Pinch Blepharoplasty for Under Eye Treatment

Question

Pinch blepharoplasty seems to suit me well: the skin under my eyes just needs to be pulled to the side a little bit.  Some questions: Does a pinch blepharoplasty have to be transconjunctival?  Can a pinch blepharoplasty be repeated as I get older?

Richard W. Westreich, MD · Answer

In appropriately selected patients, this can be a perfect intervetion that gives fabulous results.
It can be done under local in the office and takes about 1 hour in total. Healing time is about 3-5 days, depending on bruising levels. I have given fillers at the same time and have some VERY happy patients as a result of this procedure. It can be repeated and will not interfere with a more traditional blepharoplasty if you ultimately need one down the line.
Patients are typically younger (40s or 50s) and must have tight lower eyelid tone. If the lower eyelid is weak, then changes to the lower eyelid shape can occur.
Find a reputable surgeon and you will get the best answer as to whether this is the right procedure for you.
Best of luck

Brent Moelleken, MD · Answer

We do not generally perform pinch blepharoplasties in our practice.  The reason for this is that I believe that removal of skin from underneath the eyelid causes an alteration in shape of the lower eyelid.  Often this takes months to occur fully, but it is present if you look closely.
Typically the look of a slightly downgoing side of the eye is the result of removal of skin without support.
Therefore we typically perform an ultrashort incision cheeklift (USIC) when removing skin from below the eyelid.

Kenneth D. Steinsapir, MD · Answer

I highly recommend that you spend your time and energy focusing on identifying a surgeon you are comfortable with and less time and effort on what procedure you should have. Every procedure has its risks and benefits. Every procedure works differently in the hands of different surgeons. If you arbitrarily decide you need a skin pinch, I assure you that someone will offer you that surgery whether it makes sense for you or not.

Frank P. Fechner, MD · Answer

With a lower eyelid pinch, only skin close to the lower lid lashes is removed. In our practice, this procedure in isolation is very uncommonly performed.  Risks of lower eyelid position changes (ectropion, droopy lid) will limit the amount of skin that can be removed safely.
Alternatively, skin resurfacing can tighten the lower lid skin. Although not true surgery, it also carries its own risks and limitation.
You may benefit from an evaluation by an experienced cosmetic facial surgeon to see what is the most appropriate approach for your anatomy and condition.

William Portuese, MD · Answer

A pinch blepharoplasty is exactly what it describes, a pinch of skin from the lower lids. It does not address the most common issue with regards to lower blepharoplasty surgery, which is to remove fat bags. The pinch itself is usually 2 to 3 mm of skin, taken at the lash line and closed with very fine sutures or tissue glue. This can be repeated in the next 10 or 20 years if there is more skin present.

Steven Wallach, MD · Answer

A pinch blepharoplasty is a very simple procedure incorparating removing skin from the lower eyelid and sometimes doing nothing more than that.  Occasionally a canthopexy is also used.

Philip Young, MD · Answer

A pinch blepharoplasty is done through a minimally invasive incision under the eyelashes in the lower eyelid. The incision usually heals really well. The transconjunctival route is through the inside of the eyelid and through this approach we are able to take out unwanted fat. This route can avoid a skin incision in people who just have an accumulation of excess fat but not skin.

Lenore Sikorski, MD · Answer

A pinch removal of lower eyelif skin is done by taking a tiny amount of skin under the eyelash line of the lower eyelid.  I do this when patients have redundant skin that can't be improved with laser or by other means.  In the right patient this can be a wonderful solution.  
Good Luck.

Charles Perry, MD · Answer

The pinch lower lid Blepharoplasty can be repeated and a transconjunctival removal of fat or repositioning of fat does not have to be done at the same time. In most case I do find it necessary to add some tarsoligamentous tightening with a canthopexy or plasty as indicated.

Peter A. Aldea, MD · Answer

The current approach to the lower lid attempts whenever possible to avoid cutting across the MIDDLE layer of the lower lid - the septum, UNDER which the pooching periorbital fat is located. The reason - such incisions have a much higher rate of poor scarring which pulls the lid down causing while show and even ectropion (picture Google the term). In people in which fat needs to be removed, the fat is removed through an inside the lower lid incision - transconjunctival, leaving the septum intact. The excess skin on top of the thin muscle that covers the septum can then be separately removed with a PINCH procedure where only the loose skin is removed through an incision just below the lash line.
If you do not have bulging fat - you do not need the transconjunctival fat removal. If you have more loose skin but the eye is not lax you could have a repeat pinch through the same scar.
Dr. P. Aldea

Pinch Blepharoplasty for Under Eye Treatment

Answers (11)

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