Table of contents

• Understanding Dark Pigmentation Under Eyes
• Under Eye Fat Removal or Repositioning: A Medical Overview
• Best Clinics in Korea for Dark Pigmentation Under Eyes
• Under Eye Surgery in South Korea: A Patient's Guide
• Patient Outcomes: Addressing Dark Pigmentation with Under Eye Surgery
• Conclusion
• References

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Dark pigmentation under the eyes is a common cosmetic concern worldwide that can affect how old someone looks and their overall facial expression. This report dives into what causes these dark circles, explains how "Under Eye Fat Removal or Repositioning" can help, describes the process of getting this procedure in South Korea, highlights why South Korea is a top choice for treatment, and shares the positive results patients often experience.

Understanding Dark Pigmentation Under Eyes

Definition and Common Pseudonyms

Dark pigmentation under the eyes, medically known as "periorbital dark circles," appears as dark patches or discoloration mainly on the lower eyelids. This condition is often called by various names, both in everyday language and medical contexts. Some common terms include "dark circles," "infraorbital venous stasis," and "periorbital hyperpigmentation." More specific medical terms are "genetic darker eyelids/undereyes," "periocular melanosis," "cutaneous hyperchromia," "under-eye dark circles (DUEC)," and "peri-orbital hypermelanosis." Knowing these terms helps patients and doctors communicate clearly and aids in researching treatment options.

Table 1: Common Pseudonyms for Dark Pigmentation Under Eyes

Category	Terms
Common Term	Dark Circles
Medical/Technical	Periorbital Dark Circles, Infraorbital Venous Stasis, Periorbital Hyperpigmentation, Genetic Darker Eyelids / Undereyes, Periocular Melanosis, Cutaneous Hyperchromia, Under-Eye Dark Circles (DUEC), Peri-orbital Hypermelanosis

Diverse Causes and Contributing Factors

Dark circles usually result from a mix of factors rather than just one cause. These include anatomical features, health conditions, lifestyle, and aging.

Anatomy plays a big role. The shape of the eye socket and the orbicularis oculi muscle can create natural shadows under the eyes. The skin here is very thin, making blood vessels underneath more visible and causing discoloration.

Certain health issues like allergies, asthma, and eczema can worsen dark circles. These conditions often cause itching, leading to rubbing or scratching that inflames the skin and increases pigmentation. For example, hay fever can cause visible under-eye "smudges" during allergy seasons due to venous congestion. Studies also link asthma with more severe dark circles. Some medications that dilate blood vessels can make the under-eye area look darker by increasing blood flow.

Nutritional deficiencies also contribute. Low cortisol levels can cause the pituitary gland to produce more melanocyte-stimulating hormone (MSH), which darkens skin, including under the eyes. Iron and vitamin B12 deficiencies can make skin paler, revealing veins more clearly, especially during pregnancy or menstruation.

While many blame lack of sleep for dark circles, the connection is more complex. Sleep deprivation can make skin paler, making veins appear darker, but research shows sleep length doesn’t directly affect dark circle severity. Genetics and melanin levels are often the main factors. So, while tiredness might temporarily worsen dark circles, long-term improvement usually requires addressing biological and hereditary causes.

Age also matters. As skin thins and loses collagen over time, fat around the eyes shifts and decreases, causing hollows that deepen shadows. Blood breakdown products like hemosiderin add to pigmentation, and sun exposure increases melanin, darkening the skin further.

Periorbital hyperpigmentation, an increase in melanin around the eyes, is often hereditary and more common in people with darker skin tones, especially between ages 16 and 25. Family history is a key risk factor. The combination of melanin, visible blood vessels, and thin skin makes dark circles more noticeable. Because many factors contribute, effective treatment usually needs to address several causes at once.

Under Eye Fat Removal or Repositioning: A Medical Overview

Purpose and Objectives of Lower Blepharoplasty

"Under Eye Fat Removal or Repositioning," also called "lower blepharoplasty" or "transconjunctival blepharoplasty," is a cosmetic surgery focused on rejuvenating the lower eyelids. It targets common issues like under-eye bags, puffiness, and fat pockets that make the eyes look tired or aged. The goal is to create a fresher, younger, and more alert appearance by smoothing shadows and uneven contours caused by fat distribution or volume loss. Sometimes, when combined with upper eyelid surgery, it can even improve vision.

