Lower blepharoplasty corrects under-eye wrinkles and sagging by tidying loose under-eye skin and bulging fat and reinforcing the supporting structure.
The under-eye area shows change early, because the skin is thin and the structure that supports the fat from below weakens with age. Fat pushes forward and bulges, a hollow groove forms beneath it, and the skin loosens so that fine wrinkles overlap. When all three are present, the face looks tired and older. Lower blepharoplasty tidies this loose skin and bulging fat and reinforces the weakened supporting structure to smooth the under-eye area.
What matters in lower blepharoplasty is not how much skin and fat are removed but how the structure that supports the eyelid is preserved and reinforced. If too much skin is removed or the supporting structure is not taken into account, the lower eyelid can turn outward or be pulled down, exposing the white of the eye. Rather than removing bulging fat, we prioritize repositioning it into the hollow groove to soften the under-eye contour.
At Atelier Plastic Surgery we separately assess the elasticity of the under-eye skin, the degree of fat bulging, the strength supporting the eyelid, and the height difference between the cheekbone and the under-eye area. If skin sagging is minimal and fat bulging is the main problem, we recommend lower-eyelid fat repositioning without a skin incision; if skin sagging and wrinkles are pronounced, we plan lower blepharoplasty. Consultation, surgery, and follow-up are handled personally by the director.
An incision is made just below the lashes, loose skin is removed as needed, and bulging fat is moved into the hollow groove or partly removed. The incision sits along the lash line and becomes hard to notice over time.
Instead of removing bulging fat, it is moved into the under-eye groove (tear trough) and fixed there to soften the contour. This avoids the hollowing that comes from removing too much fat.
The outer ligament of the lower eyelid is tightened, or the orbicularis muscle is lifted and fixed, to prevent the eyelid from sagging or turning outward. This is considered when the strength supporting the eyelid is weak.
If the skin still has elasticity and fat bulging is the only problem, lower-eyelid fat repositioning through a conjunctival incision, with no skin incision, may be more suitable.
These may vary depending on your condition; we will give you precise details at your consultation.
Under-eye sagging is not only a matter of skin. If the ligaments and muscle supporting the lower eyelid have weakened, sagging can return or the eyelid can turn outward even after the skin and fat are tidied. At consultation we pull the eyelid to check how it springs back, and plan reinforcement alongside if needed.
Removing a lot of bulging fat may look smooth at first, but over time the under-eye area can hollow and look older. We prioritize moving fat to fill the hollow groove, and remove only as much as necessary.
Even slightly over-removing under-eye skin can pull the eyelid down and expose the white of the eye. We check how much skin to leave while you are sitting, and prioritize preserving the eyelid's position over removing every wrinkle.
If the height difference between the under-eye area and the cheekbone is large, a shadow remains even after the under-eye area is tidied. We look at the under-eye contour together with its transition to the cheek, and where needed plan the extent of fat repositioning or added volume.
Begin cold compresses and rest with your head elevated. You go home the same day and take the prescribed medication. Avoid rubbing your eyes or squeezing them shut.
Swelling and bruising are at their peak. Under-eye bruising may spread downward. Continue cold compresses and avoid bending your head down.
Stitches are removed. You can wash your face afterward, and swelling decreases noticeably. If there is conjunctival swelling, use the prescribed eye drops.
Major swelling subsides and daily activities are possible. Light makeup is possible, and bruising has mostly faded.
Fine swelling and the firm feeling under the eyes gradually ease. The repositioned fat settles and the contour softens. The incision line gradually fades.
The final shape settles. Recovery speed and results vary from person to person.
Bleeding and hematoma, infection, swelling, and bruising may occur. Ectropion, in which the lower eyelid turns outward, or lower-lid retraction, in which the eyelid is pulled down and exposes the white of the eye, may occur and may require corrective surgery. Asymmetry, incision-line scarring, under-eye hollowing if too much fat is removed, and unevenness or re-bulging of repositioned fat may occur. Eye closure may be temporarily incomplete, causing dry eye, a foreign-body sensation, and tearing, and there may be conjunctival swelling and temporary reduced sensation. In rare cases, bleeding that affects vision can occur, so you must contact us immediately if you experience sudden pain or changes in vision after surgery. Revision surgery may be needed depending on the result, and outcomes vary from person to person. We explain the risks and limitations fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Lower-eyelid fat repositioning that moves bulging under-eye fat into the hollow groove to reduce shadows
Learn more Related Upper BlepharoplastyUpper blepharoplasty that removes only as much loose upper-eyelid skin as needed to improve both vision and appearance
Learn more Related Eye Surgery GuideA guide to choosing eye surgery by sagging, opening strength, and eye exposure
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Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
