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Visible Scars from Lower Blepharoplasty?
You're describing two different approaches for blepharoplasty - One is subciliary (meaning below the eyelash) and the other is transconjunctival (through the conjunctiva at the inside of the lid). The transconjuntival approach only addresses the contents of the tear trough area. It cannot correct excess skin. This technique can be used with other techniqes (such as laser) to tighten the skin and avoid scars.
Clinical Context
The lower eyelid has very thin skin, which is why surgeons choose incision location carefully. The transconjunctival approach goes through the inner lining of the lid, reaching fat pads that bulge with age without ever cutting the outer skin — that's why it leaves no visible scar. Because it doesn't involve the skin surface, it can't tighten or remove loose skin; a skin-directed technique, like a small external incision or laser resurfacing, is needed for that separately.
