If you’re one of those people who has looked tired since you came out of the womb no matter how much sleep you get or concealer you use, a “pinch”—billed as a minimally invasive procedure that can help prop up sunken under-eyes—might just be for you. Texan Katta Kitziger, who just turned 30 and is getting married this summer, was one of those people.
“I felt like my under-eyes always looked gaunt. It’s genetic for me. I’m Eastern European, my grandpa, and my mom have the same eyes. I even had hollowness under my eyes as a kid. I was always jealous of people who have full under-eyes. Like, look at Jennifer Lawrence. Her under-eyes are perfection,” Kitziger says.
We followed Kitziger around before and after undergoing a pinch with New York City plastic surgeon Adam Kolker, M.D., to see if it could, in fact, give her J. Law under-eyes in time for her wedding.
What’s a pinch?
Long story short, it’s a subcategory of blepharoplasty. Whereas blepharoplasty rejuvenates the whole eye area by minimizing bagginess or fullness of the eyelids via fat repositioning, fat removal, or removal of excess skin, when there is only a mild excess of skin below the lower lids, a pinch may be what’s called for.
“A skin pinch entails conservative skin excision immediately beneath the lower eyelid lash line that’s determined by the amount of excess that can be pinched with a forceps,” Dr. Kolker says. “For younger women with the early hallmarks of aging, a skin pinch may be used as a stand-alone procedure. But minimally invasive fat removal, fat repositioning or addition of fat may also be performed at the same time if necessary to smooth out the area,” he says.
In Kitziger’s case, in addition to removing a little skin under each lashline, Dr. Kolker took a bit of fat out of her flanks to reinject under her eyes (a procedure known as an autologous fat transfer, which lasts much longer than filler) to really level out the playing field so to speak.
What does skin pinch surgery entail?
Dr. Kolker recommends sedation and local anesthesia for the type of pinch he did for Kitziger. Post-op, he suggests elevating the head, using chilled gauze over the eyes, and keeping the eyes closed as often as possible as well as using anti-inflammatory eye drops for five to seven days. (Note for those considering a pinch: Kitziger recommends downloading books on Audible before surgery.) Kitziger was also advised not to wear her contacts for three weeks post-op to avoid irritating the (dissolvable) stitches embedded deep within her under eyes.
How much downtime is required for pinch surgery?
“We call it ‘sunglasses-recovery’,” Dr. Kolker says. This means you’ll probably want to hide some swelling and bruising with your shades for about two to three days. “After that, most people are comfortable going out as long as lifting, straining, and exertion are avoided,” he says. Stitches are usually dissolvable and are often gone, if not removed, by seven days post-op. And most people go back to work (with concealer on) between five and seven days after surgery. For some, mild bruising or discoloration may persist for up to two weeks. Kitziger says she took regular Tylenol for a few days post-op “just to stay ahead of it,” but didn’t experience much discomfort at all.
Anyone with mild skin excess or crepe-y skin immediately beneath the lower lid lashline is a candidate, according to Dr. Kolker. The best subjects are most often in their 30’s, 40’s and early 50’s that require very little skin removal and smoothing. As we age, elastin and collagen within the skin begins to dissipate, necessitating different surgical intervention, if desired, to address excess skin and sagging.
Interestingly, Dr. Kolker says that age is not the only factor in determining eligibility for a pinch. Based on a person’s anatomy, or even aesthetic goals (very subtle improvements, for example), a skin pinch may be indicated. Fitness level and lifestyle choices, such as smoking and time spent in the sun, as well as genetics may also play a role.
“There are some people in their 50’s who may need a skin pinch only, and those in their 20’s or 30’s that may require more involved blepharoplasty maneuvers,” Dr. Kolker explains.
Skin pinch results
“I had an easy breezy recovery,” Kitziger says. She reports “holding onto a little swelling two weeks after surgery,” but says that she likes the swelling because it gives her an even fuller look. She reports that the bruising is 100 percent gone and that her lipo incisions are negligible due to the minimal amount of fat that was needed for the autologous transfer.
How much does a skin pinch cost?
Skin pinches will usually cost between $5,000 to $7,000, but can vary widely depending on where you live—and whether they do the surgery with garden shears or sterilized surgical tools. Kidding about that last part, but you do want to seek a board-certified doctor to perform the procedure, and always ask to see past photos of their work.
How to get skin pinch results at home
No topical is going to provide the same level of results as an in-office procedure, but applying a targeted eye cream can help firm and plump your under eyes, with or without a skin pinch. We like SkinMedicaTNS Eye Repair ($106) for the clinically-backed growth factors and peptides that work over time.
Peter Thomas Roth Instant Firmx Eye Temporary Eye Tightener ($38) offers immediate gratification: in a clinical study, 100% of participants experienced less puffiness just three minutes after application.
SkinCeuticals A.G.E Advanced Eye ($116) combines a cocktail of peptides, caffeine, and light-dispersing optical pigments to combat crepeiness.
What does the pinch procedure tell us about aesthetic trends?
As opposed to procedures like buccal fat removal, aimed at taking fullness away to produce more of a snatched look, a pinch aims to restore volume producing a more natural result. “As we age, we tend to lose volume, and looking our most youthful is predicated on maintaining or restoring volume,” Dr. Kolker says. For her part, Kitziger says she likes her pinch because it didn’t “skeletonize” her face.
Ah but did it give her the J. Law look she so desired? We’re happy to report that Kitziger is thrilled with her trough-free under-eyes. Our conclusion? While a pinch might not be right for everyone, for the right person, it can be everything that is needed. Literally.
Editor’s note: Kitziger’s photo was taken 33 day post-procedure, and it takes three months to see final results. Watch this space for visual updates on Kitziger’s progress post-pinch.
Featured Expert
Dr. Adam Kolker, Harvard-trained and board-certified plastic surgeon