Lower Eyelid "Skin Pinch"

“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.

Anyone with dry eyes should have this maximally treated prior to any cosmetic lid surgery. This is because after any lid surgery, with the swelling, patients can have a temporary period of time where the eye does not drain tears properly or that the eyes don't close completely.  I recommend to see a doctor that will determine why you have the dry eyes and get that taken care of prior to the operation.  A skin pinch is just that. We take a small 1-2mm of skin from the lower lid, pinch it to make sure we are only removing the excess skin and we remove it. The risk of this or any lower lid procedure, is that the lid has too much tension with gravity and the pull of the facial tissues after. If this is the case you can get ectropion. Ectropion is a open appearance to the lower lid and it can affect tearing of the eye. To prevent this I typically do a lateral muscle suspension which secures the lid as a sling. See someone who does a lot of lid surgery and you should be able to have this done without any issues as long as the dry eye situation is under control. Hope this helps.Best of luck,Drc

The skin pinch is simply a way to remove excess skin from the lower lid.  As with any skin removal of the lower lud, it has to be done with caution to avoid having your lid drag down.

                  The
lower eyelid “skin pinch” blepharoplasty is a relatively minor surgical
procedure that addresses loose lower eyelid skin. This procedure is performed
when there’s isolated loose skin in the absence of underlying fat deposits. The
procedure avoids the underlying orbicularis muscle and decreases the potential
for damage to the lower eyelid support.

                  Although
this procedure is generally thought to be safe, complications can occur with
any surgical procedure. Patients with dry eyes should approach any type of
blepharoplasty with caution. With that said, this procedure is probably less
likely to cause dry eye syndrome then other types of blepharoplasty.

                  The
choice of blepharoplasty procedure depends on the patient’s unique anatomy and
specific aesthetic goals. Consultation with a board certified plastic surgeon
with experience in this area would be appropriate. 

The lower eyelids are complex structures containing skin, muscle, and connective tissue. A skin pinch is a way to remove only skin from the lower eyelids, without disturbing the muscle or connective tissue layers. This is often paired with removal of the fat bags in the under eye region, which is performed from the inside of the eyelid.

A skin pinch excision is the removal of a small strip of lower eyelid skin from below the subciliary margin.  This is used to remove skin when either a small amount of skin removal  is indicated or in conjunction with a transconjunctival blepharoplasty. The important point of this removal is that the tarsus is untouched thus alleviating problems with the tarsus.

Thanks for your question -
Lower lid blepharoplasty can address many issues including fat herniation and excess skin. Skin only excisions tend to be more limited in what they are able to improve.
Both techniques can cause a condition called ectropion which can be caused by over resection or scar tissue. This can be serious and patients with a history of dry eye or inability to fully protect their cornea may be at increased risk from this complication after surgery.
There are several tests that can be performed to minimize the chances of this issue for patients at risk.
Speak to a board certified plastic surgeon.
I hope this helps.

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

Patients with dry eyes should undergo stringent testing to examine the quantity of tear production and the support structures of the lower eyelid. The skin pinch blepharoplasty is an important procedure for patients who do not require formal lower eyelid blepharoplasty.
The lower eyelid is composed of three major anatomic layers known as the anterior, middle, and posterior lamella. If the middle lamella, or septum, is crossed during surgery, there is a strong tendency to develop lid retraction. In the skin pinch procedure, the risk of lower eyelid retraction is significantly less, but still exists.

Lower lid blepharoplasty will continue to be a facial plastic procedure prone to complications and/or poor aesthetic outcome if not performed with care, accurate technique and artistry after appropriate assessment. Because fat removal through a trans-conjunctival approach can leave a patient with additional skin and skin wrinkles, a skin pinch has been advocated by some surgeons.
Other plastic surgeons favor skin resurfacing (peel or laser resurfacing) to tighten skin. Personally, I prefer the skin-muscle flap approach where skin removal (just a little!) is one component of the procedure. In general, complications can be seen even with a skin pinch. I certainly have consulted on patients who where left with ectropion after skin pinch.