Does an Under Eye Skin Pinch Need to Be Associated with a Canthopexy to Prevent Ectropion? (photo)

If a lower eyelid pinch procedure is done correctly, it should not make the lower eyelid turn outward.  The problem that can occur is lower eyelid retraction, if too much skin is removed.  The difference is that in retraction, the eyelid is just pulled downward.  In an ectropion, the eyelid is turned outward.  A canthopexy is normally not needed when performing lower eyelid pinch surgery.  As long as the right amount of skin is removed, there should not be any distortion to the lower eyelid. 

The answer to your question can only be given after an "in-person" consultation. The tone of the canthal ligaments [what attaches your eyelids to the bone] will determine if you need tightening of the eyelids or not. Most younger patients do not need tightening, as long as the lower lid blepharoplasty is via a conservative pinch excision of skin as opposed to an aggressive skin-muscle flap.

It is very unusual for a 24 year old to have much excess lower eyelid skin. Fine lower eyelid wrinkles is not equal to excess lower eyelid skin and lower blepharoplasty with removal of lower eyelid skin to remove all lower eyelid fine wrinkles is fraught with complications. You should have your vision checked and if you are a smoker quit because squinting regularly from either cause can create these wrinkles. This muscle action will not change because you removed some skin or lasered it. If either of these conditions is treated/resolved you would then be better off smoothing the skin with a peel or laser. Furthermore the skin thinness and visible tear trough will also not be addressed by a pinch removal of lower eyelid skin.

Canthopexy is performed to treat or prevent ectropion in those patients who have a lax tendon in the outer corner of the eye. In the absence of that a canthopexy may pull the lid down the lower half of the eyeball creating more problems than it solves.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.