Can orbital fat repositioning during transconjuctival lower blepharoplasty ever result in lumps or bumps?

It is absolutely true that lower blepharoplasty with fat transposition over the orbital rim can lead to lumps or bumps in the area.  This is why is is very important to see a surgeon skilled in this specific technique if this is what you desire. There are a number of ways to make sure this does not happen, but with all medical and surgical procedures there is always a small chance of a suboptimal result.  I prefer to carefully and meticulously drape the fat as a curtain over the orbital rim and secure it with sutures externally through the skin. Without suturing the fat it is my opinion that it could migrate back to its original position and cause the bags to return. Some surgeons suture internally with absorbable stitches. Regardless of the technique, experience and familiarity with the procedure is the most important factor.

As in all surgeries, the surgeon simply does their best to perform the surgeries skillfully in order to minimize all the risks.