Have you ever wondered why tear grooves form and what sets them apart from dark circles? In this article, we'll unravel the mysteries behind under-eye issues, exploring the difference between tear trough deformity and dark circle. Discover how under-eye fat repositioning surgery can significantly enhance the under-eye area, diminishing wrinkles and rejuvenating your appearance.


Under eye fat repositioning surgery can improve not only sagging under the eyes but also dark circles. But do you know why tear grooves form and what makes them different from dark circles? We will tell you about the difference between the two and introduce how much better you can improve under-eye fat relocation, which improves wrinkles under the eyes, with a review of under-eye fat relocation.

1. What is the naso-jugal groove or tear trough deformity?

Tear troughs, those semicircular depressions under the eyes and on the nose, can be a common concern as we age. While some individuals naturally have a slight depression in this area, aging often accentuates the sunken appearance due to the deformation of the surrounding fat under the eyes.

2. Why do tear grooves form?

Facial bones play a crucial role in supporting the tissues around the eyes.

The orbital retaining ligaments, resembling a ring around the eye, become more pronounced as we age. Initially, when these ligaments hold the skin and muscle tightly, the tear trough may be less noticeable. However, as aging progresses, surrounding tissues sag, fat diminishes, and bones recede, making the tear troughs more prominent.

eyebags surgery
1 week after eyebags surgery

3. How are Dark Circles and Tear Troughs Different?

Darkness under eyes causes are multifactoral:

  • Pigmentation of the Skin Itself
    If you've noticed darkness since a young age, they may stem from inherent pigmentation issues. Toning lasers and similar treatments can enhance pigmentation.
  • Thin, See-Through Skin
    Thin skin can make underlying structures visible. Nano fat transplantation is an effective method to reduce the visibility of dark-circles by providing coverage.
  • Shadow Phenomenon
    Shadows beneath the eyes contribute to the appearance of dark circles. Fat relocation or lower eyelid surgery may be necessary, especially if a shadow is caused by darkening. Often, a combination of procedures is required due to the multifaceted nature of dark circle causes.

1) Dark circles How to get rid of?

If darkness have been observed since a young age, they are likely due to skin pigmentation or transparency caused by thin skin. Skin pigmentation can be improved with toning lasers, and transparency due to thin skin can be treated by covering the underlying structures with nano fat grafting (referring to a form of fat grafting with smaller fat particles than conventional fat grafting) to make the dark-circles less visible.

results of eye bag surgery along with laser
results of eye bag surgery along with laser
before and after of dark circle under eyes treatment
before and after of dark circle under eyes treatment
dark circle under eyes has been well treated along with aegyo-sal fat graft
darkness under eyes has been well treated along with aegyo-sal fat graft

2) Cases of severe under-eye hollowness

If the shadowing is due to hollowness, under-eye fat repositioning or lower eyelid surgery will be necessary.

bags under eyes surgery results
eyebags surgery before and after

In the above case, only under-eye fat repositioning was performed, but since dark circles are not caused by a single factor, it is often necessary to combine various procedures.

4. Does the Lower Lid Get Elongated with Age?

lower eyelid aging change
Picture of my 20's and 40's. The lower lid looks lengthened as I get older.

As we age, the once inconspicuous boundary between the lower lid and cheeks may become more pronounced, accompanied by sagging and tear grooves. This can give the illusion that the lower eyelids have stretched.

눈밑 노화 모식도
1= palpebromalar groove. 2 = tear trough. 3 = midcheek groove.

The area beneath the eyes, commonly referred to as the sky blue area, is often the initial indicator of facial aging. To address this, lower eyelid surgery or under-eye fat repositioning can be effective.

5. Lower Blepharoplasty and Fat Repositioning Under the Eyes

The core principle of eye surgery involves manipulating fat to create a softer boundary between the lower eyelid and cheek, thereby blending the lid-cheek junction. This is achieved by cutting the extraocular ligament.

To maintain the softened border and prevent the recurrence of the severed retaining ligament, fat is transferred (fat relocation). If insufficient, fat transplantation is considered. For more comprehensive information on the treatment of under-eye bags, click here.

6. Conclusion

Darkness under the eyes are considered one of the signs of aging, often exacerbated by under-eye hollows and tear-troughs. Treating these dark-circles depends on the underlying causes, categorized into cases where pigmentation is the sole issue (addressed with laser treatments) and more complex situations requiring a combination of treatments (laser + surgery). The challenge lies in identifying the exact cause of dark-circles before initiating treatment. Another difficulty in treatment is the multifaceted nature of its origins, necessitating a combination of various procedures. Some patients may hesitate to start treatment due to the uncertainty of pinpointing the exact cause. However, surgeries and treatment processes are not overly complex or challenging, and with a hospital adept at addressing the various causes of darkcircles, effective treatment can be achieved easily. The recovery period is also short, making it a feasible option for those facing multiple causes of darkness.