Surgery · Eye Rejuvenation

Under-Eye Fat Repositioning

The bulge is moved into the hollow, and the septum is reinforced

Gangnam, Seoul | Board-certified plastic surgeon, Dr. Jonghwan Choi
KHIDI-registered for international patients · Apgujeong Rewind

Under-Eye Fat Repositioning Under-Eye Fat Repositioning Under-Eye Fat Repositioning 
Define

Under-eye fat repositioning

What is under-eye fat repositioning, and what does septal reinforcement add?

The short answer

The pad of orbital fat that bulges under the eye is relocated instead of discarded. The ligament adhesion holding down the tear trough is released, the harvested fat is carried into that hollow, and the orbital septum — the membrane the fat had been pushing forward — is drawn downward and fixed to the periosteum of the orbital bone. Rewind calls this combination septal-reinforced under-eye fat repositioning, and it is listed separately from a plain fat removal and from a full lower blepharoplasty.

Facts here come from Rewind's own Korean pages for septal-reinforced fat repositioning and for lower blepharoplasty, and from the clinic's post-surgical instruction sheet for the under-eye area. Anaesthesia type and operating time are not published on those pages and are not stated here.

Two operations share the phrase "eye bag surgery" at this clinic. One moves fat and reinforces the support that let it protrude. The other, lower blepharoplasty, also addresses lid skin and the muscle beneath it, and Rewind's page for it describes fixing the slackened muscle to the periosteum before closing. They are quoted as separate items because they are separate operations, and the examination decides which sentence your under-eye belongs in.

Dr. Jonghwan Choi operating under loupe magnification at Rewind Plastic Surgery
Fig. 01 — Under-eye work is done under magnification, Rewind operating room
Result

Before & After

Under-eye cases photographed at Rewind, procedure by procedure

The four cases below were taken at the clinic in the same conditions and are shown uncropped. Three were operated as under-eye work alone; the fourth had upper-lid surgery in the same session, which is named in its caption because the whole eye, and not only the lower lid, changed in that photograph.

Rewind patients — lower eyelid and tear trough

Before — under-eye fat repositioning, oblique view After — under-eye fat repositioning, oblique view BEFOREAFTER
case 01
Under-eye fat repositioning, no additional procedure
Individual results may vary.
Before — under-eye fat repositioning for eye bags, front view After — under-eye fat repositioning for eye bags, front view BEFOREAFTER
case 02
Under-eye fat repositioning, no additional procedure
Individual results may vary.
Before — under-eye fat repositioning for a deep tear trough After — under-eye fat repositioning for a deep tear trough BEFOREAFTER
case 03
Under-eye fat repositioning, no additional procedure
Individual results may vary.
Before — under-eye fat repositioning combined with upper blepharoplasty After — under-eye fat repositioning combined with upper blepharoplasty BEFOREAFTER
case 04
Under-eye fat repositioning + upper blepharoplasty, same session
Individual results may vary.

All photographs are of Rewind's own patients, taken by the clinic under identical lighting and framing and shown uncropped. Individual results may vary, and no case here forecasts another. Bleeding, bruising, prolonged swelling, asymmetry, altered sensation, scarring and changes in lower-lid position can follow eyelid surgery. Examination and consultation with the doctor precede any decision.

Shadow

Cause map

What actually makes an under-eye look dark and tired?

The phrase "dark circles" covers at least four different findings, and only some of them are surgical. Reading which one dominates is the whole consultation, because an operation aimed at the wrong one produces a face that looks operated on and still tired.

finding 01
The bulge
Orbital fat pushing forward under the lid. It catches light on top and throws a shadow beneath, which is why an under-eye can read dark in a photograph and normal in flat light. This is the material the operation relocates.
finding 02
The tear trough
The groove running down and outward from the inner corner, held in place by a ligament adhesion. Rewind releases that adhesion during surgery so the harvested fat can be laid into the hollow instead of sitting above it.
finding 03
The orbital septum
The membrane in front of the fat. Once it has been pushed forward it stops containing the pad, so Rewind draws it down and fixes it to the orbital bone, reinforcing the support that allowed the bulge in the first place.
finding 04
Pigment and thin skin
Colour sitting in the skin itself. The clinic's own answer is that dark circles occur mostly where the skin is thin, and that flattening the fat beneath it helps the appearance. Colour from pigment is a separate problem, and this operation does not lighten it.

