{"id":11761,"date":"2026-09-07T11:32:00","date_gmt":"2026-09-07T02:32:00","guid":{"rendered":"https:\/\/kojihifu.com\/english\/?p=11761"},"modified":"2026-09-07T12:04:30","modified_gmt":"2026-09-07T03:04:30","slug":"under-eye-bags-surgery-tokyo-2","status":"publish","type":"post","link":"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo-2\/","title":{"rendered":"Under Eye Bags Surgery Tokyo: Transconjunctival Guide"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"MedicalWebPage\",\"@id\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/#webpage\",\"url\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/\",\"name\":\"Under Eye Bags Surgery Tokyo: Transconjunctival Guide\",\"inLanguage\":\"en\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#website\"},\"about\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#clinic-biotope\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"lastReviewed\":\"2026-09-05\"},{\"@type\":[\"Article\",\"MedicalWebPage\"],\"@id\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/#webpage\"},\"headline\":\"Under Eye Bags Surgery Tokyo: Transconjunctival Guide\",\"url\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/\",\"inLanguage\":\"en\",\"author\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"publisher\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#organization\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/#webpage\"},\"description\":\"Under eye bags surgery in Tokyo: how transconjunctival blepharoplasty removes fat with no visible scar, plus recovery, costs and candidacy. Ask us today.\",\"datePublished\":\"2026-09-05\",\"dateModified\":\"2026-09-05\",\"lastReviewed\":\"2026-09-05\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/kojihifu.com\/english\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Skin & Dermatology\",\"item\":\"https:\/\/kojihifu.com\/english\/column\/skin-dermatology\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Under Eye Bags Surgery Tokyo: Transconjunctival Guide\",\"item\":\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/\"}]}]}<\/script><br \/>\n<script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"How long before I can return to work?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Many patients return to desk work within a few days, though visible bruising commonly persists for one to two weeks. In one published series, roughly two-thirds of patients had resumed social activities by the two-week mark.\"}}, {\"@type\": \"Question\", \"name\": \"Will the fat come back?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Fat that has been surgically removed does not regenerate, so the correction is generally durable. Ageing continues, however, and skin laxity or facial volume loss may create new concerns over the following years.\"}}, {\"@type\": \"Question\", \"name\": \"Can I wear contact lenses afterwards?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Contact lens wear is normally paused for a period after surgery while the conjunctiva heals, and your surgeon will specify the timing. Temporary dry eye is common in the early weeks and usually resolves within about three months.\"}}, {\"@type\": \"Question\", \"name\": \"Is this covered by Japanese health insurance?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"No. Cosmetic under-eye bag surgery is self-pay. Certain functional eyelid conditions, such as ptosis, may be assessed differently \u2014 this can be discussed at consultation.\"}}, {\"@type\": \"Question\", \"name\": \"Do I need to speak Japanese to be treated?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"No. Both clinics in the group provide English-language consultation, and enquiries can be made in English via LINE or WhatsApp.\"}}]}<\/script><\/p>\n<h2>Under-Eye Bags Surgery in Tokyo: Transconjunctival Blepharoplasty Explained<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Under-Eye Bags Surgery in Tokyo: Transconjunctival Blepharop\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_3373735_1788604769.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Under-Eye Bags Surgery in Tokyo: Transconjunctival Blepharop\" \/><\/figure>\n<p>If you have reached the point where concealer no longer hides the shadow under your eyes, and people keep telling you that you look tired when you feel fine, you are not imagining it. Under-eye bags are usually a structural change \u2014 orbital fat pushing forward against a thinning support layer \u2014 rather than a skincare problem.