When fat appears to bulge under the eyes (lower eyelids), two main methods are typically discussed: removing the fat or repositioning it. Lower eyelid surgery can be performed through an incision below the eyelashes or through the inner conjunctiva of the eyelid (transconjunctival approach). Fat removal is a method that reduces the protruding fat to alleviate the bulge, while fat repositioning is described as a technique that transfers the bulging fat to the hollow groove below (the under-eye shadow) to fill it in and create a smoother contour. Removing too much fat can actually make the area appear sunken or accentuate the shadows, so the amount of fat, the degree of under-eye hollows, and the condition of the skin must all be considered together. If there is significant skin laxity, skin tightening may also be considered. The appropriate approach depends on the individual’s anatomical characteristics; swelling and bruising are common, and recovery times vary significantly from person to person. This information is for informational purposes only and does not constitute a diagnosis. Please consult a specialist regarding actual procedures.
[Source] https://my.clevelandclinic.org/health/treatments/8409-eyelid-surgery-blepharoplasty