How to Choose a Good Clinic in Gangnam for Under-Eye Fat Repositioning — Without Recurrence and at a Fair Price

This article covers the conditions for under-eye fat repositioning surgery that is reasonably priced, long-lasting without the need for revision surgery, and able to produce safe results.

It does not focus on vague advice like “you should look at the doctor’s career” or “you should check whether customized 1:1 diagnosis is possible.” Instead, it covers only the key points from real clinical practice. In particular, if you are looking for a clinic for your parents’ under-eye surgery, please read carefully.

Gangnam under-eye fat repositioning, Vanni Plastic Surgery

Hello.

I am Ban Ho-kyung, a board-certified plastic surgeon whose specialty is eye surgery and whose strongest area is revision eye surgery.

There are quite a few patients who come to our clinic for revision surgery after having under-eye surgery at another clinic.

Why is revision surgery needed?

That’s right. Recurrence.

And in common cases, it is not because patients failed to carefully review various conditions before surgery.

They may have compared several clinics thoroughly and even heard during the consultation that “there is a septum reinforcement process, so it will last a long time.” So there was no reason to doubt it.

Before surgery

After under-eye fat repositioning surgery

Left: Before surgery / Right: After under-eye surgery

Here, you may wonder, “If septum reinforcement was done, why did it become a surgery that lasts only 1 to 2 years?” In fact, septum reinforcement can vary greatly in quality. Nearly every clinic that performs under-eye fat repositioning says they do septum reinforcement, but the level of completion is worlds apart.

So today, I’m going to explain why recurrence happens even after septum reinforcement, along with two major causes that make under-eye surgery last only about a year.

I’ll also share my honest opinion about the conditions of clinics that prioritize safe surgery and the relationship between cost and surgical quality.

To give the conclusion first: higher cost does not necessarily mean better surgery. In fact, it may be the opposite.

Before surgery

After under-eye fat repositioning surgery

Left: Before surgery / Right: After under-eye surgery

That was a long introduction, so let’s move right into the main topic.

[Table of contents]

1. Why recurrence happens even after septum reinforcement
2. Two causes of recurrence other than inadequate septum reinforcement
3. The relationship between under-eye surgery cost and results (Does a higher price mean better results?)
4. Conditions of a clinic that prioritizes patient safety

If you’re considering under-eye surgery as a gift for Parents’ Day or for your parents’ birthday, please read sections 2 and 4 especially carefully.

Essential conditions for choosing an under-eye surgery clinic that won’t require revision surgery

1. Why recurrence happens even after septum reinforcement

Conditions for a clinic that does under-eye fat repositioning well in Gangnam

Under-eye fat repositioning does not end perfectly just by repositioning the fat.

If the septum, which is the cause of the fat pushing forward, has weakened, a procedure to strengthen that septum—septum reinforcement—must also be performed.

However, the problem is that even after such septum reinforcement, under-eye fat often protrudes again within 1 to 2 years. As mentioned earlier, although the name “septum reinforcement” is the same, the method and quality differ greatly from doctor to doctor.

1. When the suture tension is insufficient or the septum is fixed in the wrong position

The septum serves to prevent under-eye fat from bulging forward. Therefore, during surgery, this septum must be firmly fixed in its original position with consistent force.

However, if the thread is tied too loosely at this stage, or if the septum is sutured at a lower position than it should be, the septum will gradually stretch over time and eventually be unable to support the fat. In particular, if the tension during suturing is insufficient, the tissue does not stay taut and instead settles loosely, allowing the fat to push forward again.

It may look fine immediately after surgery, but the reason the area under the eyes becomes prominent again after a few months lies here. Septum work is not simply about tying it down; the key is accurate positioning and firm tension.

Before surgery

After under-eye fat repositioning surgery

Left: Before surgery / Right: After under-eye surgery

2. When the fat is not repositioned evenly

Repositioning under-eye fat is not simply a matter of moving the fat.

The repositioned fat must blend well with the surrounding tissue so it can settle properly, and when moving the fat, it should be spread out thinly and evenly.

