This content has been created in compliance with the Medical Practice Act and related laws.
Can You Preserve Aegyo-sal While Undergoing Under-eye Fat Repositioning in Gangnam?
To answer directly, under-eye fat repositioning is a procedure that does not affect aegyo-sal.
According to a HiDoc plastic surgery specialist column, aegyo-sal is actually the volume of the orbicularis oculi muscle located directly under the eye. Meanwhile, under-eye fat is positioned in a deep layer beneath that orbicularis oculi muscle. Since under-eye fat repositioning approaches through the inside of the conjunctiva and only touches the fat, it does not incise or damage the skin surface or orbicularis oculi muscle. In other words, the surgical approach layer itself is different.
However, if skin sagging or fine wrinkles are present together, repositioning alone may be difficult to resolve. In such cases, it is important to first discuss with a specialist whether lower eyelid surgery or supplementary procedures are necessary.
Why Under-eye Fat Repositioning Does Not Affect Aegyo-sal — Understanding the Structure
Aegyo-sal and under-eye fat exist in completely different anatomical layers.
▪ Aegyo-sal (orbicularis oculi muscle): Muscle tissue located directly below the skin just under the eyelid
▪ Under-eye fat: Fat tissue isolated within the orbital septum below the orbicularis oculi muscle
▪ Surgical approach path: Small incision of the conjunctiva → approach to orbital septum → reposition protruding fat in the direction of the tear trough
According to a HiDoc plastic surgery specialist column, this procedure is described as 'transconjunctival orbital fat repositioning surgery,' and the key point is that the skin is not incised at all. A PubMed-published Cureus 2024 clinical study (Gupta et al.) also reports that the transconjunctival approach minimizes skin and tissue deformation and reduces the risk of complications such as ectropion or excessive fat removal. A Korean Society of Plastic Surgeons journal article also provides evidence that transconjunctival approach minimizes the impact on skin and soft tissues.
Interestingly, as under-eye fat decreases, aegyo-sal can appear more defined. If protruding fat had been pressing down and hiding the orbicularis oculi muscle, after repositioning the volume is organized and the buried aegyo-sal line becomes sharply revealed—this is confirmed in clinical cases. Of course, results vary depending on the individual's under-eye structure and the degree of orbicularis oculi development, so pre-analysis is important.
What view plastic surgery Must Confirm Before Under-eye Surgery
Whether aegyo-sal can be preserved is already determined in the pre-operative under-eye structure analysis. Below are the items a specialist confirms before surgery.
▪ Position and extent of under-eye fat protrusion: Determine which direction the fat bulges and by how much
▪ Orbicularis oculi (aegyo-sal) volume and degree of development: Confirm congenital aegyo-sal presence and degree of obscuration
▪ Tear trough depth: Judge whether natural connection is possible after repositioning
▪ Skin elasticity and sagging condition: Determine whether repositioning alone is sufficient or if lower eyelid surgery is necessary
▪ Overall volume balance below the eye: Pre-plan whether aegyo-sal filler supplementation is needed
As a Seoul National University College of Medicine educational cooperation medical institution, view plastic surgery carefully examines individual under-eye fat position and skin condition based on over 20 years of accumulated expertise before designing the optimal approach. According to the Cureus 2024 clinical study, the average return to society period after transconjunctival approach was approximately 2 weeks, with swelling and bruising typically resolving within 1-2 weeks. Through consultation that includes such recovery planning, we also pre-discuss in advance whether to proceed with repositioning alone or plan supplementary procedures such as aegyo-sal filler together.
First Confirm Whether Your Under-eye Condition is Suitable for Preserving Aegyo-sal Through Repositioning
Review the table below and first examine what type of under-eye condition you are closest to.
| Under-eye Condition | Suitable Approach | Possibility of Preserving Aegyo-sal |
|---|---|---|
| Under-eye fat protrusion as main cause, good skin elasticity | Under-eye fat repositioning | High — aegyo-sal can become more distinct after fat removal |
| Fat protrusion + tear trough depression combined | Under-eye fat repositioning | High — natural line formation through improved tear trough after repositioning |
| Skin sagging·fine wrinkles combined, orbicularis oculi laxity | Review lower eyelid surgery combination | Medium — aegyo-sal line can be affected depending on incision method, specialist judgment needed |
| Congenitally no aegyo-sal | Consider repositioning + aegyo-sal filler combination | Repositioning surgery alone cannot create new aegyo-sal — line can be completed with filler combination |
According to a HiDoc plastic surgery specialist column, under-eye fat repositioning is effective when fat protrusion is the main cause and skin sagging is minimal, and lower eyelid surgical approach is reviewed when skin and orbicularis oculi sagging are combined. A Alphabiz health article (2026) also emphasizes that plastic surgery specialists must vary their approach depending on whether under-eye fat protrusion and skin sagging are combined.
