Background: To quantify the surgical outcomes of transconjunctival fat repositioning technique, we study the lower periorbital area with magnetic resonance imaging (MRI) and three-dimensional (3D) surface imaging. Methods: The preoperative and postoperative images were analyzed. The T1-weighted MR images in the quasi-sagittal plane parallel to the long axis of the orbit and passing through the globe center were used to measure the transposed fat, and 3D comparison was performed to calculate the tear trough depth. Changes throughout the surgery and their relationships with clinical characteristics were statistically analyzed. Results: A total of 11 patients who underwent surgery were included. The mean follow-up period was 10.1 months. MRI measurements showed that the fat area beneath the tear trough increased from 0 to 22.7 ± 6.7 mm2 after fat repositioning, whereas the fat area of the eyelid bag decreased from 46.3 ± 11.0 mm2 to 25.5 ± 14.0 mm2. The 3D results revealed an increase in thickness by 1.2 ± 0.4 mm in the tear tough areas. Conclusion: Both MRI and 3D imaging provide options to objectively assess the fat-repositioning technique.