This is a great question, and not the first time it has been asked. One of the benefits of a transconjunctival lower blepharoplasty is that there are no external stitches. Most of the time, fat is repositioned through this approach, and sutures can be used to hold it in place. These sutures are actually holding the fat deep under your skin in place, and they are externalized usually in the upper part of your cheek. So while what your doctor was telling you is true (there are no external sutures as if you were to cut your skin open to perform the blepharoplasty), there's a bit of an asterisk there when the sutures to hold your fat pads in place were used. They are below your eyes, but they will not lead to any scarring, and are there just for the purpose of holding the deep fat in place.This is a great reminder for all of us surgeons that we have to be very explicit in our preoperative conversations, and we shouldn't take anything for granted.