Technique
Fat Transposition
Blepharoplasty
Reduce the bag. Soften the hollow. Preserve the volume the lower eyelid still needs.
Fat transposition blepharoplasty is the technique that defines lower eyelid surgery at EyeFACE. Rather than simply removing the herniated fat that creates under-eye bags — a technique that can discard useful orbital volume and leave a hollow, skeletonised under-eye — fat transposition repositions that fat over the orbital rim into the tear trough depression.
The goal is to reduce the bag and soften the hollow beneath it at the same time, using the patient's own orbital fat rather than synthetic filler.
This technique requires a higher level of surgical precision than simple fat excision — the fat must be mobilised from its compartments, positioned precisely over the orbital rim, and secured without tension. It is a core competency of ASOPRS-trained oculofacial surgeons and one of the primary reasons subspecialty training matters for lower eyelid work.
Why This Matters
The safest lower eyelid plan preserves what your eye may still need.
Under-eye dark circles are often shadows: a bulge above, a hollow below, and a sharp lid-cheek transition that catches light badly. Removing fat alone can flatten the bag while making the hollow more visible. Fat transposition aims to improve the contour without skeletonizing the eye.
Fat removal, transposition, and grafting are not interchangeable.
Simple fat removal
Can reduce a bulge, but may worsen hollowness if too much orbital fat is removed or if the tear trough is not supported.
Fat transposition
Repositions the patient's own lower eyelid fat across the orbital rim to soften the bag and the hollow together.
Fat grafting
Adds harvested fat as a separate volume tool. It may help selected hollows, but it is not the same as repositioning vascularized orbital fat.
Good candidates usually have a structural bag-hollow pattern.
This technique is most relevant when lower eyelid fat has moved forward and the tear trough below it has become hollow or shadowed. It is less useful when the concern is mainly pigmentation, thin skin, allergy-related puffiness, or cheek descent without a true lower eyelid fat pad.
During consultation, Dr. Gill assesses eye shape, lid tone, cheek support, skin quality, prior filler or surgery, and whether additional midface or skin treatment is needed.
Start With EyeFACE Circle™
Not ready to choose a consultation yet? Begin through our secure patient portal so our team can review your goals and photos before recommending the right next step.
A treatment plan is confirmed after the appropriate review, clinical consultation, and care planning.