qd erbium under-eye fat repositioning
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, 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. (Results vary by individual.)
is this for me
Who it’s for
Even if none of these describes you, we will look again at the consultation.
- 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.
Before you pick a treatment name, start with the cause of your concern.
start with your concern
Even a treatment with the same name takes on a different role and scope depending on your current structure, the change you want, what you have had before and the recovery time you have.
01
Where you are now, and where we start
Protruding under-eye fat, the tear trough, skin condition and preserving fat
02
The change you want, the impression you keep
We check the front and side views and expression, left-right differences, skin and deep tissue, and scars and function from earlier surgery.
03
How it differs from similar options
We compare incision and dissection, how much is removed, repositioned or fixed, the pros and cons of materials, and the option of no surgery at all.
04
Health information and recovery schedule
Anesthesia, preventing bleeding and infection, wound care, swelling and changes in sensation, and when to be seen again — all in one plan.
the
principle
Alongside shape, we examine how the eye opens and closes, the ocular surface, the fat, skin and adhesions, then set the incision and the extent of correction.
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, there is no external skin incision or visible scar line. Fat may be repositioned and, in some cases, a small amount reduced, depending on your anatomy.
How it works
01
The 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.
02
Reached 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.
03
Repositioned, 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.
04
Erbium 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.
The same treatment, never the same plan.
the qd standard
Rather than a fashionable name or a fixed package, we weigh the structure found at examination, safety, recovery and the limits within one plan.
- 01DIAGNOSIS FIRSTCause before nameWe first separate out the tissue and the function behind your concern.
- 02LESS, PRECISEOnly as much as neededRather than an excessive change, we plan the smallest scope with a clear role.
- 03HONEST LIMITThe limits, explained tooWe explain the change you can expect, the alternatives, individual differences and the risks.
From consultation to follow-up, planned as one flow.
personal plan
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, 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. (Results vary by individual.)
Anatomy and function exam
We check the front and side views and expression, left-right differences, skin and deep tissue, and scars and function from earlier surgery.
Comparing scope and method
We compare incision and dissection, how much is removed, repositioned or fixed, the pros and cons of materials, and the option of no surgery at all.
Surgery and recovery plan
Anesthesia, preventing bleeding and infection, wound care, swelling and changes in sensation, and when to be seen again — all set out in one plan.
What the procedure is like
- Consultation, eye assessment and design
- Local anesthesia (with optional light sedation)
- Transconjunctival access with the erbium laser (inside the lower lid)
- Release and repositioning of the orbital fat over the rim
- Recovery and aftercare guidance (no external stitches)
Time: The procedure takes about 30–60 minutes.
Please read this before treatment
- Performed under local anesthesia; you can usually go home the same day.
- Expect temporary swelling and possible bruising for 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.
Safety & considerations
Possible reactions
- Temporary swelling and bruising around the lower eyelids
- A dry-eye or gritty sensation, or temporary watering, that usually settles
- Mild asymmetry between the two sides while swelling resolves
- Temporary numbness or tightness in the treated area
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
what to expect
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 refines. This is typically when the result is assessed. (Results vary by individual.)
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. (Results vary by individual.)
how it compares
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.
| 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 temporary volume above the hollow | 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 | External sutures; recovery over weeks |
Neither is “better” — they work differently and suit different goals. The right choice is decided after we assess your skin.
Before you decide, the questions people always ask
before consultation
The fat is reached through the conjunctiva on the inside of the eyelid, so no incision mark is left on the outer skin. If your eyelid skin needs to be addressed at the same time, an external approach may be necessary; we work out at your consultation which of the two applies to you and tell you beforehand.
Bruising generally fades over one to two weeks, and most of the swelling you can see from the outside settles within two weeks. The deeper swelling inside the tissue, however, takes one to three months to subside completely, and the final result can only be judged after about a year. We would encourage you not to draw hasty conclusions from how the area looks in the early days.
The fat that has been repositioned does not grow back. That said, if you gain a significant amount of weight, or if the skin and supporting tissue weaken over time, the area can look fuller than it did at first. We want to say in advance that this is not an operation that prevents the changes that come with age.
The procedure is carried out under local anesthesia. You will still feel pressure and a sense of tugging during surgery, but the pain is kept under control. If you tend to get very anxious, please let us know beforehand. High blood pressure, diabetes and any medication you are taking must be reported to us before surgery.
Eye makeup and contact lenses have to wait until the wound has healed, and the timing differs from person to person. We look at how you are healing after surgery and then tell you exactly when you can start again. Until then, it is important not to rub your eyes or press hard on them.
The medical information on this page was reviewed by Hong Sahyeok, plastic surgeon and Medical Director of QD Clinic.
personal consultation
Tell us what bothers you now, the change you want, what you have had done before and any dates that matter. We will compare the possible approaches and their limits, calmly.
Consult now