Would a skin pinch be enough to take care of the extra skin under my eyes when smiling or is a lower bleph needed? (Photo)

I generally recommend people avoid having skin removed from their lower eyelids.
Doing so put people at risk for developing premature facial aging with premature ectropion development.
Contraction de zygomaticus, muscle and orbiculsris muscle both contribute to forming wrinkles in this area.
The best prevention is obsessive avoidance of sun exposure with daily use of sunscreen.
Botox can also be helpful.If you contract, yours, zygomaticus muscle, the cheek will move up and wrinkles will form.
This is normal.
Some plastic surgeons still remove the skin from the lower eyelids.
In my opinion it’s a bad operation.
Best,
Mats Hagstrom, MD