Julio F. Gallo, MD

As always, each case is individual and the treatment plan should be customized for each patient after careful evaluation and discussion with your surgeon. In general, laser resurfacing ( I prefer fractional lasers such as the Active and Deep F/X) is used to smooth out wrinkled skin. The CO2 fractional lasers have the advantage of creating more collagenesis because of the thermal (heat) component of the laser. Of course, it is limited because the surgeon is not removing skin or muscle. A transconjunctival lower lid blepharoplasty plus a laser is a great option for rejuvenating that area. Conversely, if there is a significant muscle roll, laxity of the lower lid tendon, or a lot of redundant skin, then an external incisional blepharoplasty is indicated in order to access these structures to tighten and/or remove them. Thank you.