<\/p>\n<p>This article explains<strong> transconjunctival blepharoplasty<\/strong>, the incision-from-inside approach to under-eye bag surgery, in plain language: how it works, what the published evidence reports about results and complications, realistic costs in Tokyo, recovery timelines, and who is genuinely a good candidate.<\/p>\n<p><strong>What you&#8217;ll learn in this article:<\/strong><\/p>\n<ul>\n<li>What transconjunctival blepharoplasty is and why it leaves no visible skin scar<\/li>\n<li>How fat removal differs from fat repositioning, and when each is chosen<\/li>\n<li>What clinical studies report about satisfaction rates, swelling, and complications<\/li>\n<li>Current pricing at our Tokyo clinic group and what the fee includes<\/li>\n<li>Who is suited to this surgery \u2014 and who is better served by another treatment<\/li>\n<\/ul>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>What Is Transconjunctival Blepharoplasty?<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 What Is Transconjunctival Blepharoplasty\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_5997828_1788604770.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 What Is Transconjunctival Blepharoplasty\" \/><\/figure>\n<p>Transconjunctival blepharoplasty is a lower eyelid procedure performed through an incision on the inner surface of the eyelid \u2014 the conjunctiva \u2014 rather than through the skin. Because the incision sits inside the lid, there is no external scar on the eyelid skin.<\/p>\n<p>Through that opening, the surgeon accesses the three fat compartments (medial, central and lateral) that sit in front of the eyeball, cushioned by the orbital septum. With age, the septum weakens and this fat protrudes forward, creating the bulge people call an eye bag and the shadow directly beneath it.<\/p>\n<p>In Japanese clinics the procedure is commonly listed as <em>\u7d4c\u7d50\u819c\u8131\u8102\u6cd5<\/em> (keiketsumaku dasshi-h\u014d). English-speaking patients may encounter it as &#8220;transconjunctival lower blepharoplasty&#8221;, &#8220;transconjunctival lipectomy&#8221;, or simply &#8220;under-eye fat removal&#8221;.<\/p>\n<h3>Why a shadow appears even on young faces<\/h3>\n<p>The hollow at the junction between the lower lid and the cheek \u2014 the tear trough \u2014 is anchored by a retaining ligament. When fat bulges above that fixed line, the contrast between the bulge and the hollow reads as a dark semicircle, even in people in their late twenties or thirties with no pigmentation at all.<\/p>\n<h2>How the Procedure Works<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 How the Procedure Works\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_6048006_1788604770.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 How the Procedure Works\" \/><\/figure>\n<p>Surgery is typically performed under local anaesthesia, sometimes combined with nitrous oxide or intravenous sedation for patients who feel anxious. Most cases take roughly 30 to 60 minutes for both eyes, depending on technique.<\/p>\n<h3>Fat removal versus fat repositioning<\/h3>\n<p>There are two broad strategies, and the distinction matters more than most patients realise.<\/p>\n<p><strong>Fat removal (lipectomy):<\/strong> the protruding portion of fat is conservatively trimmed so the lid surface flattens. This suits patients whose main problem is the bulge itself, with a relatively shallow tear trough.<\/p>\n<p><strong>Fat repositioning (transposition):<\/strong> instead of discarding the fat, the surgeon releases it and lays it forward over the orbital rim to fill the hollow below. This suits patients whose bulge sits above a deep, sharply defined tear trough, where simple removal alone might leave the groove looking unchanged or even more obvious.<\/p>\n<p>A published retrospective series on refined orbital fat trimming emphasised that the volume removed must be judged individually rather than to a fixed amount, because over-resection produces a hollowed, aged appearance that is considerably harder to correct than the original bulge.