide laser does not mean the hospital has especially expensive equipment.
You can think of it as basic equipment that all plastic surgery and dermatology clinics have.
Our clinic also has a carbon dioxide laser, and we mainly use it only to remove moles and age spots.
We do not use it for surgery.
All surgeries must use instruments and equipment appropriate for the area and method of treatment.
■ Performing fat removal plastic surgery in a dermatology clinic
Sometimes cosmetic surgery is performed in a dermatology clinic rather than in a plastic surgery clinic.
This is something to think carefully about.
Dermatology is the department that treats skin diseases such as acne, atopic dermatitis, athlete’s foot, and eczema.
It is a field that has no direct connection to plastic surgery.
Sometimes people confuse dermatology with plastic surgery.
Dermatology is like internal medicine.
Internal medicine treats colds and internal diseases of the body with medication, and dermatology also treats skin diseases with medication.
For a dermatologist to perform cosmetic surgery with a scalpel is no different from an internal medicine doctor picking up a scalpel.
At dermatology clinics, cases of excessive fat removal and side effects frequently come to our clinic for correction after the procedure.
In such cases, we correct them again with micro fat grafting, but these side effects should not be created in the first place.
As the saying goes, medicine should be entrusted to pharmacists and treatment to doctors; plastic surgery should be entrusted to a plastic surgery specialist.
When it comes to plastic surgery, there should be no cases where patients suffer side effects because they underwent surgery by a doctor from another field who lacks experience or proper knowledge of plastic surgery.
■ This is fat removal for improving dark circles.
The main purpose of under-eye fat removal surgery is to correct the contour of protruding under-eye fat.
It is not surgery performed to improve the color under the eyes.
In most cases, when fat is removed, the skin color changes due to skin contraction, but if too much fat is removed, the under-eye area becomes sunken and may look even darker.
The goal of fat removal is to remove an appropriate amount of fat and create a flat eye line.
Color changes after fat removal vary by individual, but it is not common for the color to become brighter.
If the skin under the eyes is thin and the reddish muscle layer beneath shows through, making it look red, then fat removal may reduce the redness.
However, in other cases, the color may become darker, so this must be kept in mind during surgery.
The color change after fat removal should be predicted in advance before surgery to prevent problems afterward.
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