My doctor told me I wouldn't have any visible stitches. Why do I have stitches below my eyes? Is this normal? (Photo)

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.

Great example of why you need to be careful what you say to patients.  Technically these sutures are stay sutures to ensure that the fat rotated from the lower eyelid stay at the top of the cheek.  Generally they are removed about a week after surgery.  The sutures your surgeon was referring tothe ones used to close a skin incision made under the eyelashes.  You surgery was done behind the eyelid so no skin closure.  Sutures were still needed to hold the transferred fat in place while initial healing takes place. 

It looks like you may have had fat repositioning along with the lower eyelid blepharoplasty.  I do this commonly to smooth out the lid cheek junction.  You should speak with your surgeon however and find out what happened and maybe there was a mis-understanding.  With fat repositioning, there are no incisions in that area so usually scarring is not an issue from the sutures but speak with your doctor since this should be clear to you.best of luck