Summary of the differences and selection criteria for sub-eyelid fat repositioning, lower eyelid surgery, and mid-face lower eyelid lift surgery.

The area under the eyes is affected by fat, skin, muscles, and the midface at the same time.
Although it may appear that “the area under the eyes is bulging or saggy,” the appropriate surgery will vary depending on where and how it has changed.
This distinction is important because choosing the wrong surgery for your condition can lead to reoperation and changes in your appearance.

Below, we will organize the procedures in order: lower eyelid fat repositioning → lower eyelid surgery → mid-face lower eyelid lift.

 

Undereye fat repositioning surgery

✔ Definition

This is a surgery to reposition the fat that has protruded through the conjunctiva on the inside of the eye downward. It is performed without making an incision on the outer skin.

✔ Principle

Rather than removing the bulging fat under the eyes, just move its location. This is an approach to alleviating under-eye bags.
It is characterized by not incising the orbicularis oculi muscle (the muscle that closes the eye).

✔ Considered in these cases

• When soft tissue and muscle tone are well maintained

• If there is little sagging of the skin under the eyes

⚠ Cases requiring attention

• If the eye area is already sunken
  → Over time, the sunken area above the eyes may become more prominent after fat redistribution.

• If the mid-face volume is originally good
  → When only the fat is moved/removed, the boundary may be more emphasized.

• A face shape with a prominent cheekbone and furrows
  → The rearrangement may actually feel unnatural.

📦 Summary
This is a surgery that is carefully considered in “a relatively early stage when the tissue elasticity is good and there is no sagging.”

 

Lower eyelid plastic surgery

✔ Definition

Make an incision under the eyelashes This is a surgery that removes fat under the eyes and corrects sagging skin.

✔ Principle

Sagging and fat problems concentrated under the eyes are corrected within the lower eyelid area.
It treats skin, fat, and supporting structures simultaneously.

✔ Considered in these cases

• The skin under the eyes is stretched, but

• If mid-face sagging is not severe

⚠ Limitations

• If the boundary between the lower eyelid and the midface itself has descended,
  → Even if only the lower eyelid is corrected, the change in youthfulness may be limited.

• In cases where midface changes are significant, single surgery may not be recommended.

📦 Summary
Suitable for “those with sagging under the eyes but no significant changes in the mid-face.”

 

Midfacial lower eyelid lift

✔ Definition

Expand the lower eyelid incision to access the midface. This is a surgery that lifts the mid-face fat layer upwards along with fat treatment.

✔ Principle

It's not just about cleaning up the under-eye area, Lower eyelid – An approach that lifts the mid-face border upward.

✔ Considered in these cases

• When the border between the lower eyelid and midface is significantly lowered

• Cases of revision surgery that did not leave a youthful appearance even after previous under-eye surgery

• In cases where mid-face sagging occurs quickly due to contouring surgery, etc.

• When accompanied by ectropion (inversion of the eyelid)

⚠ Considerations Together

• Simply lifting the sagging structure may not be enough.
  → A complex approach, including space supplementation and muscle support, is discussed.

📦 Summary
This is an extended surgery considered in cases where “there is a clear change in the boundary between the lower eyelid and mid-face.”

 

Complex Aging: Why Is It So Difficult to Make Simple Choices?

Just because the midface is sagging, it doesn't mean that it can be solved with just a facelift.
If you don't consider the space and support issues that arise while lifting, The results may be awkward.

 

So in reality

• Adjusting the location of the province

• Mid-face elevation

• Orbicularis oculi muscle support
  Approaches to combining the backs according to the condition are discussed.

 

Summary at a glance

 

Final Guide

These three surgeries are not a matter of superiority or inferiority, but rather a matter of ‘differences in indications.’
When looking at under eye problems Bulging → Off → Border → Looking at the midface together
It is important to understand which approach is right for your situation.

 

 

This article is for informational purposes only. Any decisions based on your individual circumstances should be made through professional consultation.