While some aesthetic TikTok trends are valid and worth knowing about (take #traptox, for example), other stuff is completely bogus (like these bizarre beauty myths). So where does the latest hot topic, skin pinch surgery, which treats the lower eyelid, fall on that spectrum?
Doctors say skin pinch surgery is a legitimate technique—and, interestingly enough, one that’s been around for decades. Just because something is trending doesn’t mean it’s new, and skin pinch surgery is a great example, says Dr. Robert Schwarcz, a board-certified oculoplastic surgeon in New York City. This is a procedure that’s been around for 15, 20 years and never gone out of style. But it isn’t well-known outside of the medical community, so it fits that criterion of originality that social media is hungry for, he adds.
Ahead, experts explain exactly what skin pinch surgery is and who is actually a good candidate.
What is skin pinch surgery?
It’s a minor surgery that removes excess skin from the lower eyelid, with the goal of minimizing crepiness and wrinkling. “As the name suggests, the skin under the eye, a few millimeters underneath the lash line, is pinched using small forceps,” explains Dr. Jaimie DeRosa, a board-certified facial plastic surgeon in Boston. Once the surgeon determines how much can be removed without distorting the lid, the excess skin stretching from the inner to the outer corner of the eye is removed with scissors and the incision closed with sutures. The whole thing is performed under local anesthesia and takes only about 30 minutes, Dr. DeRosa adds.
Recovery is equally quick and straightforward. Some bruising and swelling are possible, lasting from a few days to a week. You’ll also want to be careful to not pull, tug, or otherwise irritate the area until it’s fully healed, she says.
@premierimageatl Today we are doing a skin pinch lower eyelid blepharoplasty. #surgerytiktok ♬ original sound – Premier Image
How is it different from a lower blepharoplasty?
Technically speaking, skin pinch surgery is considered a type of lower blepharoplasty, as blepharoplasty simply refers to a manipulation of the eyelid, says Dr. Schwarcz. However, the most common type of lower blepharoplasty involves manipulation and/or removal of the fat under the lower lid, he adds. “The majority of complaints people have about their lower lid are contour issues, such as hollowing, shadows, and bags, all of which are related to that fat pad. True skin redundancy and only having excess skin is rare,” he explains. To that point…
@premierimageatl Happy Thursday! This patient had some crepey loose skin on her lower eyes that she was unhappy with so I performed an in office surgical procedure that included a lower lid skin pinch blepharoplasty on both eyes with Co2. This entire procedure took less than an hour and she will be able to resume wearing make up as soon as next week! #skinpinchblepharoplasty #blepharoplasty #co2 #skinresurfacing #laser ♬ girls like me don’t cry (sped up) – thuy
Who is a good candidate for skin pinch surgery?
“This is an accepted technique, but there are very specific criteria as to what makes someone a good candidate,” says Dr. Tanya Khan, a board-certified oculoplastic surgeon in Plano, Texas. There can’t be any prolapse of the fat pad, and they have to have enough excess skin to remove without compromising the integrity of the lid, as removing too much skin is what’s most likely to cause complications, she notes.
Even though it’s been around for more than 20 years, Dr. Khan says, skin pinch surgery accounts for only about 5% of all the procedures she performs compared to the more traditional lower blepharoplasties at 50%. Dr. Schwarcz agrees, citing them as about 5–10% of his procedures. Dr. DeRosa says she too rarely performs it as a stand-alone procedure, more often pairing it with a lower blepharoplasty where fat is being removed.
So how does a doctor determine if someone has enough extra skin to be removed with a skin pinch? Dr. Schwarcz says he has his patient lie back, open their mouth, and look upward. He then uses a pair of forceps to gently grasp any excess skin. “Opening the mouth pulls the skin down, and looking up makes the eyeball rotate upward. If after doing that there’s still enough skin to pinch without making it look like the lid has pulled away from the eyeball, then that’s a good indication they may be a candidate.” It’s also important that any potential candidates have good lower eyelid tone, meaning that it’s close and tight to the eye, notes Dr. DeRosa.
And FYI, this isn’t something for younger patients. “What worries me is that social media has popularized skin pinch surgery among younger patients, who just don’t have this type of loose skin,” says Dr. Khan. She says she prefers to take a more conservative approach with her patients, younger and older, and pushes them to try less invasive treatments to address lower eyelid skin, such as with a CO2 laser, before resorting to surgery.
What are the risks of skin pinch surgery?
Removing too much skin is the biggest potential pitfall. This can change the shape of the eye, creating a rounded outer corner and/or making the whites of the eye permanently visible, two telltale signs that someone’s had eyelid surgery, Dr. Schwarcz points out. This may also lead to tearing issues. The “drain” that collects tears is in the inner corner of the lower lid; if the lid is pulled down too much, the tears don’t get a chance to pool there and instead just roll down the cheek, he adds.
The bottom line
“When performed conservatively and by an experienced surgeon on the right patient, skin pinch surgery can yield good results, but it’s certainly not as easy or appropriate for everyone as it’s been made to seem on social media,” cautions Dr. Khan. If you’re intrigued and think you may be a candidate, go ahead and ask your plastic surgeon about it, but be aware that there very well may be better options to explore.