Rewind's own page sets the sequence out by decade, and it is a useful way of placing yourself. In the twenties the orbital fat protrudes and the under-eye simply looks puffy. In the thirties that protrusion starts to make the tear trough read hollow. By the forties the fat has descended and the groove is pronounced. By the fifties the skin over the groove has discoloured, and the area looks dull and tired even when it is rested. What changes with each decade is the proportion of bulge to hollow to colour, and with it the operation that answers it.

Steps

In sequence

How is under-eye fat repositioning carried out?

Rewind publishes the operation as three steps and the reinforcement as its reason for existing. The rungs below add the approach decision and the point at which the operation becomes a lower blepharoplasty instead, since that is where most consultations actually split.

01Assess

The under-eye is analysed, then the fat is harvested

The clinic's first published step is to analyse the problem before taking the fat. How much of the darkness is bulge, how much is hollow and how much is colour decides how much fat is moved and where it is laid, and that reading is done on your own face, never from a photograph of someone else's.

02Release

The ligament adhesion at the tear trough is released

The groove is held down by an adhesion, and until it is released the hollow cannot be filled from above; fat laid on top of a tethered trough simply sits over a line that remains. Releasing it is what allows the repositioned fat to reach the depression.

03Reposition

The fat is carried into the hollow it used to overhang

The same fat that made the bulge becomes the volume that fills the groove beneath it. Removing it outright takes away the protrusion and leaves the hollow where it was, which is the distinction between the clinic's fat-removal-only item and this one.

04Reinforce

The septum is drawn down and fixed to the orbital bone

The membrane that had been pushed forward is pulled downward and secured to the periosteum. Rewind's stated purpose is to strengthen the support structure holding the fat, so that the pad settles into a stable position; this is the step the clinic names septal reinforcement.

05Access

Through the conjunctiva, or under the lashes

Rewind publishes both routes. A conjunctival approach, from inside the lid, leaves no visible scar. A skin approach can leave a scar below the lash line. Which is used is decided by the state of the under-eye tissue, the elasticity of the skin and how much it has descended.

06Extend

Where skin and muscle are also part of the finding

In lower blepharoplasty the design is set from the volume of fat present; a minimal incision is made, the fat is removed or repositioned and the muscle is dissected; the slackened muscle is then fixed to the periosteum and the incision is carefully closed. Rewind records durability of more than five years for that operation, varying between individuals.

Rewind's medical director operating under the surgical light
Fig. 02 — Every step above is carried out by the medical director himself
Rewind

Why here

Why the tear trough is a surgeon's problem before it is a filler's

An under-eye that has been treated repeatedly and still looks tired is usually one where the bulge, the groove and the colour were never separated out. Rewind lists four different under-eye items at four different prices, and the point of the consultation is to establish which of them your face is asking for.

01Separation

Removal, repositioning, reinforcement and lid surgery are four listings

Fat removal alone, fat repositioning, septal-reinforced repositioning and lower blepharoplasty each carry their own price. Because none of them is bundled, a quotation reflects the finding rather than the package, and you can see what the extra step is costing you.

02Published work

The groove itself has been the subject of the director's research

Dr. Choi is a co-author of a study in the Journal of Craniofacial Surgery on improvement of the nasojugal groove — the anatomical name for the tear trough — and of the wrinkles over it, following elevation of a skin-muscle flap through a subciliary approach to the orbital rim. That series is reconstructive, so it is not a report on cosmetic repositioning; what it documents is the behaviour of the groove when the orbital rim is addressed directly.

03Continuity

One surgeon through the dressing, the sutures and the months after

Under-eye swelling is slow and uneven, and the area looks worse before it looks settled. The person who operated is the person who reviews it at every visit. International patients are supported in their own language throughout, and Rewind is a KHIDI-registered institution for foreign patients.

Journal of Craniofacial Surgery article on nasojugal groove improvement co-authored by Dr. Jonghwan Choi
Fig. 03 — Published work on the nasojugal groove, co-authored by the medical director
Theatre

In the operating room

Where the under-eye operation happens, and what you leave with

Preparation of a draped patient in the procedure room at Rewind

Fig. 04 — Preparation, Richro Building

Recovery room at Rewind Plastic Surgery, Apgujeong

Fig. 05 — The recovery room, where the first hour after surgery is spent

Rewind is a single-surgeon practice on the fourth and fifth floors of the Richro Building in Apgujeong. The under-eye is planned at consultation by the medical director and operated by him, and you go home with a dressing taped beneath the eye that the clinic asks you to leave undisturbed for three days.