<\/p>\n<h3>Closure<\/h3>\n<p>The conjunctival incision is frequently left to heal without sutures, or closed with fine absorbable stitches. Either way, nothing needs to be removed from the skin surface afterwards.<\/p>\n<h2>Comparing Your Options for Under-Eye Bags<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Comparing Your Options for Under-Eye Bags\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_14198477_1788604771.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Comparing Your Options for Under-Eye Bags\" \/><\/figure>\n<table style=\"border-collapse: collapse; width: 100%; margin: 20px 0; font-size: 0.95em; border: 1px solid #ccc;\">\n<thead>\n<tr>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Option<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Best suited to<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Incision \/ scar<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Typical downtime<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Longevity<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Transconjunctival blepharoplasty<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Protruding orbital fat with good skin quality and little excess skin<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Inside the eyelid; no external scar<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Visible swelling and bruising for roughly 1\u20132 weeks<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Long-lasting; removed fat does not return, though ageing continues<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Transcutaneous (subciliary) blepharoplasty<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Significant excess lower eyelid skin as well as fat<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Below the lash line; fine external scar<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Comparable to slightly longer; sutures removed at about 1 week<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Long-lasting<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Hyaluronic acid filler to the tear trough<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Hollowing with minimal or no fat bulge<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Needle or cannula only<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Minimal; occasional bruising<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Temporary; repeat treatment required<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Energy-based tightening (HIFU, RF microneedling such as Morpheus8)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Mild laxity and skin texture, no true fat herniation<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">None<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Little to none<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Gradual, temporary; maintenance sessions needed<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Filler and energy devices are legitimate treatments, but they address different problems. Injecting filler beneath a genuine fat bulge tends to add volume to an already crowded area, which is why an in-person assessment matters before choosing.<\/p>\n<h2>Expected Results and What the Evidence Shows<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Expected Results and What the Evidence Shows\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_3064717_1788604772.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Expected Results and What the Evidence Shows\" \/><\/figure>\n<p>Studies suggest satisfaction with this operation is generally high.<\/p>\n<p>A retrospective cohort of 97 patients undergoing transconjunctival lower blepharoplasty with refined fat trimming, published in <em>Medicine<\/em> in 2025, reported a mean FACE-Q Satisfaction with Eyes score of 3.63 out of 4, with 67.01% of patients &#8220;very satisfied&#8221; and 29.90% &#8220;somewhat satisfied&#8221;; 3.09% were somewhat dissatisfied and no major complications or reoperations were recorded.<\/p>\n<p>In that same series, minor issues were common but transient: mild chemosis (swelling of the conjunctiva) in 2.1%, temporary mid-facial numbness in 3.1% resolving within three weeks, and mild bleeding in 7.2%. Transient lid swelling occurred in essentially all patients and settled within eight weeks.