the T-c incision notoriously heals without scarring. so don'y worry. however, laser on type IV skin, light brown typically asian or hispanic, can be done but with some trepidation because of post inflammatory hyperpigmentation ( browning), so pretreatment and posttreatment using peel and bleach creams is a must. even then a light TCA peel may be a better choice.
A trans-conjunctival blepharoplasty incision will not keloid.
Lower eyelid surgery performed through an incision inside your lower eyelid will heal well. In the year 2010, I usually prefer to fill the groove below your eyelid bag (Injectable Filler Treatment) rather than removing fat.
You're more likely to have a problem with a laser treatment to your lower eyelid if you have Hispanic skin. I've never been convinced that laser treatments lead to long term tightening of lower eyelid skin. In fact, trying to tighten lower eyelid skin can lead to malposition of your lower eyelid margin. So please proceed with caution.
I hope this is helpful for you.
Keloid scarring with eyelid surgery is VERY RARE
Keloid scarring with any facial surgery is quite rare.
I have never had, seen, or heard of a keloid scar forming after eyelid surgery performed using the technique you were recommended (using an incision inside your eyelid), in any skin type.
With regard to the laser procedure, I agree with your surgeon that this is a great adjunct to this procedure. With good preoperative and postoperative care, changes in skin color are very unlikely.
Keloids of the eyelids are especially rare due to the modified epithelium. Keloids of the conjunctiva which your surgeon has advised is almost unheard of. You are corret that a laser or any resurfacing procedure could result in darkening of the skin but proper pre and post treatment care should minimize this risk
Risk of Keloid Surgery with inside the Eye incisions
Your surgeon wisely suggested going through the inner lining of the lower lid (Transconjunctival). Although it is possible, I have never heard of a keloid scar associated with a transconjunctival incision. It usually heals beautifully to the point it is hard to see the surgical scar.
You should get more information on the laser he plans on using on your lower lid skin (CO2 vs. Erbium:YAG) and what the downtime and risk would be from that procedure. Once the skin heals (days depend on the DEPTH of the laser peel) you will need to be treated with a bleaching cream to prevent skin darkening (hyper pigmentation or PIH).
Dr. P. Aldea