Conjunctival approach: no visible scar
Skin approach: a line below the lashes
Tear-trough ligament released before repositioning
Septum fixed to the periosteum of the orbital bone
Lower blepharoplasty: muscle dissected and re-fixed
Dressing under the eye kept on for three days
Operated by Dr. Jonghwan Choi
Follow-ups with the operating surgeon
Dr. Jonghwan Choi, board-certified plastic surgeon

Board-certified plastic surgeon

Korean board certification in Plastic Surgery, with ten peer-reviewed publications in the craniofacial and plastic surgery literature. Rewind is registered with KHIDI as an institution for international patients, Reg. M-2025-01-08-09288.

Cost

Pricing

What does under-eye surgery cost at Rewind in Seoul?

The four under-eye listings below are priced apart from one another, and the gaps between them are the gaps between operations. A midface lift performed together with a lower blepharoplasty is carried as its own combined item, quoted when the cheek, and not only the lid, is part of the finding.

Under-eye fat removal onlyThe protruding fat taken out without being relocated
₩1,200,000
Under-eye fat repositioningFat moved into the hollow after the tear-trough adhesion is released
₩1,600,000
Septal-reinforced fat repositioningRepositioning with the septum drawn down and fixed to the orbital bone
₩2,000,000
Lower blepharoplastyFat, muscle and lid skin addressed together, with the muscle re-fixed
₩3,900,000
Apple-cheek midface lift added to a lower blepharoplastyWhere the cheek has descended as well as the lid
₩7,000,000

Listed rates, VAT excluded; the anaesthetic fee sits inside the figure shown. Which listing applies is settled after examination, and the difference between removal and repositioning is explained before you are asked to choose between them.

Fit

Suitability

Who is under-eye fat repositioning for, and who is not helped by it?

Where this operation fits

  • A deep tear trough, the groove that runs down from the inner corner
  • Under-eye fullness that bulges forward and reads as tiredness
  • Shadowing and dullness beneath the eye that deepens in overhead light
  • Dark circles where a protruding pad is casting the shadow
  • Under-eye skin that has descended, and lid laxity alongside the bulge, where the discussion moves to lower blepharoplasty
  • Any age, since Rewind states the operation is decided by the state of the under-eye and not by the decade you are in

Reasons to slow the plan down

  • Darkness that is pigment in the skin, because contour surgery does not lighten colour
  • Concern about the small roll beneath the lash line, which the clinic states this operation does not remove
  • A previous lower-lid operation, which alters the risk of lid malposition reported in the surgical literature
  • Dry, irritable eyes or any ophthalmic condition under treatment
  • Conditions and medications affecting bleeding or healing, since this area bruises freely
  • Pregnancy, breastfeeding, or inflammation around the eye at the time of the consultation
After

Recovery

Recovery after under-eye fat repositioning, day by day

Rewind's post-surgical sheet for the under-eye is short and unusually specific, and the same four instructions are given for fat repositioning and for lower blepharoplasty. The one people forget is the dressing: it stays where it is for three days. Beyond that, the eye area is neither rubbed nor pressed, sun exposure is managed, and the heat that dilates vessels is postponed.

Days 1–3
The dressing stays on
Rewind asks that the dressing taped under the eye is left in place for three days and not peeled back to look. Sleeping with the head raised and cold compresses help the first nights.
About 5–7 days
Sutures, where there are sutures
The clinic's lower blepharoplasty page records suture removal at roughly five to seven days. A conjunctival approach has nothing on the surface to remove, which is one practical difference between the two routes.
1–2 weeks
Bruising and swelling recede
Early swelling and bruising decrease over one to two weeks in the clinic's own record, unevenly and often one side at a time. Saunas, steam rooms and vigorous exercise are set aside for at least a week, and sunscreen is used daily.
One month
Nothing that pulls on the repair
For about a month the operated area is not pulled or stretched hard, and alcohol, smoking and sauna stay off the list for a period. Rubbing the eye is the single habit most likely to undo careful work.

Eyelid surgery carries genuine risk, and the list worth naming is bleeding and haematoma, infection, swelling that outlasts the fortnight, asymmetry between the two sides, over- or under-correction of the hollow, a visible line where a skin approach was used, altered sensation, dryness, and changes in the position of the lower lid, which the published literature discusses as retraction or ectropion. Results cannot be promised and vary by individual. Tell the surgeon about every previous operation around the eye and about any medication you take before a date is agreed. Rewind publishes no fixed number of days for travellers to stay; plan around the one-to-two-week swelling window and settle your own schedule at consultation.

