Lower blepharoplasty can help when the under-eye area is puffy, hollow, or sagging.
However, lower blepharoplasty can't fix every under-eye concern.
At Gangnam Seoyon Plastic Surgery, we have outlined who is and isn't a good candidate.
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■ The Bottom Line
Lower blepharoplasty is worth considering when under-eye fat protrudes, the area beneath the eyes is hollow, or the skin has become lax.
It is most often evaluated when aging causes all three of these changes to appear together,
typically in patients in their 40s to 60s and older.
On the other hand, if the cause is pigmented dark circles (where the under-eye skin itself is darker) or simple eye fatigue,
an approach other than lower blepharoplasty may be more appropriate.
To find out whether lower blepharoplasty is right for you,
it is important to first identify what is causing your under-eye concerns.
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■ What Is Lower Blepharoplasty?
Lower blepharoplasty is surgery that corrects the lower eyelid and the area around it.
At Gangnam Seoyon Plastic Surgery, we perform lower blepharoplasty using an under-eye fat repositioning technique.
Lower blepharoplasty repositions the under-eye fat, reinforces the orbital septum, and improves sagging skin through a midface lift.
Protruding fat pads are transposed into the hollow areas to fill them,
restoring a natural contour to the under-eye region.
When the skin is significantly lax, skin excision may also be performed.
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■ When Lower Blepharoplasty May Be Considered
Look at your under-eyes in a mirror and check for the following.
The under-eye area bulges outward.
With age, the orbital septum weakens, allowing the fat behind it to herniate forward.
The under-eye area looks puffy, giving a tired or aged appearance.
Repositioning this bulging fat into the hollow below can give a smoother under-eye contour.
Hollowing under the eyes creates shadows.
When bulging and hollowing occur together, a shadow forms at the junction between them and can look like dark circles.
This must be distinguished from pigmented dark circles.
If the shadow lessens when you gently stretch the under-eye skin in good lighting,
the problem is likely structural and fat-related, and lower blepharoplasty may help.
The under-eye skin is sagging or wrinkled.
As skin elasticity beneath the eyes declines with age, the skin begins to sag.
This can be corrected by fat repositioning combined with removal of excess skin.
If even one of these three applies to you, an in-person evaluation can determine whether lower blepharoplasty is appropriate.
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■ When You're Considering Lower Blepharoplasty but May Not Be a Good Candidate
Some situations must be ruled out before surgery is considered.
The cause is pigmented dark circles, with darkened under-eye skin.
If the cause is melanin hyperpigmentation, lower blepharoplasty is unlikely to improve it.
Laser treatment or another approach is more appropriate.
If, in good lighting, the dark color appears evenly spread across the under-eye skin,
it is most likely pigmentation-related.
The skin is lax but there is no under-eye bulging.
When there is little fat herniation and only skin laxity,
there may not be enough fat to reposition, so an approach other than lower blepharoplasty alone may be considered.
The cause is eye fatigue or ptosis.
If your eyes look tired because of drooping of the upper eyelid rather than the lower eyelid,
or because of weak eyelid-opening strength, upper blepharoplasty or ptosis correction should be evaluated first.
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■ How to Check Whether Lower Blepharoplasty Is Right for You
There is a simple way to check at home.
Look at your under-eyes in a mirror under bright light.
If the shadow lessens or the bulge flattens when you gently stretch the under-eye skin with a finger,
fat structure may be the cause.
If wrinkles smooth out when you gently lift the under-eye skin with a finger,
skin laxity is also present.
This method alone cannot give an accurate assessment.
The volume of under-eye fat, skin elasticity, and the condition of the orbital septum
must be confirmed through an in-person examination.
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■ Should Lower and Upper Blepharoplasty Be Done Together?
Many patients wonder whether they need lower and upper blepharoplasty at the same time.
Combined surgery is considered when both the upper and lower eyelids show signs of aging.
If the upper eyelid skin is drooping and eyelid-opening strength has weakened, correcting only the lower eyelids
may leave the overall look of the eyes unbalanced.
When both procedures are performed at the same time, the recovery periods overlap,
so the downtime does not double.
That said, some patients do not need lower and upper blepharoplasty together.
If your concern is limited to the under-eye area and your upper eyelids are fine, lower blepharoplasty alone is enough.
It is important to decide on the surgical plan only after both the upper and lower eyelids have been evaluated during consultation.
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■ Lower Blepharoplasty at Gangnam Seoyon Plastic Surgery
At Gangnam Seoyon Plastic Surgery, Director Choi Dong-il personally handles every step, from consultation to surgery.
Our standard approach is under-eye fat repositioning, which corrects both bulging and hollowing,
and when skin laxity is also present, we plan skin excision as well.
