By Dr. Wissam Fayad, MDOctober 30, 2026Scarless Eyelid Lift
If you have started reading about lower eyelid surgery, you have probably seen two terms come up again and again: transconjunctival blepharoplasty (often called “scarless” eyelid surgery) and traditional blepharoplasty. Both aim to give you a fresher, more rested look, but they work in different ways and suit different people. This guide explains the difference in plain language so you can walk into a consultation in Chandler knowing what to ask.
The short answer
Transconjunctival (scarless): the incision is on the inside of the lower eyelid. It treats under-eye bags caused by fat. No visible scar on the skin.
Traditional: the incision is on the outside skin, hidden in a natural crease or just below the lashes. It can treat fat and remove excess skin.
The main question is simple: is your concern mostly puffy bags, or mostly loose skin?
What is transconjunctival blepharoplasty?
“Transconjunctival” means “through the conjunctiva”, the thin pink lining on the inside of your eyelid. In this approach, the surgeon makes a small incision on that inner lining, reaches the fat pads that create under-eye bags, and removes or repositions the fat to smooth the area.
Because the skin on the outside is never cut, there is no external scar. At VIA Health & Medspa, the inner incision is closed with dissolving stitches or left to seal on its own, so there are no outward signs of surgery. The procedure is typically done under local anesthesia with sedation and takes about one to two hours. Our scarless eyelid surgery page walks through each step.
What is traditional blepharoplasty?
Traditional lower blepharoplasty uses an incision on the outer skin of the lower lid, usually placed just under the lash line so it blends in as it heals. Through that opening, the surgeon can remove or reposition fat and also trim away extra skin. Traditional upper blepharoplasty uses an incision in the natural fold of the upper lid to remove heavy or hooded skin.
Because the outer skin is opened, there is a fine scar. In many people it fades well over time, but it is still a skin incision that needs to heal.
Side-by-side comparison
Transconjunctival (scarless) | Traditional | |
|---|---|---|
Where the incision goes | Inside the lower eyelid | Outer skin of the lid |
Visible scar | None on the skin | A fine scar, usually hidden in a crease or near the lashes |
Treats fat (bags, puffiness) | Yes | Yes |
Removes excess skin | No (not its purpose) | Yes |
Best suited to | Bags with good skin elasticity | Bags plus loose or sagging skin |
Outer stitches | None | Usually, on the skin |
Who is a good candidate for each?
The scarless approach often fits if you:
Mainly want to reduce under-eye bags or puffiness
Have good skin elasticity and little extra lower-lid skin
Want to avoid any visible scar
Are in good overall health and have realistic expectations
A traditional approach may be considered if you:
Have a noticeable amount of loose or wrinkled skin under the eyes
Have heavy upper lids that need skin removed
Need more extensive reshaping than fat alone
Age is not the deciding factor on its own. Some younger patients have prominent fat bags with firm skin, which is the classic scarless candidate. Others develop more skin laxity over time. The exam at your consultation is what decides it.
How recovery compares
With the scarless technique there is no skin wound and no outer stitches, so recovery is mainly about swelling and bruising settling. At VIA, these are usually mild and resolve within one to two weeks. You will need someone to drive you home after sedation, keep your head elevated, use cold compresses and avoid heavy lifting and vigorous exercise for at least one to two weeks. Initial results usually show within a few weeks, with the final result over several months.
Traditional surgery adds the healing of an outer incision, and any skin stitches need care while they heal. Your surgeon will explain what that looks like for the specific procedure you are having.
What about “laser” or non-surgical blepharoplasty?
You may also see “laser blepharoplasty” or “non-invasive blepharoplasty”. These terms describe different things. Some refer to the tool used to make a surgical incision. Others describe treatments with no surgical incision at all.
VIA offers a non-surgical blepharoplasty that uses the Renuvion Micro Handpiece, which delivers radiofrequency and cold helium plasma energy to tighten skin around the upper and lower eyelids and stimulate collagen. It is aimed at loose skin and fine lines rather than removing fat. For some patients, the scarless lift handles the bags while an energy-based treatment helps with skin. Whether you need one, the other, or both is something to decide with your provider.
Questions to ask at your consultation
Is my concern mainly fat, skin or both?
Am I a candidate for the scarless approach, and if not, why?
What anesthesia will be used, and how long will the procedure take?
What should my recovery look like week by week?
What will my result likely look like, and what will not change?
What does the full quote include?
Frequently asked questions
What is transconjunctival lower blepharoplasty?
It is lower eyelid surgery done through a small incision inside the eyelid. Fat that causes bags is removed or repositioned, and no outer skin is cut, so there is no visible scar.
Is there a non-invasive blepharoplasty?
There are non-surgical treatments that tighten eyelid skin without a surgical incision, such as the energy-based treatment VIA offers. They work on skin and texture, not on removing under-eye fat.
Is laser blepharoplasty better?
“Laser” usually describes a tool, not a different result. What matters most is choosing the right approach for your anatomy, fat, skin or both, and an experienced surgeon.
Can the scarless technique remove skin?
Not really. The scarless approach is primarily for fat pads. Traditional surgery is the option that removes excess skin.
How long do results last?
Results from scarless eyelid surgery are generally long-lasting, often ten years or more. Genetics, lifestyle and natural aging influence how long they hold.
Will it help dark circles?
Reducing bags can make shadows less noticeable, but neither approach treats pigment-related dark circles directly. Other treatments may be suggested for that.
Find out which approach fits you
The best way to choose between transconjunctival and traditional blepharoplasty is an in-person exam. At VIA Health & Medspa, Dr. Wissam Fayad and the team take a personalized approach focused on natural-looking results. We are at 3377 S Price Rd, Suite 107, Chandler, AZ 85248, convenient to Gilbert, Mesa, Tempe and Scottsdale. Book a consultation or call (480) 992-9842, Monday to Friday, 9 to 5.