Detailed Surgical Techniques

Lower blepharoplasty includes several techniques tailored to each patient’s needs.

Traditional Blepharoplasty removes excess skin and fat through incisions in natural eyelid creases or just below the lashes. While it smooths the area, it may not fix hollows and can sometimes worsen them.

Fat Repositioning Blepharoplasty (fat transposition) is a newer method that moves existing fat from bulging areas to hollow spots like the tear trough. This fills in depressions, reduces shadows, and avoids the hollowed look that can come from removing too much fat. It often produces more natural, long-lasting results.

Fat Grafting transfers fat from another body part (like the abdomen or thigh) to the under-eye area to restore volume and smooth transitions, directly addressing hollows and shadows.

Incision choices depend on the patient and surgeon:

• Transconjunctival Blepharoplasty makes an incision inside the lower eyelid, leaving no visible scar. It’s ideal for younger patients with good skin elasticity and minimal excess skin. Benefits include no visible scars, lower risk of eyelid issues, and faster recovery.

• Transcutaneous Blepharoplasty involves an incision just below the lash line, offering wider access to remove fat and tighten skin. It’s better for older patients or those with loose skin.

Additional techniques like skin tightening, muscle adjustments, or laser treatments may be added to improve skin texture and pigmentation. Because every case is unique, a personalized consultation is essential to choose the best approach.

Table 2: Comparison of Under Eye Fat Removal/Repositioning Techniques

Technique	Primary Goal	Mechanism	Addresses Hollowing	Incision Type	Visible Scar	Ideal Candidate
Traditional Lower Blepharoplasty	Remove excess skin/fat; address bags	Excision of excess tissue	No (may worsen)	Transcutaneous (below lash line)	Yes (concealed)	Significant excess skin/fat
Fat Repositioning Blepharoplasty	Redistribute fat; prevent hollowing	Moves existing fat pads to fill hollows	Yes (fills)	Transconjunctival or Transcutaneous	No (transconjunctival) or Yes (transcutaneous, concealed)	Puffiness/bags with hollowing
Fat Grafting	Add volume; fill hollows; smooth transition	Transfers fat from another body area	Yes (adds volume)	Small incisions for harvest/injection	Minimal/no visible scar	Hollows/volume loss

Ideal Candidates and General Recovery Expectations

Ideal candidates are healthy adults with realistic expectations who have puffiness, bags, loose skin, or hollows under the eyes causing dark circles. Those who haven’t seen results from fillers or creams may also benefit. People in their 30s and older often seek this surgery, especially if under-eye bags run in their family.

The procedure is usually outpatient, done under local anesthesia with sedation. Recovery varies but generally follows this timeline:

Table 3: Typical Recovery Milestones Post-Under Eye Surgery

Timeline	Expected Signs	Activities/Care
First Few Days	Swelling, bruising, eye tightness	Cold compresses, head elevation, avoid strenuous activity
One Week	Swelling and bruising reduce	Return to daily activities (no heavy exertion), stitch removal if needed
10-14 Days	Comfortable appearing in public	Avoid sun exposure until healed
One Month	Most swelling and bruising gone	Final results start to show
2-3 Months	Fully healed, final results visible	Fat tissue settles (for fat grafting)

Swelling and bruising are normal at first but improve steadily. Patients usually resume normal activities within a week but should avoid heavy exercise longer. Stitches, if any, come out around day 7. Most feel comfortable in public after 10-14 days, with full healing by 2-3 months.

