Lower Eyelid "Skin Pinch"

What does a lower eyelid "skin pinch" address exactly and does it have the same potential complications as a lower Blepharoplasty? Would this be a good option for someone who has severely dry eyes? Thanks to all of you for your continuous patient education.

Doctor Answers 34

Skin Pinch Blepharoplasty is skin removal and risky for people with dry eyes

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Skin pinch blepharoplasty is a minor excision of a small amount of skin only from the lower eyelid. It is less extensive than a formal lower eyelid blepharoplasty and less likely to weaken lower eyelid support. It is done to remove small amounts of excess skin from the lower eyelid.

Patients who have dry eyes are particularly prone to worsening of their dry eyes after any procedure which shortens the lower eyelid. Shortening the lower eyelid pulls the lid down and exposes the eye to more drying effect of the air. Even a skin pinch blepharoplasty can shorten the lid and create problems for a patient with dry eyes.

If you are prone to dry eyes and insistent upon lower lid rejuvenation the non-ablative fractional Erbium laser resurfacing would be a safer option.

Fractional ablative resurfacing can also be done but can shorten the lid. My practice is to tighten the lid with a canthopexy before any lid tightening procedure in patients with a tendancy to dry eyes.

“Skin Pinch” Blepharoplasty Eyelid Surgery

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“Skin Pinch” blepharoplasty is actually a very good option to use because it does not effect the eyelid muscles. It is very important not to divide or denervate the orbicularis oculi in blepharoplasty. It helps to maintain eyelid shape and symmetry. If one has dry eyes then one should not, perhaps, have anything done. If you choose to move forward with a history of dry eyes, it should be cleared with your opthalmologist and be done conservatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

A skin pinch has a minimal effect

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A skin pinch can be used when there is a little residual skin that can be pinched and removed without pulling the lower eyelid down at all. It does not remove wrinkles. In a competent surgeon, it shouldn't cause any problems including people with dry eyes. However, lower eyelid surgery in the wrong hands can cause significant complications that can be difficult to fix, so choose your surgeon wisely.

Dr. Miller

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Skin pinch removes just a "pinch of skin"

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The skin pinch belpharoplasty removes just a "pinch of skin." This is good if you have strong lower eyelid support but a little extra skin. If the support of your lower lid is weak, then any added tension from the tightened skin can change the shape or function of the lower eyelid. In this case, it may be better to perform an anatomical belpharoplasty. Good luck.

Skin pinch is a blepharoplasty

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In my opinion a skin pinch is a blepharoplasty, along with a high risk of eye shape alteration over time. Whether you consider this a complication will depend on how closely you examine the results of blepharoplasty.

I personally believe all lower blepharoplasties should be supported structurally if skin is tightened in ANY way (including skin pinch) or the eye shape will, however subtly, round or pull down in the corners.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Skin pinch

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The trans-conjunctival blepharoplasty may be combined with an external skin pinch, to remove the redundant skin, once the fat pads are removed and deflated.  The blepharoplasty "deflates the balloon" and then the skin pinch is to address the redundant skin left behind.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

Lower Eyelid "Skin Pinch"

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The lower eyelid pinch is removal of usually a small amount of skin so that the lower eyelid support is not damaged.  It is a good option when one has good eyelid support.  For a patient with laxity or dry eyes it may be wise to do a formal blepharoplasty or do nothing.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon

It's what else you do together with the skin pinch that's important.

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Hi! Doing anything to the lower eyelids in someone with severe dry eyes has risk. You should either not have surgery, or you must have a canthopexy which tightens the outer corners of your eyes and supports the lower lids. The canthopexy is not to make you look better; it's to prevent complications.

Together with the canthopexy, you need something done to the skin and to the fat, depending on your anatomy, to make you look better. "Skin pinch" is just one way to remove excess skin, and it means slightly different things to different surgeons. Whether it's good for you, depends on your exact anatomy.

This is tricky surgery. Make sure you go to someone who does a lot of blepharoplasties. Ask your ophthalmologist about seeing an oculoplastic surgeon.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Skin pinch is the easiest, safest alternative for dry eyes

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Skin pinch is the easiest, safest alternative for someone with dry eyes. The skin is removed from under the eyelid without touching the underlying muscle. The procedure is limited and often has very little swelling. Although the outcomes are limited, so are the risks. If you are worried about complications, this is for you! Just don't expect the world.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Skin pinch blepharoplasty

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A "skin pinch" removes a small amount of skin and leaves the underlying muscle intact.  Even with that however one could end up making a dry eye problem worse if the lid margin position was changed. With dry eyes some type of resurfacing whether it is fractionated CO2 laser or a chemical peel with TCA or phenol might be better.  With extreme dry eyes the risks may outweigh the benefits for any lower lid procedure.  If you did want to proceed a procedure to tighten the lower lid at the same time might be beneficial.

Wayne F. Larrabee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 18 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.