Erbium Under-Eye Fat Repositioningin Gangnam, Seoul
Under-eye fat repositioning treats eye bags by moving the fat that bulges under the eye down into the hollow of the tear trough, smoothing the transition between the lid and cheek. At QD Clinic in Gangnam, Seoul, South Korea, this is performed through the inside of the lower eyelid (transconjunctival) using an erbium laser rather than a blade, so there is no external skin incision. It is carried out under local anesthesia, with light sedation if needed. (Results vary by individual.)
Who it’s for
- Under-eye bags with a hollow (tear trough) below them
- Puffiness that can look tired even when well rested
- Younger patients with good skin elasticity and little excess skin
If there is significant loose or excess lower-eyelid skin, a lower blepharoplasty may suit better; this is decided at consultation.
How it works
The bulge under the eye is usually orbital fat that has become more prominent. Working through the inside of the lower eyelid (a transconjunctival approach), the surgeon uses an erbium laser to open a fine path and release the fat pockets, then repositions that fat downward over the bony rim to fill the tear-trough hollow, and secures it. Because the approach is inside the lid, the outer skin is not incised (there is still a wound on the inside of the lid). Fat may be repositioned and, in some cases, a small amount reduced, depending on your anatomy.
THE MECHANISM, STEP BY STEP
01The bulge is orbital fat
The puffiness under the eye is usually orbital fat that has become more prominent, while the groove just below it — the tear trough — sits hollow, so treating only one of the two can leave an uneven step.
02Reached from inside the lid
Access is through the inner surface of the lower eyelid (a transconjunctival approach), so no incision is made in the outer skin and there is no external scar line.
03Repositioned, not simply removed
Rather than only taking fat away, the released fat is moved downward over the bony rim to fill the hollow and smooth the transition between lid and cheek, then secured in place.
04Erbium laser under local anesthesia
An erbium laser opens the fine path and releases the fat pockets, and the procedure is carried out under local anesthesia; depending on your anatomy a small amount of fat may also be reduced.
Treatment areas
- Under-eye bags
- The bulging orbital fat that is repositioned.
- Tear trough
- The hollow below the bag, filled by the repositioned fat.
- Lid–cheek junction
- The transition between the lower lid and cheek is smoothed.
What the procedure is like
- 1Consultation, eye assessment and design
- 2Local anesthesia (with optional light sedation)
- 3Transconjunctival access with the erbium laser (inside the lower lid)
- 4Release and repositioning of the orbital fat over the rim
- 5Recovery and aftercare guidance (no external stitches)
Time: The procedure takes about 30–60 minutes.
Recovery & aftercare
- Performed under local anesthesia; you can usually go home the same day.
- Swelling and possible bruising usually settle over several days to about two weeks; because the incision is inside the lid, there are no external stitches.
- Cold compresses and keeping the head elevated help; avoid strenuous activity for a period we advise.
- Side effects such as swelling, bruising, asymmetry or a dry-eye sensation may occur and are explained at consultation.
What to expect over time
A general guide to how the days and months after treatment usually unfold. Results vary by individual.
DAY 0 Procedure day
Performed under local anesthesia in about 30–60 minutes; you can usually go home the same day. Mild swelling begins, and there are no external stitches.
DAY 1-3 Peak swelling
Swelling and any bruising are usually most noticeable now. Cold compresses and keeping the head elevated help; strenuous activity is avoided as advised.
DAY 4-14 Settling
Swelling and bruising gradually ease over several days to about two weeks. Because healing is on the inside of the lid, there are no external stitches to remove.
1-3 MONTHS Contour refines
As residual swelling resolves, the lid–cheek transition settles and the contour is largely refined. Subtle changes can continue after this.
ONGOING Longer term
This is usually a single procedure. The repositioned fat stays in place, while natural aging continues over the years.
Sessions & results
This is usually a single procedure, with swelling settling over weeks and the contour refining over about 1–3 months.
How it compares
Under-eye bags can be approached in different ways depending on the fat, the depth of the tear-trough hollow and how much loose skin is present, so these options suit different situations.
| Comparison | Erbium Under-Eye Fat Repositioning | Under-eye filler | Erbium Lower Blepharoplasty |
|---|---|---|---|
| Approach | Transconjunctival — no external skin incision | Injected gel filler — non-surgical | External incision just below the lashes |
| Targets | Repositions your own orbital fat into the hollow | Adds volume above the hollow — gradually absorbed and maintained with repeat sessions | Repositions or removes fat and trims excess skin |
| Excess skin | Suited to little excess skin | Not addressed | Also addresses loose or wrinkled skin |
| Recovery | Swelling and bruising over days to ~2 weeks | Little to none | Sutures ~5–7 days; bruising ~1–2 weeks |
They work differently and suit different goals. The right choice is decided after examination.
Safety & considerations
Possible reactions
- Swelling and bruising around the lower eyelids (settle over several days to about two weeks)
- A dry-eye or gritty sensation, or watering, that usually settles
- Mild asymmetry between the two sides while swelling resolves
- Numbness or tightness in the treated area (settles over time)
When to take extra care
- Significant loose or excess lower-eyelid skin, where a lower blepharoplasty may suit better
- Dry-eye disease or previous eye surgery — tell your doctor
- Bleeding or clotting disorders, or blood-thinning medication
- Pregnancy or breastfeeding — let us know at consultation
- A tendency to keloid or difficulty with wound healing
Risks include bleeding, infection, scarring, asymmetry, difficulty closing the eyes, lower-lid position changes and revision surgery. Sudden visual change, severe eye pain or rapidly increasing swelling require urgent care.
