Just beneath the eyelid skin sits the orbicularis oculi — a ring of muscle responsible for blinking and closing the eye. Beneath that is the orbital septum, a thin membrane that acts as a barrier holding the eye's fat pads in place behind it. In the upper lid, that fat sits in two compartments; in the lower lid, three — separated from one another by small muscles and ligaments that anchor the septum to the surrounding bone.
With age, the septum itself weakens and stretches. It's this weakening, not an actual increase in fat volume, that lets the fat pads bulge forward — producing upper-lid heaviness and the puffiness commonly called "bags" under the eyes.
Why fat repositioning, not just removal, matters
Because the septum's job is to contain fat rather than create it, simply removing the bulging fat treats the symptom without addressing the surrounding hollowing that often develops alongside it — which is what produces the sunken, over-operated look sometimes seen years after an older-style blepharoplasty.
Dr. Kim's approach in the lower lid is frequently to reposition the fat pad forward over the orbital rim to fill the hollow tear-trough area, rather than discarding it — working with the eyelid's existing anatomy instead of against it. In the upper lid, the levator muscle — the structure that lifts the eyelid itself — is carefully preserved and protected throughout, since it, not the skin removed, is what determines how the eye opens after surgery.
