Do I need to get a skin pinch for excess skin under the eye? (photos)

I had lower bleph surgery 5 months ago. I chose lower transjunct method with fat removal. I am happy with the results for the most part but when I smile I still have loose wrinkly, baggy skin. I have tried botox under the eye (orbital rim) and it helps but will a lower skin pinch help? Or would filler help? My plastic surgeon said I could use a little filler for tear trough deformity at 6 months post op.

Doctor Answers 8

Lower Lid Questions

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Hi Shauna1458,

Thanks for your question and excellent photos. I agree that you've had a nice result from your transconjunctival lower lid blepharoplasty. I can appreciate the lines you are concerned about in your lower lid when you smile. However, in looking at your photo of your lower lids at rest, I would be VERY hesitant to remove any skin from your lower lid. The reason why the transconjunctival approach has become so popular for lower lid blepharoplasty is that it significantly lowers the risk of post-op lower lid retraction. If you remove any skin from your lower lid, I would be very worried you may get lower lid retraction. I would recommend conservative measures like filler or possibly a mild skin peel. 

 I hope this helps!

Excess skin lower eyelids

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Thank you for your question.  I would not recommend removing excess skin from the lower eyelids, as this may result in an unwanted lower eyelid retraction.  You had an excellent result from your surgery.  At the most, I would consider a skin peel to address the fine wrinkles in the lower eyelids.  Good luck!  

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon

Excess skin under the eye

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A "skin pinch", or pinch blepharoplasty, is a very effective way of removing excess lower eyelid skin.  However it seems in your situation the wrinkles are only present when smiling and not at rest.   It would be best for you to be examined to determine if you truly have any lower eyelid skin excess at rest, as this may not be apparent from your pictures.  If you truly have excess lower eyelid skin, than a pinch blepharoplasty may be helpful; if you do not, than surgery is not a good idea.  Hope that is helpful -

Skin pinch?

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Hello, its normal to have some wrinkles when you smile with or without skin removal.  I would be hesitant to remove skin if you have volume loss, which fillers can help with. It may be worthwhile to seek a second opinion with an Oculoplastic surgeon to see what options you have. Best of luck, 

Smiling skin excess

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Thank you for the question and photos and an examination is really needed to see if there is any laxity other then when smiling and what might be the best treatment

Dr Corbin

You chose the transjugal approach!

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You can expect redundant skin every time you choose the transconj approach; this is often combined with a laser of the overlying skin in an attempt to tighten the skin, but you are too dark to have this. You are going to have to get excision of the redundant skin.

The skin pinch puts a scar across the lower eyelid.

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The fillers are very helpful but are fussy and your surgeon many or many not be any good at this treatment.  I suspect that you would also do well with a 35% tricholoacetic acid chemical peel.  Avoid deeper chemical peels and laser treatment  which can depigment your natural skin color.  Less is more.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Excess skin under the eye after blepharoplasty

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Blepharoplasty is a surgery to improve the eyelids addressing problems like: excess skin or fat herniation.

Fat removal is common to blepharoplasty. It gets rid of the bags under the eye; however the skin over the bag can now bunch up. After an examination, your surgeon can determine if you need medical grade skin care, resurfacing with chemical peel or laser, filler, or excess skin removal. Fat grafting can is a more permanent option to improve the eyelid-cheek area. Your lower eyelid needs to be checked for laxity. You'll need appropriate tension on your lower eyelid to avoid issues during treatment. I would also wait until your blepharoplasty surgeon says you're fully healed from your first surgery. Safety comes first. 

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.