<\/p>\n<p>A separate 2024 single-centre retrospective study of 88 patients in <em>Cureus<\/em> reported swelling in 78.41% and bruising in 87.5% at one week, both at 0% by six weeks, and symptomatic dry eye in 21.59% at one week resolving by twelve weeks. Around two-thirds of patients had resumed social activities by two weeks.<\/p>\n<p>Results are not a guarantee, and outcomes depend on anatomy, technique and healing. What the literature does support is that most patients see a meaningful flattening of the bulge with a low rate of serious complications.<\/p>\n<h3>Before, during and after: a realistic timeline<\/h3>\n<ul>\n<li><strong>Before:<\/strong> consultation, photographic assessment, and pre-operative blood work. Blood thinners, alcohol and smoking are discussed in advance.<\/li>\n<li><strong>Day of surgery:<\/strong> anaesthesia, roughly 30\u201360 minutes of operating time, then a short rest before going home the same day.<\/li>\n<li><strong>Days 1\u20133:<\/strong> peak swelling and bruising; cold compresses and sleeping with the head elevated help.<\/li>\n<li><strong>Week 1\u20132:<\/strong> most bruising fades; many patients return to work sooner if some concealer is acceptable.<\/li>\n<li><strong>Month 1\u20133:<\/strong> residual swelling resolves and the final contour becomes apparent.<\/li>\n<\/ul>\n<h2>Cost in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Cost in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_2078134_1788604773.webp\" alt=\"Under eye bags surgery Tokyo: transconjunctival bl \u2014 Cost in Tokyo\" \/><\/figure>\n<p>Under-eye bag surgery for cosmetic reasons is not covered by Japanese national health insurance. It is a self-pay (\u81ea\u7531\u8a3a\u7642) procedure, so fees vary between clinics and it is worth confirming exactly what is included.<\/p>\n<p>At our group&#8217;s aesthetic branch, the current published fees are as follows (all tax-inclusive):<\/p>\n<ul>\n<li>Transconjunctival fat removal for under-eye bags (\u7d4c\u7d50\u819c\u8131\u8102\u6cd5): 280,000 yen<\/li>\n<li>Lower eyelid sagging removal (\u4e0b\u773c\u77bc\u305f\u308b\u307f\u9664\u53bb): 320,000 yen<\/li>\n<li>Local anaesthesia: 22,000 yen; nitrous oxide sedation: 11,000 yen (used with local anaesthesia); intravenous sedation: 77,000 yen<\/li>\n<li>Pre-operative blood testing: 11,000 yen<\/li>\n<\/ul>\n<p>Please see the clinic&#8217;s official price page for the most current figures, as fees are subject to revision. When comparing quotes elsewhere, check whether anaesthesia, blood work and follow-up visits are bundled or billed separately \u2014 this is where advertised headline prices often diverge from the final total. For an accurate quote, please book a consultation.<\/p>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Who Is a Good Candidate \u2014 and Who Is Not<\/h2>\n<p>The classic indication has been recognised for decades. The 1993 retrospective analysis by Palmer and colleagues in <em>Archives of Otolaryngology\u2013Head &amp; Neck Surgery<\/em> concluded that patients with prominent orbital fat but without excess lower eyelid skin are the ideal candidates for the transconjunctival approach, and that inadequate fat removal \u2014 not lid malposition \u2014 was the most common shortcoming of the technique.<\/p>\n<h3>Likely to benefit<\/h3>\n<ul>\n<li>Visible fat bulges that become more obvious in downward lighting<\/li>\n<li>Reasonable skin elasticity, with little redundant skin<\/li>\n<li>Patients in their twenties to fifties whose concern is contour rather than skin texture<\/li>\n<li>Anyone who wants to avoid an external eyelid scar<\/li>\n<\/ul>\n<h3>Better served by something else, or requiring caution<\/h3>\n<ul>\n<li>Dark circles caused mainly by pigmentation or by thin, translucent skin \u2014 these do not respond to fat removal<\/li>\n<li>Significant loose lower eyelid skin, which may require a skin-tightening or transcutaneous approach in addition<\/li>\n<li>Pre-existing lower lid laxity, previous eyelid surgery, or thyroid eye disease \u2014 these need specialist assessment first<\/li>\n<li>Active eye infection, severe dry eye, uncontrolled bleeding disorders, or pregnancy<\/li>\n<\/ul>\n<p>At <strong>BIOTOPE CLINIC<\/strong> in Shirokanedai, we frequently see patients who arrive expecting surgery and turn out to have a mixed picture \u2014 a modest fat bulge combined with hollowing and pigmentation. In those cases the plan often involves discussing surgery alongside adjunct options such as hyaluronic acid filler or PicoWay laser for pigmentation. These are treatments available at <strong>BIOTOPE CLINIC<\/strong> \u2014 feel free to ask about them during a consultation with Dr. Karibe.