Your care at QD Clinic
No external skin incision
The approach is through the inside of the lower eyelid, so the outer skin is not incised (there is still a wound on the inside of the lid).
Care in your language
Consultation in English, with 中文 and 日本語 support arranged on request — including questions before you travel.
A 4-minute walk from Sinnonhyeon and Nonhyeon stations
Central Seoul location with guidance from the airport and nearby hotels, and hours shown in KST.
Frequently asked questions
In Korea it is often shortened to “nunmitji”. It is surgery that moves the fat bulging under the eye down into the hollow groove just below it (the tear trough), smoothing the border between the eyelid and the cheek. At QD Clinic, erbium under-eye fat repositioning is done through the inside of the lower eyelid (the conjunctiva) with an erbium laser, so the outer skin is not cut.
The puffiness under the eye is usually prominent orbital fat, while the groove right below it is hollow, so treating only one of them tends to leave a step. That is why, rather than simply removing fat, the erbium laser is used to release the fat pad, which is then moved below the bony rim to fill the hollow groove and secured in place. Depending on the anatomy, a small amount of fat may also be removed, and the extent is decided at the examination.
Transconjunctival under-eye fat repositioning uses an incision inside the lower eyelid to avoid an external skin incision. The internal surgical wound still needs to heal; this does not eliminate risks such as scarring or adhesions. If skin removal is needed, the alternative approach and its scars are discussed separately.
It is usually performed under local anesthesia, with light sedation if needed. Because the approach is through the inside of the lower eyelid, there is no incision on the outer skin. Whether sedation is added is decided at the examination, based on the extent of surgery and how tense you feel.
Expect swelling and possible bruising for several days to about two weeks; because the incision is inside the lid, there are no external stitches to remove. Cold compresses and keeping your head elevated help, and strenuous activity should be avoided for the period we advise. Side effects such as swelling, bruising, asymmetry or dryness can occur, and we explain these at consultation. Bleeding, infection, scarring, asymmetry, difficulty closing the eye, a change in lower-lid position and the possibility of revision surgery can occur. Sudden visual change, severe eye pain or rapidly increasing swelling needs immediate medical care.
Under-eye filler adds product to the hollow to restore volume, while fat repositioning moves your own bulging orbital fat toward the hollow tear trough, addressing the cause itself. Filler is gradually absorbed over time, whereas the moved fat settles into its new position. If there is hollowing without a noticeable fat bulge, filler may suit you better, so we compare the two at your examination.
Fat repositioning suits protruding fat with hollowing when the lower-eyelid skin is still firm. If loose or wrinkled skin is also present, a lower blepharoplasty, which trims the skin, may be needed. The amount of excess skin and the support of the lower lid have to be assessed in person, so we decide this at your examination.
The repositioned fat stays in place, so the change does not wear off the way filler does. Swelling settles over weeks and the contour refines over about one to three months. Aging continues, though, so the area still changes gradually over the years.
Yes. Consultations are available in English, and Chinese or Japanese support can be arranged on request. At the consultation we look at how much fat bulges, how hollow the area is and how much spare skin the lower eyelid has, and explain whether repositioning or a lower blepharoplasty suits you. Please let us know your preferred consultation language when you book.
Preoperative assessment and in-person recovery visits need to be planned before travel is finalised. Tell us how long you can stay. A plan combining surgery and another procedure needs recovery and review arrangements for both. This is usually a single procedure, with swelling settling over weeks and the contour refining over about 1–3 months. Swelling and possible bruising usually settle over several days to about two weeks; because the incision is inside the lid, there are no external stitches. Depending on the examination, same-day treatment may not be possible or additional visits may be needed. Please also confirm in advance how to reach us after you return home and any in-person care you may need. What the doctor looks at first for this treatment: “Protruding under-eye fat, the tear trough, skin condition and preserving fat”.
Often considered together
Treatments that are sometimes planned alongside this one, decided at consultation.
+Erbium Under-Eye Fat Repositioning + Eye Sofwave
A consultation option combining Erbium under-eye fat repositioning with Sofwave. Surgery and energy treatment have different roles and treatment areas; the need for each is assessed first.
+Upper Blepharoplasty
If upper-eyelid heaviness is also a concern, upper-eyelid surgery may be planned in the same session to balance the eye area; whether to combine is decided by your surgeon.
+Lower-lid skin treatments
Fat repositioning smooths the contour but does not change skin texture; laser or skin-quality treatments for the lid surface may be considered separately, depending on your skin.
For international patients
Consultation in English / 中文 / 日本語 · WhatsApp · WeChat · KakaoTalk · a 4-minute walk from Sinnonhyeon / Nonhyeon Station (hours in KST).
How many days should I stay?
Surgery and course-based treatments need a check-up. We tell you before you book whether that means staying longer or coming back another time.
For International Patients