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.

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.

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