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2025.11.16
Does fat removal alone solve dark circles? ⸻ The balance between “bulges” and “hollows”
As a board-certified plastic surgeon, I have handled numerous cases involving trauma, reconstruction, and congenital conditions, cultivating precise techniques and deep anatomical understanding. Driven by the desire to deliver the transformative power of beauty—where visible change uplifts the spirit—I pursued a career in cosmetic surgery. My areas of expertise include comprehensive eye treatments, injectable therapies, and anti-sagging procedures. Guided by a commitment to sincerely address each patient's aspirations, I provide meticulously crafted treatments focused on achieving beauty.
Hello!
Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
We receive numerous inquiries such as "I want to remove my dark circles" or "I want to get rid of my dark circles," and it seems many people equate dark circle treatment with dark circle removal (fat removal).
Generally, “dark circle removal” refers to surgery to remove fat from the lower eyelid—specifically, fat removal.However, in society, the image of "bear removal = surgery to cure bears" seems to have taken precedence and become oversimplified, taking on a life of its own.
HoweverIn realityOnly a very small number of cases see dark circles improve significantly with fat removal alone.is.
As mentioned in the previous article, the reason dark circles are noticeable is the shadow created by the difference in height between the bulge and the hollow.
Reducing only the bulges won't give you a healthy appearance if the hollows remain.
Here, we will clearly explain why degreasing alone is insufficient.
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■ Fat removal can only address “bulge”
Fat removal is the cause of lower eyelid puffiness.Treatment to reduce orbital fat is.
Source: 'Facial Plastic Surgery, 1st Edition' (Nihon Iji Shinposha, 2021) p.74, Figure 1, modified and reproduced
For individuals with significant fat protrusion, it is true that fat removal can make the lower eyelids appear lighter and more defined.
However, many people simultaneously,tear trough(the indentation near the inner corner of the eye),nasojugal to mid-cheek groove(Indentation extending from the center outward)such asIt has a dent beneath the bulge.。
The main reason bears appear as shadows is that...The step created by this indentation causes light hitting from above to cast shadows. is.
If only degreasing is performed, only this indentation will remain.Far from eliminating shadows, it actually accentuates the hollows, risking an aged appearance.There is.
For those with a pronounced concave shape,Removing too much fat can create a more sunken appearance, so fat removal alone can only be performed conservatively.restrictions also come into play.
Since excision is a procedure prone to recurrence, a conservative resection volume increases the risk of recurrence several years later.
In other words, many people will need an approach to address their low points.
The essence of bear treatmentNot "how much fat to remove,"“How to smooth out the unevenness (protrusions × depressions)” is the keyThat's why.
Incidentally, cases where degreasing alone can achieve a perfect finish are rare; degreasing alone is sufficient only whenIn my opinion, About one in every 10 to 20 people.
However, there are rare casesFor those with minimal dents, degreasing alone is sufficient to achieve a clean finish.
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■ Treatment for Depressions
The primary treatments for the “indentation” causing the shadow are the following three:
① Fat injection
Fill in the hollow areas with your own fat to smoothly connect the tear trough to the mid-cheek. Unlike hyaluronic acid, it does not dissolve, providing long-term stability.
Nanofat, which consists of finely crushed fat, can be injected into the skin's superficial layers, allowing for precise adjustments.
② hyaluronic acid injection
This treatment involves minimal downtime and swelling. However, injecting hyaluronic acid into the superficial layers of the skin can cause the skin to appear bluish and translucent (the Tyndall effect), making fat grafting a better option for fine adjustments.
③ Hamra Method (Fat Transfer)
Instead of removing orbital fat,Surgery to move the indented side and eliminate the step。
This treatment addresses both bulges and indentations, making it the most structurally sound approach.
We will explain the Hamra method in detail in the next article.
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■ Summary
The essence of bears is,The three-dimensional difference between protrusions and depressions is emphasized by light, creating visible shadows.is.
Fat removal is a treatment targeting only the "bulge" within it.
As long as the indentation remains, the shadow won't disappear and may even make you look older.
That's precisely why,The core of bear treatment lies in how to eliminate the gap.。
Let's deepen our knowledge about "bear treatment," not "bear hunting."
What kind of treatment does your bear need?We will carefully assess your condition during the examination and propose the most appropriate treatment.
Please feel free to come in for counseling.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
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