Background: Transconjunctival orbital fat removal has exhibited an increasing trend in Japan. This study, conducted in more than 100 clinics in Japan, aimed to contribute to the evolving body of evidence guiding surgical procedures.
Methods: We analyzed data from our institutional database of 127,505 patients who underwent orbital fat removal for dark circles under the eyes at our clinic. Parameters evaluated included age, sex, occupation, number of debridement sites, medications, and comorbidities.
Results: The number of procedures has been increasing annually, surpassing 70,000 in 2023. A total of 86.5% of patients were women and 13% were men. The top 3 occupations of patients included company employees (46.2%), housewives (10.4%), and others (9.9%). The median age of patients was 43 (range 33-51) years, showing a trend toward older age. Nearly all excess orbital fatty areas were removed via total resection. Patients undergoing total resection were significantly older on average compared with those undergoing partial resection. Comorbidities, including hypertension, glaucoma, and retinal disease, tended to increase annually. Both steroids and antiplatelet/anticoagulant medications were increasingly used, with the former accounting for 26.5 patients per month and the latter for 10.8 patients per month in the last year.
Conclusions: The number of middle-aged and older patients is increasing, suggesting a future increase in procedures. The aging demographic will likely lead to a higher prevalence of comorbidities and high-risk medications in the patient population. Surgeons must be aware of these risk factors and possess the skills to manage them safely and effectively.
Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.