LOWER BLEPHAROPLASTY
We preserve your aegyo sal. We reposition fat rather than remove it. The under-eye stays full, never hollow.
Aegyo Sal
Preserved as Default
Fat Repositioned
Not Excised — No Hollowing
Transconjunctival
No Visible Scar
Home/ Procedures/ Lower Blepharoplasty
Lower blepharoplasty corrects under-eye bags, dark circles, and tear trough hollowing. At Etonne, fat is repositioned (not excised) into the tear trough — preserving aegyo sal and avoiding the hollow eyes that fat excision produces within 5 years. Recovery: 7 days. Transconjunctival approach, no visible scar.
Lower blepharoplasty corrects under-eye bags, dark circles (also called "panda eyes"), hollow under-eye depression, and the tired appearance caused by fat herniation, tear trough deepening, and skin laxity.
At Etonne Plastic Surgery in Gangnam, we use a fat repositioning technique rather than fat excision wherever clinically possible — preserving volume, eliminating hollowing, and producing a result that ages naturally. Equally important: we preserve your aegyo sal, the youthful muscular roll just below the lash line.
SIGNATURE TECHNIQUE
The single most important clinical decision in lower blepharoplasty is what to do with the herniated fat. Three options exist.
OPTION 1 — OUTDATED
The herniated fat is simply cut away. Standard Western approach for decades. Problem: removing volume creates a sunken, skeletal, prematurely aged appearance — often within 5 years.
OPTION 2 — ETONNE PREFERRED
The herniated fat is mobilized — released from its capsule and redraped downward into the tear trough. Excess becomes a solution. Result: smooth contour, no hollowing, volume preserved, natural aging.
OPTION 3 — SELECTIVE USE
Autologous fat harvested from abdomen or thigh, grafted into the tear trough. Used selectively when patient has very little fat to reposition. Not Etonne's default.
Etonne's clinical position: fat repositioning is preferred whenever anatomy allows. We choose to preserve and redirect your existing tissue rather than remove it.
DIFFERENTIATION CORE
Aegyo sal (애교살) — the youthful muscular roll directly beneath the lash line — is one of the most distinctive features of East Asian beauty. It is not fat, and it must not be removed.
The mistake we see most often in revision patients is a clinic that confused aegyo sal with herniated fat and excised both. The result: a flat, expressionless lower lid that lost its charm and youthful appearance.
WHEN TO MOVE FROM FILLER TO SURGERY
Many patients arrive at Etonne after years of under-eye filler. The progression is familiar: the first round of hyaluronic acid filler hides dark circles and fills the tear trough; subsequent rounds become less effective; eventually a bluish discoloration appears under the skin even when the filler is freshly placed.
This bluish discoloration is the Tyndall effect — light scattering through superficial filler in thin under-eye skin, producing a cool blue cast that resembles a permanent dark circle. Once Tyndall effect is established, additional filler typically makes it worse rather than better.
Lower blepharoplasty with fat repositioning is the surgical correction. The fat that was being hidden by filler is mobilized into the tear trough, the hollow fills with the patient's own tissue (no Tyndall effect), and the dark-circle appearance resolves anatomically rather than cosmetically.
PRICING
Same fee for local Korean and international patients. No nationality markup.
| Procedure | Price (USD) | Notes |
|---|---|---|
| Transconjunctival Lower Blepharoplasty | [TBD] | Fat repositioning, no visible scar |
| Subciliary Lower Blepharoplasty | [TBD] | For significant skin excess |
| Add-on: Fat Grafting | [TBD] | When repositioning insufficient |
| Add-on: Aegyo Sal Enhancement | [TBD] | Filler or fat graft |
| Add-on: Skin Resurfacing (laser) | [TBD] | For texture and pigmentation |
Etonne does not work through Bookimed, MediGo, or other third-party concierges that often quote international patients 3–5× the actual clinic fee.
For full pricing including VAT refund elimination effective January 1, 2026, see Cost Guide 2026.
RESULTS
Gallery placeholder — 5–10 watermarked Before/After pairs to be selected.
FAQ
Puffy eyes (herniated fat) and aegyo sal (the muscular roll just below the lash line) are anatomically distinct. At Etonne, we mark these separately during preoperative planning and preserve the aegyo sal. Only the herniated fat is touched.
Yes, with a different approach. When there is minimal fat to reposition, dark circles often come from tear trough hollowing combined with thin skin. Etonne's options include tear trough release, selective fat grafting, or skin texture treatment.
Fat repositioning moves your existing herniated fat — released from its capsule and redraped into the tear trough. The fat stays attached to its blood supply. Fat grafting harvests fat from another body site (abdomen, thigh) and injects it as free graft. Etonne prefers repositioning when anatomy allows.
Not with our approach. Hollowing is the result of fat excision. Etonne repositions fat — moving it from where it bulges into where it fills. Volume is preserved.
"Non-incisional" in the lower lid context typically refers to the transconjunctival approach (incision is inside the eyelid, not on external skin). The terms are used interchangeably in marketing. The procedure is identical.
Chemosis is treated with topical steroid drops, lubricating ointment, gentle warm compresses, and patience — most cases resolve within 2–4 weeks. See Eye Surgery Complications.
SCHEDULE
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