Why Lower Blepharoplasty Is a Better Option Than Under Eye Fat Repositioning

Transconjunctival fat repositioning is a minimally invasive procedure performed through the inner side of the eyelid (called the conjunctiva). It redistributes under-eye fat to fill in the hollow areas of the lower eyelid—all without any external skin incision. That’s why at Noonopi Plastic Surgery, we also refer to it as a Scarless lower blepharoplasty.

This type of lower lid fat transfer is a form of blepharoplasty specifically designed to treat bags under eyes.

Because no skin is removed, recovery is fast. Many patients can return to work within 3–4 days after surgery, although minor swelling and bruising may persist briefly.

A one-size-fits-all approach doesn’t work for under-eye rejuvenation. Depending on the degree of volume loss, skin laxity, or deep wrinkles, additional techniques may be necessary.

The photos above show me in my 20s and in my 40s… 😂

With this type of under-eye shape, there isn’t enough fat to reposition into the hollow areas, so fat repositioning alone is often not enough. A combination approach is usually needed for better results.

1. Combining Fat Grafting

In cases where the patient lacks sufficient fat for repositioning or has significant hollowing, Scarless LB with fat grafting is preferred. Nano-fat or micro-fat injections can be used to create a smooth contour under the eyes.

Injecting micro-fat adds volume to hollow under eyes that can’t be corrected by repositioning alone.

2. Laser Resurfacing for Wrinkles

Some patients are hesitant about having incision, even when loose skin needs to be addressed.

In such cases, combining under-eye fat repositioning with Erbium:YAG or CO₂ laser resurfacing can be a great alternative for under-eye wrinkle reduction.

This approach stimulates collagen regeneration in the dermis and helps improve fine lines without surgical skin excision.

Eyelid tightening laser benefits include:

• Can be safely repeated if needed
• Adjustable intensity based on desired results and individual downtime
• Can also help remove some age spots around the eyes

In Asian skin, overly aggressive laser settings can lead to post-inflammatory hyperpigmentation (PIH), which may last up to 6 months.

Although the pigmentation typically resolves on its own, proper post-treatment care—such as the use of brightening agents—is essential.
This is why thorough aftercare guidance by experienced professionals—like the team at Noonopi Plastic Surgery—is so important.

However, laser therapy also has some limitations for tightening the eyelids.

Resurfacing lasers do not offer the same degree of tightening as surgical excision and may be insufficient for patients with moderate to severe skin laxity.

As with any surgery, lower blepharoplasty with skin incision technique carries potential risks, including:

• Lower lid retraction
• Scleral show
• Ectropion
• Conjunctival swelling - temporary
• Blurred vision - temporary

These complications are rare when performed by experienced surgeons who evaluate eyelid tone and tissue elasticity before surgery.

👉 Click here to read more about lower blepharoplasty complications and how Noonopi correct it.