There is no external incision with transconjunctival approach, so there is no possibility for an external scar. That does not mean that an internal scar cannot for and cause distortion of the lower lid.
A subciliary approach is the most often employed external incision. This incision tends to heal imperceptibly, although as with any cut, there is the possibility of poor healing, and distortion of the lower lid. Even the most prominent of incisions usually become inconspicuous within several months. The usual problem with an external incision is not so much the cicatricial scarring of the skin, but the septal scarring that may cause lower lid distortion.