Before lower blepharoplasty, we also assess the upper eye area (for upper blepharoplasty or ptosis correction)
to separate the corrections you need from the ones you don't.
Consultations can be booked by phone (02-535-8889) or through our KakaoTalk channel.
Office hours are 09:30–18:30 on weekdays and 09:30–16:30 on Saturdays.
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■ Frequently Asked Questions
Q1. Who is a good candidate for lower blepharoplasty?
A. Lower blepharoplasty is considered when under-eye fat bulges outward, when hollowing under the eyes creates shadows,
or when the under-eye skin is sagging or wrinkled.
If even one of these three applies, a board-certified specialist can evaluate whether you are a suitable candidate.
Q2. Can lower blepharoplasty get rid of dark circles?
A. It depends on what is causing the dark circles.
Shadow-type dark circles caused by under-eye fat bulging and hollowing
can often be improved with lower blepharoplasty.
However, dark circles caused by skin hyperpigmentation
are difficult to resolve with lower blepharoplasty and require a different approach.
Q3. Is there an age limit for lower blepharoplasty?
A. There is no specific age limit.
Under-eye fat herniation can appear as early as your 30s and 40s,
and correction is also possible in your 50s, 60s, and beyond, when skin laxity becomes more pronounced.
What matters more than age is your current under-eye condition and whether correction is needed.
Q4. Do I have to have lower and upper blepharoplasty together?
A. They do not have to be done at the same time.
If your concern is limited to the under-eye area, lower blepharoplasty can be performed on its own.
However, if both the upper and lower eyelids show signs of aging, combined surgery may be considered,
and this is decided after an in-person assessment during consultation.
Q5. Is under-eye fat repositioning different from under-eye fat removal?
A. Repositioning moves protruding fat into the hollow areas to fill them,
whereas removal simply takes the fat out.
Q6. How long is the recovery after lower blepharoplasty?
A. It depends on the surgical technique.
You can return to daily activities from day 3, and sutures need to be removed at 5–7 days.
About 70–80% of the swelling subsides within one month,
and the final result can be seen after 3–6 months.
Q7. Is the scar from lower blepharoplasty very noticeable?
A. With a transconjunctival approach (through the inner surface of the eyelid), no external scar is left.
When skin excision is needed, a subciliary incision is made just below the lashes,
but over time it usually blends naturally into the lash line.
Q8. How can I tell if lower blepharoplasty is right for me?
A. If, when you examine your under-eyes under bright light or gently stretch the skin,
the bulge decreases or the shadow fades, fat structure may be the cause.
However, an accurate assessment requires an in-person evaluation of under-eye fat volume and skin elasticity.
A consultation with a board-certified specialist is the most reliable way to confirm whether you are a suitable candidate.
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Side effects such as bleeding, infection, or inflammation may occur after surgery, depending on the individual,
and subjective satisfaction may vary from person to person.
An accurate diagnosis and surgical plan should always be determined through an in-person consultation with a board-certified specialist.
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Director Choi Dong-il
Board-Certified Plastic Surgeon
Current: Chief Director, Gangnam Seoyon Plastic Surgery (2015–present)
Former: Director, BK Plastic Surgery (2011–2013)
Former: Director, Regen Plastic Surgery (2013–2015)
Adjunct Professor, Department of Plastic Surgery, Korea University College of Medicine
Chair of the Scientific Committee, Eye Plastic Surgery Study Group, Korean Society of Plastic and Reconstructive Surgeons
Adjunct Professor, Department of Plastic Surgery, Kangdong Sacred Heart Hospital
Regular Member, Korean Society of Plastic and Reconstructive Surgeons
Regular Member, Korean Society for Aesthetic Plastic Surgery
Regular Member, Korean Society of Craniofacial Surgery
Member, International Confederation for Plastic, Reconstructive and Aesthetic Surgery (IPRAS)
Regular Member, Korean Society for Surgery of the Hand
Regular Member, Korean Association of Plastic Surgeons
Member, Scientific Committee, Korean Society of Plastic and Reconstructive Surgeons
Expert Reviewer, Editorial Board, Korean Society for Aesthetic Plastic Surgery
Former Director of Finance and Current Director of Information, Korean Association of Plastic Surgeons
Member, Information and Communications Committee and Public Relations Committee, Korean Society for Aesthetic Plastic Surgery
Regular Member, Eye Plastic Surgery Study Group, Korean Society of Plastic and Reconstructive Surgeons
Former Secretary General, Eye Plastic Surgery Study Group, Korean Society of Plastic and Reconstructive Surgeons
Regular Member, Rhinoplasty Study Group, Korean Society of Plastic and Reconstructive Surgeons
The photographs in this post were taken under identical conditions with the patient's prior consent.
In addition, side effects such as bleeding, infection, and inflammation may occur after plastic surgery or procedures depending on the individual, so caution is required.