“Eyelid Fat” Is Just as Important as Double Eyelids in Eye Surgery… Surgical Techniques Vary Depending on the Condition
Date posted
<JAYJUN Plastic Surgery & Dermatology Clinic> Medical Director Kang Hyungjoo, Board-Certified Plastic Surgery Specialist
When considering eyelid surgery, people often focus on the double eyelid crease, eye size, or changes in the shape of the eyes. However, the amount of fat in the upper eyelid and the condition of soft tissues—such as the skin and muscles—are also important factors that influence the surgical outcome. The causes can differ between cases where the upper eyelid appears thick and those where it appears sunken, so a surgical plan tailored to the individual’s eye structure and tissue condition is necessary.
If the eyelids appear thick due to excess fat, a procedure involving an incision to remove unnecessary fat can be considered. The incision method allows direct access to the eyelid, enabling the surgeon to verify the location and amount of fat and remove it within the necessary range. However, care must be taken not to remove too much fat from the upper eyelid. Excessive removal can actually make the upper eyelid appear sunken or give the patient a tired appearance.
Therefore, rather than simply assessing the amount of fat, it is important to comprehensively evaluate the condition of the surrounding tissues—such as the thickness of the skin and muscles, the degree of eyelid drooping, and the position of the eyebrows—to determine the appropriate extent of removal.
Conversely, if the eyes appear sunken due to a lack of fat in the upper eyelids, one may consider methods to restore lost volume rather than removing fat. Particularly in middle age and beyond, changes in the fat and soft tissues around the eyes due to the aging process can cause the upper eyelids to gradually appear sunken. In such cases, fat grafting to the upper eyelids using the patient’s own fat can be considered; this procedure involves assessing the degree of sunken appearance, bilateral symmetry, and skin condition to inject the appropriate amount into the necessary areas.
There are also cases involving complex conditions, such as excessive fat combined with sagging skin, or, conversely, simultaneous skin sagging and a lack of fat. In such cases, rather than applying a single method, a comprehensive surgical plan can be developed by evaluating the fat volume in the eyelids, skin laxity, eyebrow position, and the condition of the surrounding soft tissues.
Medical Director Kang Hyungjoo (Plastic Surgery Specialist) of JAYJUN Plastic Surgery stated, “Just because the upper eyelid appears thick does not necessarily mean fat removal is required, and conversely, just because the upper eyelid appears sunken does not automatically mean fat grafting is needed,” he explained, adding, “It is important to comprehensively assess the individual’s eye structure, fat volume, and the condition of the skin and surrounding soft tissues before selecting the appropriate method.”
Dr. Kang went on to emphasize, “When planning eyelid surgery, rather than simply focusing on removing or adding fat, one must accurately assess the current condition of the eyelids and the characteristics of the tissues surrounding the eyelids before determining the scope and method of the surgery.”