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 30

Skin pinch is a blepharoplasty

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.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 109 reviews

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

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.

“Skin Pinch” Blepharoplasty Eyelid Surgery

“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 28 reviews

Lower Eyelid "Skin Pinch"

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 6 reviews

A skin pinch has a minimal effect

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
5.0 out of 5 stars 102 reviews

Skin pinch removes just a "pinch of skin"

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 63 reviews

Skin pinch is the easiest, safest alternative for dry eyes

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
5.0 out of 5 stars 24 reviews

Dry Eyes and Eyelid Surgery

A skin pinch blepharoplasty is a way to remove a small amount of extra skin from the lower eyelids.  Most patients have problems with eyelid texture, as opposed to eyelid skin quantity.  If the problem is texture, a skin pinch is not the ideal treatment.

Most importantly you should be very cautious having eyelid surgery is you have severe dry eyes.  It is essential that your dry eyes be well controlled before considering cosmetic eyelids surgery.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 15 reviews

Skin pinch

The trans-conjunctival blepharoplasty may be combined with an external skin pinch, to remove the redundant skin, once the fat pads are removed and deflated.  The blepharoplasty "deflates the balloon" and then the skin pinch is to address the redundant skin left behind.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.0 out of 5 stars 5 reviews

Pinch Blepharoplasty

Thank you for posting your question. Dry eyes is a red flag for any patient that wants surgery on their eyelids. Your dryness may get worse after any surgical procedure involving your eyelids. A pinch blepharoplasty does not affect the muscle around your eye, and in theory, pulling down on the eyelid is less likely. Only a few patients (those with isolated excess skin in the lower eyelid) are good candidates for this procedure. If too much skin is removed with a pinch, malposition of the lower eyelid is still possible. A formal blepharoplasty with adequate support at the lateral canthus with a canthoplasty or canthopexy may be a good way to prevent pulling down on your eyelid which will prevent long-term worsening of your dry eyes. This being said, a formal transcutaneous blepharoplasty may cause temporary weakness of your eye closure mechanism which can cause evaporation of your tears and temporary worsening of your dryness. This is a very tough case in the hands of any experience surgeon. Hope this was helpful. Good luck!

Jose Rodríguez-Feliz, MD
Miami Plastic Surgeon
5.0 out of 5 stars 5 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.