The key element here in your decision making process and why it is hard to determine from these photos is the following.
Is your problem:
- Prominent fat deposits?
- Loose skin?
- Both of the above?
If it is 1, then use the transconjunctival technique.
If is is 2, then use the external approach.
If it is 1 and a mild amount of 2, then use the transconjucntival technique plus fractional resurfacing.
If it is 1 and a large amount of 2, the use the external approach.
Although the fractional laser was thought to be excellent in skin tightening, it has also been shown to provide benefits with skin discoloration.



