Can you tell me risks, healing time and what to expect with skin pinch?

Question

Not enough skin removed during previous lower blepharoplasty so having crepey under eye skin done but nervous about outcome.

Adam Bauermeister, MD · Answer

Hello. Based on your description and photo it appears that you most likely had a transconjunctival lower blepharoplasty with no skin removal. A "skin pinch" lower blepharoplasty with skin removal alone is a much shorter surgery than a traditional lower blepharoplasty and involves an incision immediately beneath the lower eyelash line to remove excess skin. It is typically recommended to relax and avoid strenuous activities for the first 48 hrs after surgery. Periodic application of cold packs help reduce swelling. It is recommended to sleep in an upright supine position with a few pillows behind your head. Avoid pain medications such as Advil, Aleve, Aspirin to decrease bleed risk. Swelling and bruising around the eyes are expected and will resolve over the following weeks. Depending on the surgeon, either an absorbable suture or permanent suture will be used for incision closure. If a permanent one is used, it is often removed ~7 days after surgery. Typically you can resume relatively normal activity ~3-4 weeks after surgery. Some more general risks include infection, bleeding, injury to adjacent anatomic structures, contour irregularities, eyelid shape changes, scar prominence, ectropion, as well as others.

Michelle Zweifler, MD · Answer

Lower eyelid crepey skin can be addressed in several ways.  If just wrinkles when smiling, off-label botox temporarily helps the lines.  
With skin pinching technique, the excess lower eyelid skin at rest is determined with pinching just below the lashes.  Some risks include bleeding, infection, scars, keloids, over resection, eyelid malposition, residual wrinkles, etc.  Downtime varies most take 1-2 weeks off work; scars may need a least 6 months to fade.
Chemical peels, microneedling and some lasers also help improve lower eyelid wrinkles.

Zoran Potparic, MD · Answer

There is always skin wrinkling when face is animated (smiling). Depending how much wrinkling is present over the lower eyelids when face is not animated decision can be made; microneedling, chemical peel, skin only blepharoplasty. Hope this helps.

William Portuese, MD · Answer

If there's excess skin at rest, (not upon animation when smiling only then can you consider a very conservative pinch of skin. The  Incision is located directly under the lower lash line, and we close that incision in our practice with tissue glue. No sutures necessary. Expect a visible pink line for a few weeks after the surgery

Mats Hagstrom, MD (license on probation) · Answer

For those who have skin damage of their lower eyelids, the treatment of choice is not to remove skin until it’s smooth.
The lower eyelid does not have the strength to hold up the skin of your lower eyelid under tension.
Removing more skin will give you a premature entropion.
 With enough age, all people will develop an entropion. Removing skin and or obicularis muscle. It’s a good way to speed up the process.
The best way to avoid wrinkles in this area is to avoid sun exposure and be obsessive about sunscreen protection.
You can’t reverse what’s been done, but you can reduce future damage.
Wrinkles in this area are difficult and those who have sun damage are probably never going to get rid of them.
Be careful with what you ask for.
Best,
Mats Hagstrom, MD

Can you tell me risks, healing time and what to expect with skin pinch?

Answers (5)

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