In cases with no congenital aegyo-sal, clinical cases show that after repositioning when the under-eye becomes smooth, patients may actually feel that "aegyo-sal seems to have disappeared," so aegyo-sal filler combination is sometimes pre-planned. You must discuss this during pre-operative consultation.
Responses may vary depending on constitution and symptom severity.
Many patients from nearby areas such as Seocho, Nonhyeon, and Apgujeong come to view plastic surgery for under-eye consultation. If you are considering Seocho under-eye fat repositioning, Nonhyeon under-eye fat repositioning, or Apgujeong under-eye fat repositioning, you can comfortably receive consultation at our main branch in Gangnam.
If You're Considering Under-eye Fat Repositioning in Gangnam, Discuss Aegyo-sal First
With over 20 years of clinical experience and the perspective of a specialist from Seoul National University Hospital's plastic surgery department, view plastic surgery will directly examine your under-eye structure.
What determines the result in under-eye surgery is not just surgical technique. As a HiDoc plastic surgery specialist column emphasizes, sufficient consultation with a plastic surgery specialist before surgery directly affects the final result. Clearly conveying the desire to preserve aegyo-sal before surgery and checking together whether your under-eye structure is suitable for that goal is the most important first step.
Whether only under-eye fat should be reduced, the tear trough should be improved together, or the aegyo-sal line should be supplemented with filler — all these judgments are only possible after directly examining the under-eye. When the under-eye changes, the entire facial impression changes. If you have questions, start with a consultation.
Under-eye Fat Repositioning + Aegyo-sal, What People Actually Want to Know
Q1. Won't aegyo-sal disappear if I undergo under-eye fat repositioning?
Aegyo-sal (orbicularis oculi muscle) is located in the skin layer just below the eyelid, and under-eye fat is in a deeper layer. Under-eye fat repositioning approaches through the inside of the conjunctiva, so it does not affect the skin or orbicularis oculi muscle. Since the approach layer itself is different, aegyo-sal will not disappear due to surgery.
Q2. Is it true that removing fat makes aegyo-sal even more distinct?
Yes. When under-eye fat is protruding, that volume may press down the orbicularis oculi muscle and hide the aegyo-sal line. Through repositioning, as the fat is organized, the buried aegyo-sal becomes relatively more distinct—this is confirmed in clinical cases. However, the sensory difference varies depending on the individual's under-eye structure and orbicularis oculi development.
Q3. I don't have aegyo-sal congenitally. Can aegyo-sal develop after repositioning?
The repositioning procedure itself does not create new aegyo-sal where none existed. When the orbicularis oculi volume is naturally low, after repositioning when the under-eye becomes smooth, you may actually feel that aegyo-sal is even less visible. In such cases, it is better to plan to combine aegyo-sal filler and complete the line in the pre-operative consultation.
Q4. Between under-eye fat repositioning and lower eyelid surgery, which preserves aegyo-sal better?
Under-eye fat repositioning through transconjunctival approach does not incise the skin and thus does not affect the aegyo-sal line. Lower eyelid surgery, on the other hand, adjusts skin and orbicularis oculi together, so the position or volume of aegyo-sal may change depending on the surgical method and incision line. If skin sagging is minimal and fat protrusion is the main cause, repositioning is advantageous in terms of aegyo-sal preservation.
Q5. How long does swelling last after repositioning, and when does the aegyo-sal shape settle?
According to the Cureus 2024 clinical study (Gupta et al.), swelling and bruising typically resolve within 1-2 weeks after transconjunctival approach, with an average return to society period of approximately 2 weeks. The final under-eye line and aegyo-sal shape typically settle between 4-8 weeks after swelling completely resolves, and this can vary depending on individual recovery speed.
Responses may vary depending on constitution and symptom severity