Doctor

Professional

At Rewind, one board-certified plastic surgeon carries every case — from the first consultation to the final follow-up. Because a face is a story, and a story deserves a single author.

Dr. Jonghwan Choi, board-certified plastic surgeonRewind,
Dr. Jonghwan Choi presenting at an academic session
Fig. 06 — Academic presentation, thread-lifting session

Rewind's Doctor

Dr. Jonghwan Choi Medical Director

One surgeon, from the first
consultation to the last follow-up.

A board-certified plastic surgeon devoted to anti-aging lifting — with the precision and restraint built through years of craniofacial practice.

Board-certified plastic surgeon (Plastic Surgery)
10 peer-reviewed publications
Medical Director, Rewind Plastic Surgery
Korean Society of Plastic & Reconstructive Surgeons
Former chief director, Apgujeong Y&T Plastic Surgery
Korean Society for Aesthetic Plastic Surgery
J Craniofac Surg · JKMS · Arch Craniofac Surg
Korean Cleft Palate-Craniofacial Association
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Ask

Questions

Under-eye fat repositioning — questions asked at consultation

How is repositioning different from simply removing the under-eye fat?
Removal takes the protruding pad away and leaves the hollow beneath it as it was. Repositioning carries that same fat down into the groove after the tear-trough adhesion has been released, so the bulge and the depression are treated with one piece of tissue. Rewind lists and prices the two separately.
What does septal reinforcement actually mean?
The orbital septum is the membrane in front of the fat, and a protruding pad has pushed it forward. Rewind draws it downward and fixes it to the periosteum of the orbital bone, strengthening the structure that supports the fat so the repositioned pad settles in a stable place.
Will this get rid of my dark circles?
Partly, depending on their cause. The clinic states that dark circles arise mostly in people with thin skin and that flattening the fat beneath the skin helps the appearance. Where the darkness is shadow cast by a bulge, the surgery addresses it; where it is pigment sitting in the skin, it does not.
Why does a ligament have to be released?
The tear trough is tethered by an adhesion. Until that is released the groove stays pinned in place and fat laid over it cannot reach the depression. Releasing it is Rewind's second published step, immediately before the fat is repositioned.
Is this operation only for older patients?
No. Rewind's answer is that it depends on the state of the under-eye, not on the age of the patient, and that bulging or sagging is the finding that matters. The clinic's own material describes protruding orbital fat as something that appears in the twenties and changes character each decade after.
Will the small roll under my lower lashes disappear?
It should not. Rewind states plainly that the two are unrelated: the roll is a separate structure, and what changes is that a smoother under-eye makes it less conspicuous, which some patients read as having lost it.
Will I have a scar, and where?
It depends on the route. A conjunctival approach works from inside the lid and leaves no visible scar. A skin approach can leave a line beneath the lashes. Rewind selects between them according to the condition of the under-eye tissue, skin elasticity and how far the lid has descended.
When is a full lower blepharoplasty done instead?
Rewind's lower blepharoplasty page lists marked skin laxity, under-eye descent and a tired, heavy lower lid alongside the bulge. That operation also dissects the muscle and fixes the slackened part to the periosteum. Which listing applies to you is a decision made at examination.
How long does the under-eye result hold?
For lower blepharoplasty the clinic records a durability of more than five years, with individual variation. Ageing continues in the meantime: skin thins, the cheek descends, and colour changes independently of anything done to the fat.
What is the dressing under my eye, and when can it come off?
A small dressing is taped under the eye at the end of surgery, and Rewind asks that it is left alone for three days and not lifted to check the result. It is the instruction patients most often break.
When do the bruising and the sutures go?
Bruising and early swelling decrease over one to two weeks in the clinic's record, and the lower blepharoplasty page gives roughly five to seven days for suture removal. A conjunctival approach leaves nothing on the surface to take out.
What can go wrong with lower-eyelid surgery?
Bleeding, bruising, infection, prolonged swelling, asymmetry, under- or over-correction of the hollow and altered sensation are the everyday risks. The published literature on lower blepharoplasty also discusses lid malposition, meaning retraction or ectropion, which is why previous lid surgery changes the conversation.
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Scientific evidence

Published research on transconjunctival lower blepharoplasty and the tear trough

These papers describe transconjunctival access, tear-trough ligament release, fat redistribution and the complication profile of lower-eyelid surgery as a class; the last of them is a reconstructive series co-authored by this clinic's medical director. None of them is a study of the operation as performed here, and none forecasts an individual outcome. The techniques, access routes and follow-up periods reported belong to each study.