Whether or not double eyelid surgery can be performed without fat depends on the specific case, but if the surgery is purely aesthetic and the subcutaneous fat itself is small, it can also be removed without fat. In some cases, it is possible to remove only the skin and not the fat, for example, if the person wants a purely aesthetic effect, and the eyelids are in a good condition and there is no excessive accumulation of fat, so that the effect of the double eyelids is guaranteed after the operation, it is possible to realize this if the person wants to do so. However, if there is excessive accumulation of orbital fat in the upper eyelid or even ptosis in the case of puffy eyes, simply removing the skin will not achieve a better result, and lipectomy is not just an aesthetic act, but has a certain therapeutic effect. To determine whether or not to remove the fat, you need to go to a regular hospital or aesthetic organization and choose the most appropriate procedure under the advice of a professional.