If, during the repositioning process, it cannot be spread thinly and evenly and instead clumps together or shifts to one area?

Exactly. Even if it looks successful right after surgery, it becomes noticeable over time. One side may appear sunken while the other becomes bulged, and as the clumped fat gradually moves downward, revision surgery eventually becomes necessary.

3. When the tear-trough ligament is not sufficiently released

The under-eye groove ligament is a structure that extends from beneath the eye to the cheekbone area, and it serves to firmly connect the skin and deeper tissue. If this ligament remains strongly intact, the fat may not be able to spread adequately beneath it even after repositioning.

Gangnam under-eye fat repositioning, Vanni Plastic Surgery

Why is that?

Because this ligament acts like a kind of wall.

For fat to spread naturally, there should be no physical obstruction in its path. If the ligament remains in place, the fat will only collect above it, and the lower area may remain hollow-looking and unfilled.

As a result, the area under the eyes may not appear smoothly connected, and the improvement expected after surgery may not fully show.

That is why the ligament must be sufficiently released during surgery. Only then can the fat spread evenly to the desired areas and create a natural contour. However, the ligament should not be released excessively. If it is, the tissue may become loose and, instead, cause the skin to sag downward.

4. When the septum is not firmly fixed to the periosteum

One of the important points in septum reinforcement is to fix the septum accurately to the periosteum. Only then can the tissue avoid stretching over time and prevent the fat from pushing forward again.

What if this fixation is not done properly?

That’s right. As time passes, the septum can no longer maintain its position and gradually loosens, allowing fat to protrude forward again through the gap. This is one of the most representative causes of recurrence.

Cause of recurrence after under-eye fat repositioning in Gangnam

In fact, when written out, the process may seem simple, but the actual surgery is not simple at all.

Because the septum is an extremely thin and sensitive tissue, suturing it at the exact position with the exact tension is quite difficult. If the force used during suturing is insufficient, it will loosen again over time; on the other hand, if too much force is applied, it can lead to unnatural results.

The problem is that the structure under the eyes differs from person to person, so the same method cannot be applied to everyone, and the results vary quite a lot depending on the surgeon’s skill.

2. Two causes of recurrence other than inadequate septum reinforcement

1. When lower eyelid surgery is more appropriate than under-eye fat repositioning

If the skin around the eyes has sagged significantly or the tissue itself is loose, simple under-eye fat repositioning alone may not produce a satisfactory result. That is because changing the position of the fat alone cannot solve already stretched skin.

Lower eyelid surgery procedure

In such cases, the surgical approach should have been different from the start. Instead of under-eye fat repositioning, lower eyelid surgery, which can correct sagging skin and muscle at the same time, was likely more appropriate.

Therefore, rather than choosing a clinic that insists on only one type of procedure, it is safer to choose a clinic that handles a wide range of eye plastic surgery methods in depth. That way, you can receive an accurate recommendation for the surgery that fits your eyes.

Left: Before surgery / Right: After lower eyelid surgery + brow lift

Left: Before surgery / Right: After lower eyelid surgery + brow lift

2. When only the fat is removed

The procedure is called under-eye fat repositioning, but in some cases the surgery is ended simply by removing the bulging fat. It is faster and easier. However, although it may be more convenient for the doctor, the harm falls entirely on the patient. The problem is recurrence.

Above all, when fat is removed this way, the problem is not only recurrence. Over time, the area under the eyes can also start to look hollow and sunken. Under-eye fat naturally decreases with aging, and if some of it has already been removed surgically, that change becomes even more pronounced.

That is why I perform the surgery by preserving as much fat as possible, moving it downward, and reinforcing the septum. This helps prevent recurrence while also stopping the area from later becoming hollow with age.

3. The relationship between under-eye surgery cost and results

Gangnam under-eye fat repositioning, Vanni Plastic Surgery

When surgery is expensive, it somehow feels like it will be performed more precisely. On the other hand, if the cost is reasonable, people may think “something must be missing.” But in reality, it is often the opposite.

