Can the under eye skin pinch make the eye appear smaller or more slanted?

A skin pinch to remove excess skin on the lower eyelids will not make the eyes look smaller. A canthoplasty, which is on rare occasion done with a skin pinch, is what can make the eye look smaller or can make the eyelids look slanted upwards or slanted downwards. A canthopexy, which is done more frequently with a canthoplasty, can make the eye look smaller for a few months, until the suture dissolves, and then the eye does not look smaller anymore. If the skin pinch gives a tiny bit of retraction, the eyes may look a tiny bit bigger or a tiny bit rounder. Of course, our goal, as an oculoplastic surgeon, is to not change the eye shape or size unless the patient wants it to be changed.

It does not happen that way, fortunately. Conservative shin excision and fat bag reduction (if needed) should not change shape and size of the eye. In person consultation with a board certified plastic or oculoplastic surgeon is recommended. Good luck.

It is performed to remove a small amount of loose skin in the lower eyelid. This should be performed in conjunction with some sort of lateral canthoplasty to support the lower eyelid. Skin pinch is generally a misnomer. Often these procedures are far more aggressive and remove skin and muscle. This can and often also injures the underlying motor nerves to the lower eyelid margin. As you note, the effect can profoundly compromise the result. It is unlikely that this surgery will make the eyes look smaller. I would encourage you to further clarify with your surgeon precisely the anticipated effect of your surgery. Studying your pictures and your posts, I suspect that you are on track to cause yourself unintended harm from eyelid surgery. Do not let anyone graft fat into your face. Caution is advised. Less is more.