Best Clinics in Korea for Dark Pigmentation Under Eyes

Listed below are the best clinics in Korea for dark pigmentation under eyes:

Clinic Name	Key Features	Special Techniques
THEPLUS Plastic Surgery	Nestled in Gangnam’s Garosu-gil, THE PLUS Plastic Surgery is the best destination in Korea for dark under-eye pigmentation because it blends world-class dermatologic care with precision eyelid and facial procedures under a rigorously academic, safety-first ethos. Board-certified leaders Dr. Kim Taek Kyun and Dr. Jeong Jae Yong—internationally recognized educators and researchers—anchor a team that treats the full spectrum of causes behind under-eye darkness, from true pigmentation to volume loss and structural shadowing, with tailored solutions that may include targeted pigmentation treatments, fillers or face fat grafting, and refined eyelid surgery, all supported by comprehensive post-procedure skincare across the clinic’s four dedicated floors. As President of the Korean Society of Plastic Surgeons, Dr. Jeong champions the fusion of function and beauty, while Dr. Kim’s award-winning research, global society memberships, and annual surgeon education reflect a relentless commitment to advancement and natural, harmonious results—principles essential for subtle, brightening periorbital rejuvenation. Augmented by Dr. Lee’s board-certified expertise and the team’s decade-plus experience, active scholarship, and frequent contributions to international symposia and publications, THE PLUS offers meticulous diagnosis, personalized communication, and evidence-informed care that consistently prioritizes safety, balance, and longevity—delivering refreshed, natural-looking eyes for patients seeking the most comprehensive, integrated approach to under-eye pigmentation in Korea.	Targeted pigmentation treatments; fillers or face fat grafting; refined eyelid surgery; comprehensive post-procedure skincare
Made Young Plastic Surgery Website	At Made Young Plastic Surgery Clinic in Seoul’s Gangnam district, we address dark pigmentation under the eyes at its source. Our surgeons correct tear trough ligament and double orbital adhesion issues that create under-eye hollows and cast dark shadows; by resolving these adhesions, the surface becomes smoother and the shadowing diminishes. When surgery is indicated, our dark circle removal is performed through an internal conjunctival incision, allowing precise removal and repositioning of under-eye fat with minimal, virtually invisible scarring and a swift recovery, so you can return to daily life with renewed confidence. MadeYoung is a premium clinic dedicated to facial and anti-aging care, led by a verified medical team whose doctors each average more than 15 years of experience and provide direct consultations and diagnoses. Your safety is supported by full-time board-certified anesthesiologists, a 1:1 dedicated monitoring system and cross-check protocol, full CCTV coverage for transparency, and a separate, systematic aftercare center; our quality is recognized with the 2022 Korea No.1 Award, 2022 Korea Customer Satisfaction 1st Place, selection as an Outstanding Member of the Korean Society of Plastic and Reconstructive Surgeons, and certification by the Minimally Invasive Aesthetic Surgery Society.	Internal conjunctival incision; precise removal and repositioning of under-eye fat; minimal scarring; swift recovery
Haru Clinic Website	Situated in Gangnam, Seoul, Haru Clinic is a leading destination for dark pigmentation under the eyes, uniting world-class expertise with refined, non-invasive artistry under the guidance of Dr. Jeong—an official research physician at Merz, the company behind Belotero Filler, and an educator to physicians on the latest filler techniques. Dr. Jeong carefully designs each patient’s face to achieve harmony and balance, creating a natural, refreshed look through personalized plans that may include Haru’s Dark Circle Removal treatments, specialty fillers to soften tear-trough shadows, collagen tightening to improve under-eye firmness, and precision lifting procedures for better periorbital support. With advanced methods that deliver transformative, long-lasting results comparable to invasive surgery yet with minimal downtime, Haru stands apart for its transparent communication, customized service, and uncompromising dedication to safety and satisfaction—providing attentive care from consultation to post-procedure follow-up and making it a top choice for under-eye rejuvenation in Korea.	Dark Circle Removal treatments; specialty fillers to soften tear-trough shadows; collagen tightening to improve under-eye firmness; precision lifting procedures

