Skin Pinch in Cheek Lift?

Could you explain in further detail the skin pinch with support of the corner of the eye, usually with an ultrashort incision cheeklift (USIC)? Thank you.

Doctor Answers 7

Skin pinch with cheeklift

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The lower eyelid is a very weak structure. Maintaining an almond shape is important for mainatining a normal eye appearance.

When skin is removed from the lower eyelid, a downward pull is exerted on the lower eyelid. The greater the amount of skin removed, the looser the lower eyelid, or the more prominent the eyeball is in the eye socket, the more downward pull there is when skin is removed, and the greater the resulting deformity. This deformity usually manifests as a pulling down of the lower eyelid, a rounding of the eye, or a "sad", downgoing appearance of the eye.

One method of retaining eye shape is by supporting the corner of the eye, not just with a canthopexy (tightening of the lower yelid), but of elevating the cheek tissue, essentially "giving" it to the lower eyelid. The tension then does not rely on removing from the lower eyelid, but rather from an elevation of the cheek. Then, a small amount of skin can more safely be removed, tightening the skin with minimal risk of affecting eye shape.

A great risk of lower eyelid surgery is in scarring that can occur within the orbital septum, pulling down severely on the lower eyelid, or of removing too much skin from the lower eyelid, causing an ectropion. This can be avoided not with an incision that goes completely across the lower eyelid (therefore affecting the orbital septum), but with an ultrashort incision just on the side of the eye, the ultrashort incision cheeklift, or USIC cheeklift.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Fancy new names for known procedures

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The gold standard in medical practice is to properly diagnose the clinical problem, perform the correct procedure in a safe and effective way.

The combination of lower lid /cheek lift procedure is a very effective procedure for midface rejuvenation. It is a highly techincal procedure and is not for every patient to have nor for every surgeon to perform.

Skin pinch is a very limited procedure that only address a small amount of skin excess. In my mind with time the skin will stretch out again. The key is to address all the components of facial aging.

The skin, fat, and muscles need to be addressed to be able to have a stable result. The lid need to be properly supported to avoid any future complications.

Lower lid surgery is a one way street, if perfomed properly you will have a good result. Stay away from fancy new names for old procedures. The key is proper diagnosis and technique.

Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Pinch technique is when a conservative amount of lower eye lid skin is pinched with clamp and cut

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Best is to break down the your question:

1. Pinch technique: To help the creapy and loose skin of lower eye. The skin just below the lash line is pinched with clamps. This preserves the underlying muscle and does not pull the lower eye lid down. A simple procedure but requires experience and a steady hand.

2. Support of the corner of the eye. Cantopexy, Cantoplasty etc are procedures that thighten the lower eyelid so that it stays up and does not pull down after eye lid surgery or specially a lower lid access midface lift.

3. Mid face lift through lower lid incision. A procedure that has inherent complications which include execive swelling, lower lid pull down, and may not be that effective in lifting the midface.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.0 out of 5 stars 8 reviews

Cheek lift with skin pinch could cause lower eyelid deformity

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A skin pinch can make an improvement in excess lower lid skin when it is present in the lower lid's natural state. You have to be very careful when doing it in combination with a cheeklift, though, because the natural state is shifted when a cheeklift is done.

Obviously, when the cheek is pulled up, it will look like there is extra skin present. However, if all the excess is removed with a skin pinch, then when the cheek tissue relaxes, and it always does, it could pull the lower eyelid down with it, resulting in a deformity.

Make sure you speak with surgeons who are well experienced in performing this type of surgery.

Dr. Miller

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

Don't Get Caught Up in Gimick Names

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There are many ways to address the lower lid and the cheek. Surgical procedures that have a gimick name don't mean anything. The actual procedure, how it's performed and what the outcome is suppose to achieve is important.

A midface lift which address the cheek can be done through several incisions in the lower lid. Depending on what needs to be addressed, ie removal of skin from the lower lid, fat removal from the lower lid or just midface elevation determines the incision to be used.

Sot see several board certified plastic surgeons to have your consultation regarding your cheeks and lower lids.

This is a rather specific technical question you pose

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Dear Jackster212,

There are almost as many variations on mid-face/lower eyelid surgery as there are surgeons performing these procedures. This means that individuals considering these procedures should approach unsubstantiated claims regarding the success of a particular approach with a critical eye. The take home message when there are so many surgical approaches to the same area is that nothing works for everyone. There is no secret surgical fix that addressed the lower eyelid issues for all patients.

The so-called ultra short incision cheeklift is just what one surgeon calls their transcutaneous lower blepharoplasty when combined with some supporting stitches to help keep the weight of the cheek off the lower eyelid once some skin has been removed and the tissues contract from scaring. Does this procedure work? For the right person this can be a very workable solution. The rub is that for the wrong person, this procedure will not be right. So how do you know what you need?

The answer is that there is no substitute for finding the right doctor, who will personally assess you and design a surgery that meets your goals, expectations, and anatomic issues. Unfortunately this means finding a surgeon with the ability to adapt and alter their approach to fit your particular circumstance. Cookie cutter surgery is almost always going to produce an unsatisfactory result.

Don't sell yourself on a particular surgery or approach. Seek multiple opinions and see who makes the most sense. They say don't fall in love with a stock. Well, we surgeons think that the chemistry of confidence is very important. But try to not let it be love at first sight. Carefully listen to the surgeon, be aware of the level of detail of their assessment. How are their powers of observation and insight.

Finally, study their before and after pictures. Ask yourself if you like what you see, are the results plausible for you? Google your doctor so you have done your homework on them and consider contacting the state medical board where your doctor practices to determine if their are any disciplinary actions against your potential surgeon.

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

Lateral mini-cheek lift can be done

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This is a frequently asked question about lifting of the cheek fat pad through a lower eyelid incision. The lower eyelid can be a weak structure and care must be given not to weaken the support of the lid. Your lower eyelid will not support your cheek. The typical patient who is a good candidate for this type of procedure has a lateral skeltonization of the orbital region and a descent of the cheek fat pad. If you place your finger over the prominent area of the cheek and gently push upward and this give you improved fullness in the lower eyelid and lateral orbital zone then the procedure may be appropriate for you. I typically perform this procedure through a lower eyelid incision and raise a short skin only flap, leaving the muscle layer and underlying fat layer alone. The cheek tissue is then gently elevated at a level just above the cheek bone carefully disecting between the sensory nerves. Next a the cheek is suspended and anchored to the lateral orbit and a lateral canthal tendon tighening procedure is done. This essentially tightens the lower eyelid in a transverse direction. This helps to prevent any downward pull of the lower lateral eyelid. This procedure can rejuvenate the lower eyelid area and gives a gentle upward fullness to the orbital zone.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 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.