Under eye fat removal or repositioning, medically known as lower blepharoplasty, is a surgical procedure aimed at addressing the appearance of under-eye bags, puffiness, or hollows. The procedure typically begins with the administration of anesthesia, either local with sedation or general, depending on the patient's preference and the surgeon's recommendation. Once the patient is anesthetized, the surgeon makes a small incision either on the inside of the lower eyelid (transconjunctival approach) or just below the lower lash line (subciliary approach). Through this incision, the surgeon accesses the fat deposits that contribute to the puffy appearance. Depending on the case, the surgeon may remove excess fat or redistribute it to smooth out the under-eye area and create a more natural contour.

In instances where additional skin needs to be addressed, the surgeon may remove a small amount of skin to tighten and smooth the under-eye region. After the necessary adjustments are made, the incision is closed with fine sutures that minimize visible scarring. If a transconjunctival approach is used, the incision typically does not leave any visible scar since it is made inside the eyelid. Post-operatively, patients are advised on care routines to reduce swelling and bruising, such as applying cold compresses and keeping the head elevated. Recovery varies, but most patients can expect to return to normal activities within one to two weeks, with full results becoming evident as the healing process completes.