Is It Common for a Lower Eyelid Skin Pinch to Alter the Shape of One's Eye?

A plastic surgeon told me I have excess skin on my lower eyelids. CO2 fractional laser was recommended as first step. That was done 3 months ago. Mild improvement but did not tighten much. Botox under the eye and on the sides made my under eye bunch more. It is saggy & redundant skin under my eyes rather than just fine lines. When I smile it pleats & folds. Regarding a lower eyelid skin pinch - my main concern is that it could alter my eye shape. Is rounding the eye a risk? Thank you.

Doctor Answers 7

It can pull down one’s eye and change the shape

It can pull down one’s eye and change the shape.  Fraxel CO2 laser can sometimes help, but it can also pull the lid down more.  I would see the doctor and possibly get another opinion to see if any further correction should be done.

New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

When Done Appropriately, Lower Lid Skin Pinch Does Not Alter Eyelid Shape

When done for the appropriate reasons (e.g., excess skin of the lower lid, as well as good lower lid "tightness," on exam by your facial plastic surgeon, among other things), the skin pinch does not commonly cause rounding of the lower eyelid. That said, over-aggressive skin removal can lead to problems, including change in the shape of your eyelids. 

Jen Yuan Chow, MD
Pasadena Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Skin pinch

A skin pinch blepharoplasty really should not change the shape of your eye.  If a canthopexy is performed to maintain support, then the eye may appear a bit almond shaped. This usually softens with time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Lower lid skin pinch

Lower lid skin pinch can affect the lower lid contour and position if done aggressively and incorrectly.  It is not supposed to if done correctly, as proven in a paper I published entitled "Lower transconjuctival blepharoplasty with and without skin pinch" (referrence is on my website).  Consult an oculplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

A photograph is worth a thousand words.

Generally yes, removing skin from the lower eyelid has the risk of altering the shape of the lower eyelid.  For every action there is an equal and opposite reaction.  This can be even more dramatic because some doctors don't just do a skin pinch but use this term to lull individuals into having what is actually a much more radical lower eyelid transcutaneous lower eyelid procedure.  So generally you really need to know your surgeon before agreeing to a "skin pinch."  Consider reposting your question with photos for a more specific answer.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Skin Pinch Blepharoplasty

It sounds like you've exhausted through a number of conservative measures. Sometimes by performing Botox laterally around the corners of the eye to help diminish those fine wrinkles (rhytids), you then leave the muscle beneath the eye to become hyperactive and can produce greater skin folds and patient dissatisfaction. A skin pinch blepharoplasty or eyelid rejuvenation technique is typically performed in patient's who demonstrated mild skin fold excess without signficant lower eyelid festoons. Because there is limited skin removed, it should not alter the shape of your eye. My preferred technique is a transconjunctival fat removal (inside the eyelid), followed by a skin pinch anteriorly. However if you demonstrate appreciable skin excess, a more traditional blepharoplasty would probably work better for you. 

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon
4.1 out of 5 stars 16 reviews

Skin pinch

Unfortunately its not possible to assess your lower eye needs without an exam and certainly not without pictures. If you have significant skin excess or laxity, as well as fat herniation and/or festooning, you will need a traditional blepharoplasty with treatment of fat, a suspension procedure and skin excision. Any type of lower eyelid surgical procedure has a potential of changing the shape of your eyes and causing some rounding.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 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.