<\/p>\n<h2>What People Often Get Wrong<\/h2>\n<h3>Misconception 1: &#8220;This surgery will get rid of my dark circles.&#8221;<\/h3>\n<p>It reliably addresses the shadow cast by protruding fat. It does not treat melanin pigmentation, nor the bluish tone caused by visible blood vessels beneath thin skin. Palmer and colleagues framed the candidacy question in exactly these anatomical terms \u2014 prominent fat, minimal excess skin \u2014 and that framing still holds. Patients whose darkness persists in flat, even lighting usually have a pigment or vascular component that needs a different treatment.<\/p>\n<h3>Misconception 2: &#8220;No external scar means no risk.&#8221;<\/h3>\n<p>Avoiding a skin incision does reduce certain problems. A 2025 meta-analysis in the <em>Journal of Clinical Medicine<\/em>, pooling 19 studies and 2,103 patients in the context of orbital and zygomaticofacial fracture repair, found the subciliary (through-the-skin) approach carried higher odds of ectropion, scleral show and visible scarring \u2014 but also found the transconjunctival approach carried higher odds of entropion, an inward-turning lid margin. That evidence comes from trauma surgery rather than cosmetic cases, so it should not be read as a direct complication rate for elective blepharoplasty, but it does illustrate the principle: each route has its own risk profile. Temporary dry eye, chemosis and asymmetry during healing are also realistic possibilities in the cosmetic setting.<\/p>\n<h2>Where to Get Under-Eye Bag Surgery in Tokyo<\/h2>\n<p>Within our clinic group, both <strong>BIOTOPE CLINIC<\/strong> (Shirokanedai, Minato-ku) and <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic<\/strong> (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Jun Karibe&#8217;s team. Transconjunctival blepharoplasty for under-eye bags is handled at <strong>BIOTOPE CLINIC<\/strong> in Shirokanedai, where Dr. Karibe personally consults. Bookings and enquiries in English: LINE or WhatsApp.<\/p>\n<p>The two clinics are sister facilities under the same medical group. Kojimachi handles insurance-covered general dermatology \u2014 eczema, acne, rashes, warts, moles \u2014 as well as general and aesthetic plastic surgery, while <strong>BIOTOPE CLINIC<\/strong> covers cosmetic dermatology, aesthetic surgery, injectables, regenerative medicine and men&#8217;s health.<\/p>\n<h2>Frequently Asked Questions<\/h2>\n<dl class=\"kj-faq\">\n<dt>Q. How long before I can return to work?<\/dt>\n<dd>Many patients return to desk work within a few days, though visible bruising commonly persists for one to two weeks. In one published series, roughly two-thirds of patients had resumed social activities by the two-week mark.<\/dd>\n<dd><\/dd>\n<dt>Q. Will the fat come back?<\/dt>\n<dd>Fat that has been surgically removed does not regenerate, so the correction is generally durable. Ageing continues, however, and skin laxity or facial volume loss may create new concerns over the following years.<\/dd>\n<dd><\/dd>\n<dt>Q. Can I wear contact lenses afterwards?<\/dt>\n<dd>Contact lens wear is normally paused for a period after surgery while the conjunctiva heals, and your surgeon will specify the timing. Temporary dry eye is common in the early weeks and usually resolves within about three months.<\/dd>\n<dd><\/dd>\n<dt>Q. Is this covered by Japanese health insurance?<\/dt>\n<dd>No. Cosmetic under-eye bag surgery is self-pay. Certain functional eyelid conditions, such as ptosis, may be assessed differently \u2014 this can be discussed at consultation.<\/dd>\n<dd><\/dd>\n<dt>Q. Do I need to speak Japanese to be treated?<\/dt>\n<dd>No. Both clinics in the group provide English-language consultation, and enquiries can be made in English via LINE or WhatsApp.