A high surgery fee means that the number of surgeries the doctor can perform in a day is limited. That also implies that the surgery takes a long time. When the surgery takes longer, it is natural for the cost to go up because it is more demanding for the doctor.

The importance of anesthesia in Gangnam under-eye fat repositioning

Why does the surgery take so long?

The biggest reason is anesthesia.

The under-eye area is wide and deep, so some parts may receive less anesthesia. As a result, it is more common than you might think for under-eye surgery to proceed without anesthesia being evenly and accurately applied. If the anesthesia is insufficient, the patient will feel pain, which inevitably leads to small movements during surgery.

The patient’s movement creates variables during surgery and adds unnecessary tissue damage, increasing bleeding and ultimately raising the difficulty of the procedure. In addition, the surgeon must keep paying attention to the patient’s reactions, which lengthens the surgery.

Then what if the anesthesia is sufficiently stable and works well?

Both the patient and the doctor are more comfortable. First, there are fewer variables and less unnecessary tissue damage, so bleeding decreases and the difficulty of surgery is reduced. In the end, the surgery time shortens and recovery is faster.

Before surgery

After under-eye fat repositioning surgery

Left: Before surgery / Right: After under-eye surgery

The reason our clinic’s surgery fee is reasonable is also the same. Yes, that’s right. I have studied anesthesia separately and am good at it. That allows the surgery to be performed accurately and efficiently. (For reference, under-eye surgery is done under sedation, not general anesthesia. General anesthesia is mainly used in clinics that perform contouring or breast surgery, and a board-certified anesthesiologist is needed only for surgeries that actually require general anesthesia.)

The conclusion? A higher cost does not mean more precise results. In fact, a reasonably priced clinic may have a higher level of completion.

4. Conditions of a clinic that puts patient safety first

Is the result the most important thing in surgery?

Of course, the result is important, but the first thing to consider is safety.

Many people think of under-eye surgery as a simple cosmetic procedure, but because of the nature of the eye area, a very rare but serious complication can occur: blindness.

“Blindness from under-eye surgery?” Many people are surprised to hear that.

This does not refer to something happening during surgery, but to an extremely rare situation in which bleeding occurs internally immediately after surgery and compresses the eyeball, potentially damaging the optic nerve. The incidence is very low, but because the possibility is not zero, it is something you must know.

Of course, that does not mean you should worry excessively.

Such situations can usually be prevented, and even if they do occur, they can often be fully managed with prompt action.

If you follow basic precautions such as controlling blood pressure before surgery, stopping anticoagulants or dietary supplements, and avoiding strenuous exercise or air travel immediately after surgery, the risk of bleeding is greatly reduced.

Gangnam under-eye fat repositioning, Vanni Plastic Surgery

If bleeding does occur and blood collects inside, the most important thing is not to panic and to go to the nearest emergency room immediately. In most cases, it can be resolved with a simple procedure to partially open the surgical site and drain only the accumulated blood. What matters is that you know in advance so a quick response is possible.

In other words, a truly good clinic is not simply one that makes the surgery look pretty. It is a place that transparently explains even the possibility of exceptional complications and can guide you on how to respond if a problem occurs. That is what a truly good clinic is.

Today’s conclusion

Ask, listen, understand, then choose.

Under-eye fat repositioning is often thought of as a simple procedure because people can return to daily life within 1 to 2 days after surgery. But if you look at the surgical process step by step, it is by no means simple. There are many details that determine the outcome.

So if you have questions during the consultation, you should ask them all. Ask even the questions that feel too trivial to mention. You should make your decision only after fully understanding the procedure.

Ask, listen, understand, and then choose. Even if the surgery date is delayed a little, that is okay. What matters is your safety, a comfortable surgical process, and avoiding unnecessary revision surgery.

If you need help, please feel free to contact us anytime. It is my role to help reduce your concerns.

This is Ban Ho-kyung, and that’s why you’ll like Ban. Thank you.

[Additional helpful posts to read next.]

https://blog.naver.com/rush_724/223776150003

https://blog.naver.com/rush_724/223810472256