Leave it to TikTok to turn the lower eyelid skin pinch procedure into the next big thing. Although the skin pinch is a less invasive way to turn back the clock on aging eyes, it doesn’t mean it is a fit for everyone. In fact, despite the surgery’s recent explosion in popularity, there’s plenty to know about it to determine if it will benefit you.
What iIs a Skin Pinch?
A skin pinch is a quick, minimally invasive surgical procedure that only eliminates small amounts of excess skin from the lower eyelids. “With a skin pinch, the excess skin is measured, “pinched” together to separate it from the underlying muscle and then trimmed,” explains San Diego oculoplastic surgeon Allison McCoy, MD. Most skin pinch surgeries are performed on the lower lid to remove a few millimeters of extra skin, but Beverly Hills, CA oculoplastic surgeon Raymond Douglas, MD says they can be done on the upper lids when necessary.
Skin Pinch vs. Traditional Blepharoplasty
A skin pinch and traditional blepharoplasty address characteristics of an aging eye, each providing individual benefits.
Boca Raton, FL, oculoplastic surgeon Steven Fagien, MD says a skin pinch is more limited than blepharoplasty and only benefits someone with limited wrinkles or skin redundancy, “which is a small subset of patients.” Because of that, Dr. Fagien shares that the procedure can fall short in the expectations department if a patient has an abundance of wrinkles, significant excess skin or muscle or tendon laxity, which a skin pinch doesn’t address.
Although a skin pinch only removes excess and doesn’t alter the surrounding fat pads or muscles as blepharoplasty does, Dr. Douglas says it will improve the appearance of the eyelid. However, a lower blepharoplasty is necessary if there are fat-related concerns, such as puffiness, under-eye bags, hollows, or dark shadowing. “A full blepharoplasty takes the area and all structures into consideration, working with skin, tissue, fat, and muscles to correct the area and create the most natural enhancement,” he adds.
What to Expect
During the 30-to-45-minute procedure, which is performed under local anesthesia, Dr. Douglas explains that excess or sagging skin is first pinched with forceps and then pulled away from the eye. Next, an ultra-sharp, refined scissor excises lax skin. “Then, the razor-fine incision is folded into the upper eyelid crease and closed with fine, dissolvable sutures,” he adds.
The recovery is short and manageable, with bruising and swelling lasting three to five days. A skin pinch is a good alternative for those who can’t be out of commission for long.
Once the skin is fully healed, Dr. McCoy says it should appear tighter and smoother. “Keep in mind that the procedure leaves a hairline incision hidden beneath the lower eyelid lashes or at the outer corners of the eyes,” she adds.
Naturally, excising loose skin comes with potential risks. To prevent them, Dr. Douglas explains that removing the right amount of skin without lid distortion is paramount. “Eliminating too much skin can lower the lid position and expose too much sclera or change the eye shape,” he shares. “In men, the risk of malpositioning can be more problematic.” Tearing issues can also arise if too much skin is deleted and the lid is pulled too far down.
Should You Get a Skin Pinch?
If you’ve had your eyes done before, you may want to pass on a skin pinch. Since there’s less extra skin, Dr. Douglas says the results can look strange or artificial in someone with surgical enhancement.
In some cases, removing redundant skin can call attention to aging eyes. That’s why some surgeons, like Dr. Fagien, perform skin pinches occasionally and instead rely on other techniques. “For example, a skin flap, which uses the same incision as a skin pinch plus one just below the eyelashes, allows for better wrinkle and skin laxity reduction and addresses skin, muscle and tendon tightening,” he explains.
When extra or wrinkled lower eyelid skin is indeed the issue, this treatment can create smoother-looking eyelids without the downtime that comes with CO2 laser resurfacing (usually six to eight weeks). The key to garnering good results is ensuring that the skin beneath the eyes lacks elasticity without excess fat.