<\/dd>\n<\/dl>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Summary<\/h2>\n<p><strong>Transconjunctival blepharoplasty<\/strong> treats under-eye bags by removing or repositioning protruding orbital fat through an incision inside the lower eyelid, leaving no external scar. Published series report high patient satisfaction and a low rate of serious complications, with swelling and bruising as the main short-term inconveniences.<\/p>\n<p>It is not a universal fix for dark circles. The strongest candidates are those whose concern is a genuine fat bulge with reasonably firm skin; pigmentation, thin skin or significant laxity call for different or additional approaches.<\/p>\n<p>If you have questions about under-eye bags surgery and transconjunctival blepharoplasty, both <strong>BIOTOPE CLINIC<\/strong> (Shirokanedai, Minato-ku) and Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Karibe and his team. Transconjunctival blepharoplasty is primarily handled at <strong>BIOTOPE CLINIC<\/strong> in Shirokanedai. English enquiries: LINE or WhatsApp.<\/p>\n<div class=\"kjmc-en-booking-box\" style=\"background: linear-gradient(135deg,#f1faf3 0%,#e6f3ea 100%); border-radius: 14px; padding: 32px 24px; margin: 36px 0 24px; border: 1px solid #c5dccd; text-align: center;\">\n<h3 style=\"margin: 0 0 8px; color: #3a6e3a; border: none; padding: 0; font-size: 1.3em;\">24\/7 Consultation &amp; Booking<\/h3>\n<div style=\"width: 48px; height: 2px; background: #3a6e3a; margin: 0 auto 22px;\"><\/div>\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 1.1em; font-weight: bold;\">Book a Consultation or Treatment<\/p>\n<p style=\"margin: 0 0 24px; color: #2c4a35; line-height: 1.75;\">Our English-speaking team responds via LINE or WhatsApp \u2014 usually the same day.<\/p>\n<p style=\"margin: 0 0 10px; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #06C755; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(6,199,85,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #25D366; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(37,211,102,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>References<\/h2>\n<ol>\n<li>Li W, Gao Y, Qi Z, Li Z, Wu F. Refined trimming of orbital fat in transconjunctival lower blepharoplasty: A retrospective cohort study on clinical outcomes and aesthetic assessment. Medicine (Baltimore). 2025.<\/li>\n<li>Gupta R, Khosa A, Bansal P, Chaudhury G. Exploring the Versatility of Transconjunctival Blepharoplasty: A Retrospective Single-Center Study. Cureus. 2024.<\/li>\n<li>Palmer FR 3rd, Rice DH, Churukian MM. Transconjunctival Blepharoplasty: Complications and Their Avoidance \u2014 A Retrospective Analysis and Review of the Literature. Archives of Otolaryngology\u2013Head &amp; Neck Surgery. 1993;119(9):993\u2013999.<\/li>\n<li>Chen YY, Lai YJ, Chen TY, Yen YF. Eyelid Complications in Subciliary Versus Transconjunctival Approaches to Orbital and Zygomaticofacial Fractures: A Meta-Analysis. Journal of Clinical Medicine. 2025.<\/li>\n<\/ol>\n<h2>Related Articles<\/h2>\n<p>You may also find these articles useful.<\/p>\n<ul>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-dark-circles-treatment-tokyo-2\/\" target=\"_blank\" rel=\"noopener\">Under Eye Dark Circles Treatment Tokyo: Injections vs Surgery<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-filler-tokyo-risks-benefits-3\/\" target=\"_blank\" rel=\"noopener\">Under Eye Filler Tokyo: Risks, Benefits &amp; Costs<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/ptosis-correction-surgery-tokyo\/\" target=\"_blank\" rel=\"noopener\">Ptosis Correction Surgery Tokyo: Droopy Eyelid Treatment<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/double-eyelid-surgery-tokyo-downtime-stay-flying\/\" target=\"_blank\" rel=\"noopener\">How Long Should You Stay in Tokyo for Double Eyelid Surgery? Downtime, Pain &amp; Flying Guide<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-filler-tokyo-risks-benefits-2\/\" target=\"_blank\" rel=\"noopener\">Under Eye Filler Tokyo: Risks, Benefits &amp; Results<\/a><\/li>\n<\/ul>\n<div style=\"margin: 2.5em 0 1em; padding: 1.5em; border: 1px solid #d5d5d5; border-radius: 10px; background: #fafafa; font-size: .9em;\">\n<p style=\"font-size: .72em; font-weight: bold; color: #888; margin: 0 0 1.2em; letter-spacing: .08em;\">SUPERVISED BY<\/p>\n<div style=\"display: flex; align-items: flex-start; gap: 1.2em; flex-wrap: