In-Depth Guide to "Lower Blepharoplasty": Solving Tired Eyes with Fat Repositioning and Midface Lift Techniques

Last updated: 29 Dec 2025

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Do you get a full night's sleep but still wake up looking tired? Do people often comment that you look fatigued or older than your actual age? These issues are frequently caused by "Eye Bags" (protruding fat pads) and deep tear troughs—signs of aging that even the best concealers struggle to hide.

Today, lower eyelid surgery is no longer just about cutting away excess skin. Advanced medical techniques have evolved to deliver natural, youthful results. In this article, ALINE Clinic will guide you through 5 advanced techniques tailored to specific problems, including Inner Incision (Transconjunctival), Outer Incision, Fat Repositioning, Canthopexy, and Midface Lifts, helping you choose the best solution for your eyes.

Diagnosis First: What Type of Eye Bag Problem Do You Have?

Before discussing treatments, it is crucial to understand that not all under-eye issues are the same. They generally fall into these categories:

Fat Protrusion: Distinct, puffy bulges of fat under the eyes.
Skin Laxity: Wrinkles, crepey skin, and lack of firmness.
Tear Trough Deformity: Deep hollows or grooves under the eyes, creating a tired, sunken look.
Midface Ptosis: Sagging cheek tissue, which accentuates the under-eye hollows.

At ALINE Clinic, our specialists perform a detailed facial structural analysis because each problem requires a specific surgical approach.

5 Popular Lower Blepharoplasty Techniques at ALINE Clinic

To achieve a beautiful, permanent, and youthful result, the technique must match your specific anatomy:

1. Inner Incision (Transconjunctival Blepharoplasty)

The Inner Incision technique involves making a small incision inside the lower eyelid (the conjunctiva), leaving the external skin untouched.

Best Candidates: Younger patients or those with only bulging fat pads but good skin elasticity and no significant wrinkles.
Key Benefits: 100% scarless externally, minimal swelling, no stitches to remove, and the fastest recovery time.

2. Outer Incision (Subciliary Incision)

For the Outer Incision technique, the surgeon makes an incision just below the lower lash line to access the problem area.

Best Candidates: Individuals with Skin Laxity, significant under-eye wrinkles, or sagging orbicularis muscle.
Key Benefits: Allows for the removal of excess skin and tightening of the under-eye area—something the inner incision cannot do. While there is an incision, the scar is hidden neatly along the lash line and becomes virtually invisible once healed.

3. Fat Repositioning (Under-Eye Fat Transposition)

This technique is a "Game Changer" in modern eye surgery. Simply removing fat can sometimes leave the eyes looking hollow and sunken.

The Concept: Instead of discarding the protruding fat, the surgeon preserves it and "repositions" it to fill in the deep Tear Troughs. (This can be combined with both Inner and Outer incisions).
Key Benefits: It is the most effective solution for deep hollows. The under-eye area becomes smooth and full, creating a naturally youthful appearance and reducing the chance of recurring eye bags.

4. Canthopexy (Lateral Canthal Suspension)

For older patients or those with prominent/round eyes, there is a risk of the lower eyelid sagging (Ectropion) after surgery.

The Concept: A procedure to tighten the lower eyelid tendon and anchor it securely to the orbital rim.
Key Benefits: Prevents postoperative eyelid retraction (ectropion) and can slightly lift the outer corner of the eye for a "Foxy Eye" look, resolving droopy eyes for a brighter appearance.

5. Midface Lift

In severe cases involving Eye Bags, wrinkled skin, and sagging cheeks with deep nasolabial folds, treating the eyes alone may not be enough.

The Concept: Through the lower eyelid incision, the surgeon accesses the midface area to lift and tighten the cheek fat pads (SOOF).
Key Benefits: A "2-in-1" result—eye bags are eliminated, and cheeks are lifted. Nasolabial folds are softened, making the entire face look instantly younger.

Comparison: Which Technique Should You Choose?

To make it easier to decide, here is a quick summary:

Young / Only Bulging Fat: Choose Inner Incision (No visible scar).
Wrinkles / Sagging Skin: Choose Outer Incision (Removes excess skin).
Deep Hollows / Tear Troughs: Must include Fat Repositioning (Fills the hollows).
Droopy Outer Eyes / Weak Tendons: Add Canthopexy (Prevents sagging/ectropion).
Sagging Cheeks / Deep Smile Lines: Add Midface Lift (Lifts the cheeks).

Aftercare: How to Maintain Beautiful Results

Excellent surgical results depend on excellent aftercare:

Cold Compress: Apply strictly for the first 48 hours to minimize swelling.
Elevate Head: Sleep with high pillows for the first 3-5 days to reduce bruising.
Avoid Rubbing: Do not rub your eyes vigorously and keep the wound dry until stitches are removed.
Dietary Restrictions: Avoid fermented foods, alcohol, and supplements that thin the blood for at least 2 weeks.

How Much Does Lower Blepharoplasty Cost?

A common question is, "How much does eye bag surgery cost?" The cost varies depending on the complexity of the case and the techniques used (e.g., simple fat removal vs. Fat Repositioning or combining with a Midface Lift).
At ALINE Clinic, we focus on delivering high-quality, worthwhile results at reasonable prices. Our Lower Blepharoplasty starts at just 19,900 THB. To get an accurate quote and a treatment plan tailored to your budget and needs, we highly recommend scheduling a consultation for a personalized facial analysis.

Conclusion: Where to Get Eye Bag Surgery?

Eyelid surgery is a delicate art. It is not just about removing fat; it is about "designing" new eyes that harmonize with your face. Whether you are worried about Eye Bags, wrinkles, or deep hollows, and aren't sure if you need Fat Repositioning or a Midface Lift, we can help.

At ALINE Clinic (Korat), our team of medical experts prioritizes Case-by-Case analysis to select the best technique for you. regain your youthful, bright eyes with confidence in our safety standards.

Consult on Eye Bag problems or get a facial assessment at ALINE Clinic:

LINE OA: @alineclinic
Facebook: ALINE Clinic
Tel: 099-269-2663