This 33-year-old woman underwent treatment for under-eye bags and cheek descent. Through a transconjunctival approach behind the lower eyelid, the fat and retaining ligaments were addressed and the midface was repositioned. The oblique and frontal photographs show the early changes at one month.
Case summary
- Age: 33 years
- Primary concerns: under-eye bags and cheek descent
- Procedure: transconjunctival midface lift
- Treatment course: one operation followed by several postoperative examinations and follow-up visits
- Photographic time points: before surgery / one month after surgery
Priorities in this case
When under-eye fat protrusion and ligamentous tethering are present, the lower eyelid, under-eye bag and cheek can appear as a series of separate steps. The priority was therefore to treat the lower eyelid and midface as one continuous structure rather than flattening the under-eye area alone.
Without creating a visible skin incision, fat protrusion and ligamentous tethering were addressed together and the upper-cheek tissues were returned to a more appropriate position, aiming for a natural transition and gentle cheek contour.
Elevating the cheek apex can also help create a more youthful facial contour.
Procedure selected and its purpose
Transconjunctival midface lift
The procedure is performed through the conjunctival surface behind the lower eyelid. Under-eye fat, retaining ligaments and midface tissues are addressed to improve under-eye bags and midface descent without creating a visible incision on the skin.
Another procedure may be more appropriate when there is substantial excess skin or inadequate lower-eyelid support. The treatment plan is selected after each patient’s anatomy and findings are assessed.
Changes visible at one month
In the oblique view, the boundary between the under-eye prominence and the cheek is softer, producing a smoother transition from the lower eyelid into the cheek. In the frontal view, under-eye contour irregularity and midface heaviness are less apparent than before surgery.
At one month, swelling and tissue firmness may still be present. Contour and sensation may continue to change. Results and recovery vary between patients, and the same degree of change cannot be guaranteed.
Treatment course and fees
- Usual treatment period and number of visits: One operation, followed by several postoperative examinations and follow-up visits. The exact number varies between patients and may also differ according to the conditions of the monitor discount.
- Total fee for the procedures shown (tax included): ¥649,000 (including anesthesia; partial-face monitor discount applied)
- Breakdown: Transconjunctival midface lift (partial-face monitor) ¥484,000 + general anesthesia with mechanical ventilation ¥165,000
*The fees shown above apply at Cinderella & Da Vinci Clinic. International patients are accepted through Your Face Clinic. Please refer to the price list for international patients (PDF) for the applicable fees.
Principal risks, adverse effects and complications
Possible risks include bleeding, hematoma, infection, swelling, bruising, pain, altered sensation, dry-eye symptoms, asymmetry, contour irregularity, entropion, double vision and a result that differs from the patient’s expectations.
Author and medical review
- Written and medically reviewed by: Shoichi Sasaki, M.D.
- Created: July 26, 2026
For detailed information about treatment, fees, principal risks and potential adverse effects, please refer to the explanation provided during your consultation.