wrap;\">\n<div style=\"flex-shrink: 0; text-align: center; min-width: 110px;\"><img decoding=\"async\" style=\"width: 100px; height: 100px; border-radius: 50%; object-fit: cover; object-position: top center; display: block; margin: 0 auto; border: 3px solid #e0e0e0;\" src=\"https:\/\/kojihifu.com\/hon\/wp-content\/uploads\/2022\/01\/photo-karibejun-400-3_re-300x300.jpg\" alt=\"Dr. Jun Karibe MD \u2014 Board-certified Plastic Surgeon, Director of Kojimachi Dermatology &amp; Plastic Surgery Clinic\" \/><\/p>\n<p style=\"margin: .6em 0 .1em; font-weight: bold; font-size: .95em; color: #222;\">Dr. Jun Karibe<\/p>\n<p style=\"margin: 0 0 .1em; font-size: .75em; color: #999;\">MD<\/p>\n<p style=\"margin: 0; font-size: .75em; color: #555; font-weight: bold;\">Director<\/p>\n<\/div>\n<div style=\"flex: 1; min-width: 200px;\">\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Education &amp; Career<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Juntendo University School of Medicine<\/div>\n<div>Department of Plastic Surgery, University of Tokyo Hospital<\/div>\n<div>Assistant Professor, Plastic &amp; Cosmetic Surgery, Saitama Medical University<\/div>\n<div>Assistant Professor &amp; Chief Resident, Yamanashi University Hospital<\/div>\n<div>2019: Founded Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Tokyo)<\/div>\n<div>2021: Founded BIOTOPE CLINIC Shirokanedai (Minato-ku, Tokyo)<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Certifications<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Specialist \u2014 Japan Society of Anti-Aging Medicine<\/div>\n<div>Certified Industrial Physician \u2014 Japan Medical Association<\/div>\n<div>Allergan VST-certified Injector (Botox &amp; Hyaluronic Acid)<\/div>\n<\/div>\n<\/div>\n<div style=\"background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Awards<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Best Presentation Award \u2014 Dept. of Plastic Surgery, University of Tokyo (2016)<\/div>\n<div>Excellence Award \u2014 Japan Society of Plastic and Reconstructive Surgery (2018)<\/div>\n<div>Featured Presentation \u2014 ASPS Annual Scientific Meeting, USA (2018)<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px solid #e8e8e8; display: flex; flex-wrap: wrap; align-items: center; gap: .5em;\"><a style=\"display: inline-block; background: #e1306c; color: #fff; padding: .4em .9em; border-radius: 4px; text-decoration: none; font-size: .8em; font-weight: bold;\" href=\"https:\/\/www.instagram.com\/dr.jun_\/\" target=\"_blank\" rel=\"noopener noreferrer\">Instagram<\/a><\/p>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px dashed #d5d5d5; font-size: .78em; color: #555; line-height: 1.7;\">\n<p style=\"margin: 0 0 .3em; font-size: .72em; font-weight: bold; color: #888; letter-spacing: .08em;\">MEDICAL REVIEW<\/p>\n<div><strong>Jun Karibe, MD<\/strong> \u2014 Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Medical Director, BIOTOPE CLINIC<\/div>\n<div>Last medically reviewed: 2026-09-05<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"Under eye bags surgery in Tokyo: how transconjunctival blepharoplasty removes fat with no visible scar, plus recovery, costs and candidacy. Ask us today.","protected":false},"author":4,"featured_media":11760,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21,22],"tags":[893,894,456,302,297,83,26],"class_list":["post-11761","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-skin-dermatology","category-plastic-surgery-tokyo","tag-lower-eyelid-surgery","tag-fat-repositioning","tag-transconjunctival","tag-eye-rejuvenation","tag-under-eye-bags","tag-blepharoplasty","tag-tokyo-clinic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/comments?post=11761"}],"version-history":[{"count":1,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11761\/revisions"}],"predecessor-version":[{"id":11786,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11761\/revisions\/11786"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media\/11760"}],"wp:attachment":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media?parent=11761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/categories?post=11761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/tags?post=11761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}