Please explain how surgeoes do a "pinch blepharoplasty". Is it commonly done? Does this technique minimize the risks of surgery?
What is a "Pinch Blepharoplasty"
Doctor Answers 14
Pinch Blepharoplasty (Eye tuck or lift) lower eyelid
A pinch blepharoplasty generally refers to a procedure performed on the lower eyelid.
Any eyelid procedure can address skin, muscle or fat. This can be complex and require greater intervention. However, a pinch only removes the skin.
It is commonly performed in combination with a cheek lift or midface lift which can push loose skin into the eyelid area. Rather than do a "complete" eyelid procedure, the excess skin is pushed and gathered into a ridge. This ridge is pinched thereby crushing the blood supply and making essentially bloodless removal of the pinched skin.
It is also occasionally performed with a transconjuntival blepharoplasty in which the fat is removed from inside the eyelid.
The advantage of the procedure is relatively little surgery with quicker recovery. The disadvantage is the limits of the procedure and inability to address the fat and muscle if they are contributing to the undesireable appearance of eye.
This technique in blepharoplasty is classically a maneuver done with minimal skin removal that is calculated by pinching the skin together with a tiny forceps. It's done to calculate a minimal amount in order to not overdo the operation. This technique is indicated when there is minimal skin excess, minimal wrinkling and no structural deformity of the lower lids. Your board certified plastic surgeon can evaluate your anatomy and see if you are a good candidate for this procedure.
Pinch blepharoplasty- pluses and minuses
We typically do not perform pinch blepharoplasties as a standalone procedure. The reason for this is simple. It too often changes the eye shape to a pulled down or rounded appearance. The change in the eye does not appear right away; it usually takes months. Patients notice their eyes look sad or that too much white shows.
When we perform an ultrashort incision cheeklift, then the cheeklift essentially "gives" tissue to the lower eyelid, and this can then more safely be removed with a "pinch".
Not every cheeklift "gives" tissue to the lower eyelid. Cheeklifts performed through the mouth and temple do not, in my opinion, rejuvenate the lower eyelid although they can elevate the cheeks nicely in the right patient, especially if an endotine type device is used. Cheeklifts that are aggressive, violate the orbital septum are more likely to pull down or alter the eye shape.
When you are looking at before-after pictures, look carefully at eye shape. Is the eye shape the same or better than before the surgery or is it altered? Without asking a single question, you can tell volumes from before-after pictures if you look carefully.
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The "pinch and peel" approach to eyelid rejuvenation
When the lower eyelids show only excess skin and wrinkling but little to no protruding fat, I'll usually recommend a "pinch and peel" approach. This adds a chemical peel to the traditional skin pinch lower blepharoplasty.
Under local anesthesia, the excess skin (and a tiny bit of muscle) is pinched up with a special instrument just beneath the lash line and trimmed away. Fine sutures close the wound. Once that's healed, I like to perform a chemical peel of the lower eyelid skin. The peel resurfaces the skin, creating some subtle tightening and some more significant smoothing.
In recent years, I've found this more effective than just a peel alone for many patients.
All the best,
The pinch blepharoplasty
As Drs. Placik and Aldea have mentioned, a "pinch" blepharoplasty addresses excess lower eyelid skin only. While it is deceptively simple, if a patient has loose lower eyelids as determined by preoperatively pulling down and pulling out on them, there is still a distinct possibility of the lower lid dragging down during recovery (called an ectropion) which can be very difficult to fix at times.
Pinch Blepharoplasty (Eye Job)
A "pinch Blepharoplasty" is the removal of ONLY excess lower lid skin as contrasted to a Lower Lid Blepharoplasty which refers to EITHER a TRANSCUTANEOUS Blepharoplasty (incision though lower lid skin with removal of excess skin, muscle and fat) or a TRANSCONJUNCTIVAL Blepharoplasty (incision though the inner lining of the lower lid in which lower lid fat is either re-arranged or removed).
Dr. P. Aldea
I typically offer a lower lid trans-conjunctival blepharoplasty. Instead of approaching the fat pads from the outside (trans-cutaneous blepharoplasty) the dissection is actually performed from behind, within the eyelid.
The trans-conjunctival blepharoplasty is usually combined with an external skin pinch, to remove the redundant skin, once the fat pads are removed and deflated.
Hope this answers your question. Good luck.
A pinch blepharoplasty relates to the excess skin on the lower lids once the fat has been removed. The puffiness on the lower lids is caused by excess fat, which is removed, usually from an inside incision called the transconjunctival approach. Once the fat has been removed there is usually excess skin, and this is pinched on the lower lid just immediately below the lash line and then either sutured or glued together.
When performing a pinch blepharoplasty, the surgeon will pinch a small amount of skin and remove it. The surgeon will then stitch it together carefully. It is important to be conservative, otherwise the procedure may cause lower eyelid retraction. And every surgery has its risks. Hope this helps answer your question. Thank you and best of luck.