Changes under the eyes due to aging: Appropriate eye plastic surgery should be selected after detailed diagnosis.
Date posted
<JAYJUN Plastic Surgery & Dermatology Clinic> Plastic surgery specialist Kang Hyungjoo Medical Director
The area beneath the eyes is one of the places where age-related changes can appear relatively early. Bulging fat or hollowing beneath the eyes can create shadows; together with sagging skin and fine lines, these changes may make a person look tired or older than their actual age.Fat, skin and muscle all contribute to the appearance of the under-eye area. Similar concerns can require different treatments depending on whether the cause is bulging fat, sagging skin or hollowing. The appropriate method should therefore be chosen after an accurate assessment of the current condition, rather than simply following a popular procedure.
Common under-eye procedures include fat repositioning, lower blepharoplasty and fat grafting. Fat repositioning may be considered when fat bulges beneath the eyes while the tear trough appears hollow. It can address simultaneous bulging and hollowing that create shadows and a tired appearance. Rather than simply removing the protruding fat, the procedure moves it into the hollow areas to smooth the under-eye contour.
Under-eye fat repositioning uses a transconjunctival approach, so concerns about skin scarring are reduced and recovery tends to be relatively quick. However, when skin sagging is severe, under-eye fat repositioning alone may not provide sufficient improvement.
In cases where fat protrusion and skin sagging are present together, lower blepharoplasty may be considered. Lower blepharoplasty is a surgery that focuses on improving not only fat protrusion under the eyes, but also loss of elasticity and sagging skin. It is mainly performed on middle-aged and older adults and involves making an incision just below the eyelashes to remove sagging skin, suspending the muscles to supplement elasticity, and redistributing fat. It is known as a surgery that goes beyond simply solving fat problems and corrects the overall structure under the eyes that has changed due to aging.
If under-eye hollowing is the main concern, fat grafting may be considered. This uses the patient’s own fat to fill the hollow areas. It may supplement fat repositioning when some hollowing remains, or be performed alone when volume loss is more prominent than bulging fat.
If aging is not severe or in the early stages, you can expect improvements in skin elasticity around the eyes and changes in facial appearance through procedures such as skin booster, collagen injection, and laser lifting. These procedures help increase moisture and elasticity in the skin and promote collagen production, which can play a positive role in restoring elasticity to the skin around the eyes where sagging has begun. However, the range of effect may vary depending on the individual's skin condition and degree of aging.
Director Kang Hyungjoo, a plastic surgery specialist at JAYJUN Plastic Surgery, explained, “Under-eye surgery involves more than removing fat or tightening skin. It requires a comprehensive assessment of fat position and volume, skin elasticity, and the extent of both sagging and hollowing. Fat repositioning, lower blepharoplasty and fat grafting each suit different situations, so choosing surgery without an adequate assessment may make the expected result difficult to achieve.”
The doctor added, “The skin beneath the eyes is thin and delicate, so excessive fat removal can cause hollowing or an unnatural appearance. It is important to choose a method suited to the individual after thorough consultation with an experienced surgical team.”