It’s also not a new surgery, despite what your late-night scrolling may tell you. “It’s a nuance of [surgical] technique, [but] not a revolutionary new procedure that didn’t exist before,” says Steven Teitelbaum, MD, a board-certified plastic surgeon in Santa Monica.
How does it differ from a blepharoplasty?
“Blepharoplasty just means eyelid surgery,” says Dr. Teitelbaum. A skin pinch is “a subcategory of blepharoplasty: One method is pinch, another method is the skin flap or muscle flap.”
The one major difference between a traditional blepharoplasty and the skin pinch: With the latter, “you’re doing nothing to the muscle and nothing to the fat underneath,” says Dr. Few. “You’re only dealing with skin.” That can make it a more precise method for reducing crepiness or sagging. “It is a less traumatic, more controlled way of doing it [than a blepharoplasty],” says Dr. Teitelbaum.
That’s because a blepharoplasty goes deeper. As Dr. Doft explains, in a traditional blepharoplasty procedure, an incision is made along the lashline to separate the skin and muscle from fat. That excess fat is removed and the skin and muscle are redraped by the surgeon to reduce undereye puffiness, for example. “Although it is possible to obtain excellent results with this technique, and some patients who have large lower eyelid bags really need this procedure, it can change the shape of the eye by making it rounded due to scarring,” she says. “To decrease that risk, many surgeons will approach the fat through the mucosa of the lower eyelid (the lining of the lower eyelid).” This is what the pros call a “transconjunctival blepharoplasty.”
Sometimes this is enough for a patient, but if they have minimal to moderate excess skin in addition to eye bags, a pinch can also be removed. “Once in a while, a patient does not have excess fat but does have excess skin, and then only a skin pinch is necessary,” says Dr. Doft.
Who is a skin pinch best for?
Since just a small amount of skin is removed from the undereye area, it’s best for people with mild to moderate excess skin — which can look crepey or crinkled — without the excess fat that can cause heavy bags.
Dr. Doft recommends the service for people with “good lower lid support.” How do you know if you have that? “We do a snap test where we gently pinch the lower lid, pull it out, and let it snap back to see how quickly it [does],” says Dr. Teitelbaum. The faster the skin snaps back, the better the lower lid support, and the less likely that removing skin will change the shape of the lid.