What you should know for lower blepharoplasty via fat repositioning
What you should know for lower blepharoplasty via fat repositioning
  • Philip Choi
  • 승인 2021.09.29 09:33
  • 댓글 0
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Puffy eyes make you look tired and aged. As we age, the membrane structure that surrounds the fat under the eyes and the elasticity of the muscles around eyes decrease and the supporting force is reduced, causing the puffy eyes. The skin under the eyes is thin, it wrinkles easily or the fat under the eyes protrudes, and aging proceeds quickly. There are genetical cases which is a lot of fat around eyes, it can appear easily in young people as well as aged people.

Types of under eye bags

Eye bags can be classified into different types according to the area and shape where it appears.

(Photographs courtesy of Dr. Hyungsoo Kim, Seoul H dermatologic Clinic)

① Medial protrusion: The fact under the eyes protrudes inward under the eyes
② Outward protrusion: The fat under the eyes protrudes outward under the eyes
③ Central protrusion: The fat under the eyes protrudes as a whole
④ Fat with under eye love band: The fat is combined with under eye love band
⑤ Edematous swelling: Swelling under the eyes and around the eyes

There are classified types of under eye bags, but the surgical methods are not significantly different. Dr. Hyungsoo Kim, founder and president of Seoul H dermatologic Clinic, said “It is not easy to simplify the various cases of patients into a few types. It needs to be considered carefully of the skeletal structure and surround structures of the eye, the degree of dent of the sulcus lacrimalis, and the thickness of the skin.”

Lower blepharoplasty via fat repositioning

There are 2 ways to get rid of under-eye fat. Lower blepharoplasty via fat removal: the methods to remove the amount of fat under the eyes by making an incision in the conjunctiva inside the eye. However, the inner part of the eye under the eyes was left with a hollow-shaped sulcus lacrimalis, which made the under eye look more wrinkled even after surgery. Lower blepharoplasty via fat repositioning is the method to compensate for this weakness.

Theare are 2 ways of lower blepharoplasty via fat repositioning, conjunctiva incision and under eyelid incision.

Items The Conjunctiva Incision The Under Eyelid Incision
Incision Conjunctiva(inside) Under eyelid (Outside)
Scar None Fine scar under eyelid
Suture None(Natural recovery) Suture
Period of recovery Few days Few weeks or months
Shape of eye

Keep the under eye love band
Natural appearance

Remove the under eye love band
Side effects Almost nothing Ectropion, involutional eyelid
Wrinkles     It can appear but laser treatment could help Reduced

The conjunctiva incision is a surgical procedure that uses a laser to cut the conjunctiva inside the eye. In some case, wrinkles may appear, but it has the advantages of keeping natural appearance, fast recovery, and low side effect. The under eyelid incision is a method of cutting the skin under the eyes. It can make fine scars, remove under eye love band, and change the appearance of the eyes after surgery. But it has advantages for removing wrinkles and improving skin sagging.

Recently, there is a method that complements the advantages and disadvantages of blepharoplasty via fat removal and fat repositioning. Dr.Kim explained, “ The surgery of under eye bag treatment has gradually shifted from fat removal to fat repositioning, but the commonly known methods of fat repositioning can also damage the orbital septum. So as a method to supplement the pros and cons of fat removal and fat repositioning, an appropriate amount of fat is removed and then repositioned removed fat in a similar way to fat grafting.”

Dr. Kim said “It is not easy to simplify the various cases of patients into a few types. It needs to be considered carefully of the skeletal structure and surround structures of the eye, the degree of dent of the sulcus lacrimalis, and the thickness of the skin.”
Dr. Kim said “It is not easy to simplify the various cases of patients into a few types. It needs to be considered carefully of the skeletal structure and surround structures of the eye, the degree of dent of the sulcus lacrimalis, and the thickness of the skin.”

What you want for your under eye bag

Middle-aged people who have a lot of fat under the eyes and lack of skin elasticity, the under eyelid incision is performed because it can improve skin sagging and wrinkles. However, it is not mandatory for everyone. The important thing is an individual’s condition and preference. If you prefer to have no wrinkles even if the under eye love band disappears and your eyes change slightly, choose the under eyelid incision. If you prefer natural appearance with slight wrinkles, you can choose the conjunctiva incision.

Additional treatment with fat repositioning surgery

Under eye fat bag can also be the cause of dark circles. However, there are some cases that dark circles are not improved even after surgery. If there is the sulcus lacrimalis or infraorbital groove, or there is pigmentation under eyes, or the skin is thin to be shown inside blood vessels. These are the symptoms that is shown after surgery. When you have sulcus lacrimalis or infraorbital groove, a filler is helpful, when you have pigmentation, a laser treatment is helpful. When you have visible blood vessel, a vascular laser treatment is helpful. This additional treatment can make your appearance more improved combine with fat removal or fat repositioning surgery.

Conclusion

Lower blepharoplasty via fat repositioning seems simple, but it is not an easy operation because every patient has different levels of fats and skin condition. The surgery requires skilled technical for decision of how much fat to remove and reposition. To check the prediction of surgical results based on accurate analysis and to communicate with doctor sufficiently are important.

Dr. Kim emphasized, “Some patients expect the same appearance as before and after surgery, but you should know that the thickness of the skin and the shape of the fat under the eyes are different for each person. Therefore, it is necessary to have sufficient communication with doctor before surgery, such as what the results will be and what limitations there are. It is better to understand the additional treatment may be required.”


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