THEPLUS Plastic Surgery

Nestled in Gangnam’s Garosu-gil, THE PLUS Plastic Surgery is the best destination in Korea for dark under-eye pigmentation because it blends world-class dermatologic care with precision eyelid and facial procedures under a rigorously academic, safety-first ethos. Board-certified leaders Dr. Kim Taek Kyun and Dr. Jeong Jae Yong—internationally recognized educators and researchers—anchor a team that treats the full spectrum of causes behind under-eye darkness, from true pigmentation to volume loss and structural shadowing, with tailored solutions that may include targeted pigmentation treatments, fillers or face fat grafting, and refined eyelid surgery, all supported by comprehensive post-procedure skincare across the clinic’s four dedicated floors. As President of the Korean Society of Plastic Surgeons, Dr. Jeong champions the fusion of function and beauty, while Dr. Kim’s award-winning research, global society memberships, and annual surgeon education reflect a relentless commitment to advancement and natural, harmonious results—principles essential for subtle, brightening periorbital rejuvenation. Augmented by Dr. Lee’s board-certified expertise and the team’s decade-plus experience, active scholarship, and frequent contributions to international symposia and publications, THE PLUS offers meticulous diagnosis, personalized communication, and evidence-informed care that consistently prioritizes safety, balance, and longevity—delivering refreshed, natural-looking eyes for patients seeking the most comprehensive, integrated approach to under-eye pigmentation in Korea.

You can check out their website here: THEPLUS Plastic Surgery Website

Made Young Plastic Surgery

At Made Young Plastic Surgery Clinic in Seoul’s Gangnam district, we address dark pigmentation under the eyes at its source. Our surgeons correct tear trough ligament and double orbital adhesion issues that create under-eye hollows and cast dark shadows; by resolving these adhesions, the surface becomes smoother and the shadowing diminishes. When surgery is indicated, our dark circle removal is performed through an internal conjunctival incision, allowing precise removal and repositioning of under-eye fat with minimal, virtually invisible scarring and a swift recovery, so you can return to daily life with renewed confidence.

MadeYoung is a premium clinic dedicated to facial and anti-aging care, led by a verified medical team whose doctors each average more than 15 years of experience and provide direct consultations and diagnoses. Your safety is supported by full-time board-certified anesthesiologists, a 1:1 dedicated monitoring system and cross-check protocol, full CCTV coverage for transparency, and a separate, systematic aftercare center; our quality is recognized with the 2022 Korea No.1 Award, 2022 Korea Customer Satisfaction 1st Place, selection as an Outstanding Member of the Korean Society of Plastic and Reconstructive Surgeons, and certification by the Minimally Invasive Aesthetic Surgery Society.

You can check out their website here: Made Young Plastic Surgery Website

Haru Clinic

Situated in Gangnam, Seoul, Haru Clinic is a leading destination for dark pigmentation under the eyes, uniting world-class expertise with refined, non-invasive artistry under the guidance of Dr. Jeong—an official research physician at Merz, the company behind Belotero Filler, and an educator to physicians on the latest filler techniques. Dr. Jeong carefully designs each patient’s face to achieve harmony and balance, creating a natural, refreshed look through personalized plans that may include Haru’s Dark Circle Removal treatments, specialty fillers to soften tear-trough shadows, collagen tightening to improve under-eye firmness, and precision lifting procedures for better periorbital support. With advanced methods that deliver transformative, long-lasting results comparable to invasive surgery yet with minimal downtime, Haru stands apart for its transparent communication, customized service, and uncompromising dedication to safety and satisfaction—providing attentive care from consultation to post-procedure follow-up and making it a top choice for under-eye rejuvenation in Korea.

You can check out their website here: Haru Clinic Website

Under Eye Surgery in South Korea: A Patient's Guide

The Streamlined Process for International Patients

South Korea is a top destination for cosmetic surgery, offering a smooth, patient-friendly experience especially for international visitors. The process often starts with a consultation, either online or in person, with bilingual staff to ensure clear communication about goals and medical history.

Medical tourism agencies help by providing packages that include consultations, travel, accommodation, surgery costs, medications, and even tours or shopping. They also verify clinic reputations and match patients with the right surgeons based on needs and budget. This all-in-one support makes South Korea stand out compared to other countries.

