When the Under-Eye Fat Bulges While Smiling, Is It Really Just Muscle and Not Something That Can Be Improved?

Hello,

I’m Yoo Young-gi, the chief director of Roy Plastic Surgery.

Today, I’d like to introduce the case of a woman in her late 30s who had been worried about her under-eye fat when smiling.

In fact, when her face was expressionless, her under-eye area did not bother her that much, but when she smiled, the under-eye fat under the right aegyo-sal bulged out prominently and caused a lot of stress.

Shall we take a look at the photos before surgery?

No expression

When smiling

When she has no expression, the dark circles are noticeable, but rather than the bulging fat, pigmentation stands out a bit more.

But when she smiles, the bulging fat appears to protrude excessively, and only on one side.

She had already visited several clinics and received consultations,

and most of them said, “It’s a muscle issue, so it won’t improve with surgery.”

So when she came to us, she came with little expectation,

but still with a bit of hope.

However, when we examined her during the consultation, the reason the under-eye fat became excessively bulged when smiling was not simply a muscle issue.

When smiling, the orbicularis oculi muscle contracts, causing the aegyo-sal to stand out slightly, which is a natural phenomenon, and it can even create a cute impression.

But in this patient, the aegyo-sal protruded normally, and the problem was that the area beneath it was being pulled downward when smiling, causing a large mass of fat to push outward.

In other words, there was adhesion between the orbicularis oculi muscle and the fat, so every time she smiled, the fat protruded further downward as well.

In the end, to solve this problem, under-eye fat repositioning surgery was the right approach, but the important thing was how the under-eye fat was dissected during surgery.

The area where the orbicularis oculi muscle and fat were tangled together had to be thoroughly released.

After actually performing the surgery, I think the key point of the procedure was indeed “clean dissection.”

Even if the fat is repositioned, the space where the orbicularis oculi muscle and fat are attached has to be fully released from top to bottom, without leaving any adhesion behind. If adhesion remains, there is a high possibility that the under-eye fat will still bulge when smiling.

Of course, the term “under-eye fat repositioning” is the same everywhere, but in reality, the surgeon’s approach and technique can vary quite a bit.

The reason another clinic said, “This is difficult to improve even with surgery,” was probably because they assumed it would be hard to properly release the adhesions.

In fact, during surgery, I even found myself thinking unconsciously, “Why is this area so strongly adhered to the muscle? I need to separate it clearly, so the under-eye fat won’t be pulled downward again when she smiles.”

It felt unusually strong in terms of adhesion.

Fortunately, the surgery went well, and when we looked at her on day 10, the patient smiled broadly, saying that her under-eye fat no longer protruded like before when she smiled. :)

The left side is before surgery / the right side is 10 days after surgery. These are photos taken while smiling.

The area that bulged prominently when smiling was clearly improved, and the patient herself said she was very satisfied.

In particular, she happily said, “Before, when I smiled in front of people or took photos, I would unconsciously cover my under-eye area, but now I don’t have that habit anymore.”

Through cases like this, rather than simply dividing things into “muscle vs. fat problems,” we can see that the cause and condition can be different for each patient.

So before surgery, a precise diagnosis and a careful surgical method are important.

Even if the terminology is the same, the range of dissection and the suturing method can differ from surgeon to surgeon.

If you’re also wondering, “I’m worried about under-eye fat when smiling too—can surgery solve it?” we recommend visiting a clinic first to receive an accurate diagnosis.

If the cause, like in this case, is not simply muscle, but rather adhesion of the fat or a repositioning issue, there is a good possibility that surgery can improve it sufficiently.

I hope the case I introduced today is of some help to those who are worried about under-eye fat when smiling.

If you have any further questions, please feel free to contact us anytime.

Thank you.

If you’d like a summarized article about the overall details of under-eye fat repositioning, please check the link below. :)

https://blog.naver.com/youngkeeyoumd/223487712998

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Roy Plastic Surgery Clinic (Sinsa Station, Line 3) Main phone: 02-516-5525

Weekdays 10:00 ~ 19:00 Saturdays 10:00 ~ 16:00

Roy Plastic Surgery complies with the Medical Service Act. The photos in this post were taken under the same conditions, and were captured with the patient’s prior consent. In addition, after plastic surgery and procedures, side effects such as bleeding, infection, and inflammation may occur depending on the individual, so caution is required.