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 32

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

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

“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
4.9 out of 5 stars 51 reviews

Skin pinch is a blepharoplasty

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 136 reviews

A skin pinch has a minimal effect

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 187 reviews

Lower Eyelid "Skin Pinch"

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
4.7 out of 5 stars 12 reviews

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

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
4.8 out of 5 stars 9 reviews

Skin pinch removes just a "pinch of skin"

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.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Skin pinch is the easiest, safest alternative for dry eyes

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 30 reviews

Lower eyelid skin pinch blepharoplasty

Lower lid skin pinch is a type of lower eyelid blepharoplasty. "Skin pinch" refers to the removal of excess skin under the eye area. Lower lid malposition is less frequent with skin pinch blepharoplasty, as compared to formal subciliary lower eyelid blepharoplasty. In patients with insufficient support of the lower eyelid, additional procedures may be needed to maintain the position of the lower lid.

Lara Devgan, MD, MPH
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Lower eyelid skin pinch

This a skin excision of excess eyelid skin below the eyelashes after eye fat bag removal. There is a lot of controversy on whether or not removal of this skin can cause the eyelids to retract or be pulled down after blepharoplasty. Thus, consulting an eyelid specialist would be helpful to decide to add this to the eye fat bag removal or transposition part of the surgery. If you have severely dry eyes, I would definitely see an eyelid and Oculoplastics specialist to assess your ocular health prior to considering any eyelid procedure.

Sean Paul, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 7 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.