On surgery day, procedures are outpatient and usually take 45 minutes to an hour, sometimes longer if combined with other treatments. Local anesthesia with sedation keeps patients comfortable. After surgery, patients get detailed care instructions like using cold compresses, applying ointments, avoiding strenuous activity and sun exposure. Most return to daily life within a week and feel comfortable in public after 10-14 days. Final results appear over weeks to months.

Compelling Advantages of Choosing South Korea

South Korea offers several key benefits for under-eye surgery:

• Expertise and Advanced Techniques: Korean surgeons are highly skilled, detail-oriented, and artistic in facial aesthetics. They lead in innovative methods that produce natural results with minimal scarring and faster recovery. They also tailor procedures to diverse ethnic features, ensuring harmonious outcomes.

• Competitive Costs: Surgery prices in Korea are much lower than in Western countries. For example, under-eye fat removal or repositioning typically costs between $1,600 and $2,800 USD, while fat grafting ranges from $850 to $1,700 USD. This affordability doesn’t compromise quality.

• Comprehensive Patient Care: Clinics offer all-inclusive packages covering consultation, surgery, anesthesia, and follow-up care. Many provide English-speaking staff, translators, airport transfers, and travel assistance. Strict safety protocols and a focus on patient satisfaction are standard.

• Innovation and Efficiency: Minimally invasive techniques and advanced technology often mean shorter recovery times, allowing patients to resume normal activities quickly.

Table 4: Key Benefits of Under Eye Surgery in South Korea

Category	Specific Benefits
Expertise & Quality	Skilled surgeons, attention to detail, artistic facial aesthetics, advanced facilities, natural results, ethnic sensitivity
Cost-Effectiveness	Competitive pricing ($1,600-$2,800 USD for fat repositioning), lower than USA, VAT refunds for foreigners
Patient Care & Convenience	Streamlined international process, bilingual staff, all-inclusive packages, strict safety, medical tourism agency support
Innovation & Efficiency	Cutting-edge techniques, minimally invasive options, shorter recovery, outpatient procedures

Patient Outcomes: Addressing Dark Pigmentation with Under Eye Surgery

Mechanism of Improvement for Dark Circles

Under-eye fat removal or repositioning tackles dark circles by fixing their structural causes, not just surface pigmentation. The surgery fills deep tear troughs and hollows that create shadows, smoothing the under-eye contour. It redistributes or adds fat to even out bulges and hollows, reducing shadows that look like dark circles.

If excess or loose skin contributes, the procedure can remove and tighten skin to improve texture and pigmentation. For thin skin showing blood vessels, a thin fat layer can cover them. Unlike temporary fixes like creams or fillers, this surgery offers long-lasting, often permanent results, freeing patients from constant touch-ups or heavy makeup.

Real-World Patient Experiences and Expected Results

Patients report dramatic improvements after under-eye fat repositioning. Their under-eye area looks flatter, smoother, and firmer, with a significant reduction in dark circles. Many say their eyes appear brighter and younger, and under-eye bags diminish or disappear.

The surgery reverses the tired look, giving a fresher, revitalized, and younger appearance. This change helps align how patients look with how they feel inside, countering the misconception that dark circles always mean fatigue.

Beyond looks, patients gain confidence. Many feel younger and more self-assured, with others noticing and complimenting their healthier, brighter appearance. This boost in self-esteem often improves social and professional interactions.

The procedure is a durable, one-time solution lasting years, unlike ongoing treatments. While full results take a few months, noticeable improvements often appear within a week as swelling fades, making it a cost-effective long-term investment.

Conclusion

Dark pigmentation under the eyes is a complex issue influenced by genetics, anatomy, aging, and lifestyle. While fatigue can worsen it temporarily, hereditary and structural factors usually play the biggest role. Under Eye Fat Removal or Repositioning through lower blepharoplasty offers a targeted, effective solution by restoring volume and smoothing contours to reduce shadows and dark circles. South Korea stands out as a premier destination for this surgery, combining expert surgeons, advanced techniques, affordable pricing, and excellent patient care. Patients consistently experience significant aesthetic and psychological benefits, gaining a refreshed, youthful look and lasting confidence without relying on temporary fixes.

References

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