It seems like every day there's a new plastic surgery or injectable technique to learn about: ponytail facelifts, liquid brow lifts, traptox. The latest treatment in the spotlight is the “skin pinch,” which has gained momentum due to prominent placements on — you guessed it — TikTok. The basic social-media pitch: It's a simple, relatively low-pain way to reduce excess skin and crepiness under the eyes to make you look fresher and more awake. But is that true? And how does this procedure differ from a traditional blepharoplasty, a.k.a., eyelid surgery, which is on the rise for younger patients and consistently ranks among the top five most popular procedures? Below, learn about the procedure — and what surgeons really think of it.
Meet the experts
- Melissa Doft, MD, is a board-certified plastic surgeon in New York City.
- Steven Teitelbaum, MD, is a board-certified plastic surgeon in Santa Monica.
- Julius Few, MD, is a board-certified plastic surgeon based in Chicago.
- Steven Williams, MD, is a board-certified plastic surgeon in the Bay Area and president-elect of the American Society of Plastic Surgeons.
Okay, so what is a “skin pinch”?
Pretty much exactly what it sounds like. “A pinch of skin is removed from the lower eyelid along the lash line. Only skin is removed, not the underlying muscle or fat,” says Melissa Doft, MD, a board-certified plastic surgeon in New York City. “It can be a standalone procedure or part of a lower blepharoplasty [lower eyelid surgery'.”
In both cases, a skin pinch is performed to remove excess skin from your lower eyelid, making the area look less saggy or wrinkled. It got its name because, as Dr. Doft says, “only a pinch of skin is removed, so as not to change the shape of the lower eyelid.”
Julius Few, MD, a board-certified plastic surgeon in Chicago, compares it to visiting the tailor (but you're the one leaving with stitches). “The best analogy is thinking of a dress or pants that are too big and just a little bit of fabric needs to be removed,” he shares. “By crimping up the skin [similar to a pinch] along the eyelash line [using a surgical tool], you [can then] just cut it off at the seam with a special scissor. It delivers a dramatic result by making the lower eyelid look very smooth.” He adds that it can be much more effective than lasers at getting rid of crepey skin under the eye.
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.
The doctors we spoke to typically do a skin pinch on older clients who are dealing with aging-related crepiness and sagging. But Dr. Few has seen an uptick in requests from people who have gotten too much filler around their eyes in the past and are now dealing with the aftermath: deflated, crinkled skin. “That’s the cautionary tale of doing filler around the eyes,” he says. “If someone is doing it indiscriminately, it can cause the skin to become wrinkled.”
Who should not get a skin pinch?
If you have heavy bags caused by excess fat under the eyes, a traditional blepharoplasty is a better option. “If you try to [just tighten] the skin to force the fat down, it will cause the eyelid to pull down and change the shape of the eye,” explains Dr. Few.
The skin pinch is great for reducing small amounts of skin responsible for that crepey look, but "it's not good at getting rid of puffiness,” says Steven Williams, MD, a board-certified plastic surgeon in the Bay Area and president-elect of the American Society of Plastic Surgeons. Heavy bags can actually be “a tear trough deformity," explains Dr. Williams. "The underlying problem is fat sticking under [the tear trough].” A blepharoplasty will be able to take care of that issue much more efficiently.
Can you do a skin pinch with other services?
Because a skin pinch is a relatively fast procedure, it's often paired with other plastic surgery procedures. At her practice, Dr. Doft often combines a skin pinch with transconjunctival blepharoplasty or a Fraxel laser treatment or TCA peel on the lower eyelid skin, both of which she uses to smooth fine lines or tighten the skin under the eyes. Dr. Few likes pairing a skin pinch with a facelift: “Typically you're lifting up on the face and cheek area, so getting rid of that skin [that's causing crepiness under the eyes] is a nice, quick, and easy additive.” He also frequently adds it to thread lifts, especially because both can be done under local anesthesia. Combining the two procedures gives “a mini-lift effect without undergoing major anesthesia or surgery,” he says.
How much does a skin pinch cost? What's the recovery like?
Typically, you can expect to pay anywhere from $5,000 to $7,000 for a skin pinch.
The procedure takes well under an hour — usually about 30 minutes — and while you will likely experience light bruising for about a week, pain is minimal. (Icing helps, and so does Tylenol.) If you use contacts, your surgeon may advise wearing glasses for a few weeks so you're not disrupting the delicate incision site. But, in comparison to other plastic surgery procedures, the skin pinch is relatively simple and it can be permanent, says Dr. Williams — once you remove the skin it's gone. “It’s a really fast, turnkey procedure and the results are significant and last a very long time,” says Dr. Few.
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