Lower Eyelid "Skin Pinch"

What does a lower eyelid "skin pinch" address exactly and does it have the same potential complications as a lower Blepharoplasty? Would this be a good option for someone who has severely dry eyes? Thanks to all of you for your continuous patient education.

Doctor Answers (26)

Skin Pinch Blepharoplasty is skin removal and risky for people with dry eyes

+5

Skin pinch blepharoplasty is a minor excision of a small amount of skin only from the lower eyelid. It is less extensive than a formal lower eyelid blepharoplasty and less likely to weaken lower eyelid support. It is done to remove small amounts of excess skin from the lower eyelid.

Patients who have dry eyes are particularly prone to worsening of their dry eyes after any procedure which shortens the lower eyelid. Shortening the lower eyelid pulls the lid down and exposes the eye to more drying effect of the air. Even a skin pinch blepharoplasty can shorten the lid and create problems for a patient with dry eyes.

If you are prone to dry eyes and insistent upon lower lid rejuvenation the non-ablative fractional Erbium laser resurfacing would be a safer option.

Fractional ablative resurfacing can also be done but can shorten the lid. My practice is to tighten the lid with a canthopexy before any lid tightening procedure in patients with a tendancy to dry eyes.


Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

“Skin Pinch” Blepharoplasty Eyelid Surgery

+3

“Skin Pinch” blepharoplasty is actually a very good option to use because it does not effect the eyelid muscles. It is very important not to divide or denervate the orbicularis oculi in blepharoplasty. It helps to maintain eyelid shape and symmetry. If one has dry eyes then one should not, perhaps, have anything done. If you choose to move forward with a history of dry eyes, it should be cleared with your opthalmologist and be done conservatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

Skin pinch is a blepharoplasty

+3

In my opinion a skin pinch is a blepharoplasty, along with a high risk of eye shape alteration over time. Whether you consider this a complication will depend on how closely you examine the results of blepharoplasty.

I personally believe all lower blepharoplasties should be supported structurally if skin is tightened in ANY way (including skin pinch) or the eye shape will, however subtly, round or pull down in the corners.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

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Lower Eyelid "Skin Pinch"

+2

The lower eyelid pinch is removal of usually a small amount of skin so that the lower eyelid support is not damaged.  It is a good option when one has good eyelid support.  For a patient with laxity or dry eyes it may be wise to do a formal blepharoplasty or do nothing.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 4 reviews

A skin pinch has a minimal effect

+2

A skin pinch can be used when there is a little residual skin that can be pinched and removed without pulling the lower eyelid down at all. It does not remove wrinkles. In a competent surgeon, it shouldn't cause any problems including people with dry eyes. However, lower eyelid surgery in the wrong hands can cause significant complications that can be difficult to fix, so choose your surgeon wisely.

Dr. Miller

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.5 out of 5 stars 28 reviews

Skin pinch removes just a "pinch of skin"

+2

The skin pinch belpharoplasty removes just a "pinch of skin." This is good if you have strong lower eyelid support but a little extra skin. If the support of your lower lid is weak, then any added tension from the tightened skin can change the shape or function of the lower eyelid. In this case, it may be better to perform an anatomical belpharoplasty. Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 56 reviews

Skin pinch is the easiest, safest alternative for dry eyes

+2

Skin pinch is the easiest, safest alternative for someone with dry eyes. The skin is removed from under the eyelid without touching the underlying muscle. The procedure is limited and often has very little swelling. Although the outcomes are limited, so are the risks. If you are worried about complications, this is for you! Just don't expect the world.

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

Blepharoplasty for Lower Eyelid Skin Sag

+1

                  The lower eyelid “skin pinch” blepharoplasty is a relatively minor surgical procedure that addresses loose lower eyelid skin. This procedure is performed when there’s isolated loose skin in the absence of underlying fat deposits. The procedure avoids the underlying orbicularis muscle and decreases the potential for damage to the lower eyelid support.

                  Although this procedure is generally thought to be safe, complications can occur with any surgical procedure. Patients with dry eyes should approach any type of blepharoplasty with caution. With that said, this procedure is probably less likely to cause dry eye syndrome then other types of blepharoplasty.

                  The choice of blepharoplasty procedure depends on the patient’s unique anatomy and specific aesthetic goals. Consultation with a board certified plastic surgeon with experience in this area would be appropriate. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 74 reviews

Lower Eyelid Skin Pinch

+1

The lower eyelids are complex structures containing skin, muscle, and connective tissue. A skin pinch is a way to remove only skin from the lower eyelids, without disturbing the muscle or connective tissue layers. This is often paired with removal of the fat bags in the under eye region, which is performed from the inside of the eyelid.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Lower Blepharoplasty Techniques and Dry Eyes

+1

The skin pinch technique for lower blepharoplasty is a method for removing a small amount of excess lower lid skin.  It is nice in that it does not disrupt the obicularis muscle, and is relatively safe. Other options for a similar change would be a skin flap blepharoplasty or resurfacing (laser or chemical peel).  The skin flap technique allows for skin smoothing further from the lash margin, but has a higher bleeding risk.  The peel also can smooth the skin further from the lash margin, but runs the risk of pigmentary change (which is more of an issue in patients with darker complexion).  All of these techniques that tighten lower lid skin run the risk of dry eyes.  To think about it in simplistic terms: if the lower eyelid tone (the force holding the eyelid against the eyeball) is not good and the skin tightening is enough to get the eyelid to not smoothly glide on the eyeball, you will end up with dry eyes.  If you have poor lid tone, a lid tightening procedure (such as a muscle pexy with or without canthopexy/canthoplasty) will be required in addition to the skin procedure when doing your lower lid surgery.  You would be best served by visiting with a surgeon who specializes in lid surgery, and ask them what they recommend (and why), rather than shopping for a particular procedure.

Best regards,
Dr. B

Michael A. Bogdan, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 48 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.