Hello, I had a hard 7 months after a bad Retylane job under my eyes. I had vitrase, ulthera, fractional co2, and sclerotherapy before I found a surgeon who was able to properly dissolve everything and start from scratch. The contour looks normal now, but I have many fine lines and some crinkling in tear troughs. How long should I wait before pursuing a chemical peel to smoothe out the skin? Thanks.
Crepey Skin and Fine Lines Under Eyes?
Doctor Answers 8
Damaged Skin After Repeated Treatments
I agree with the other doctors; there may be permanent damage to the delicate skin under your eyes from having excessive treatments done. Without seeing a picture, I recommend you hold off on the chemical peel and apply moisturizer and retinal under the eyes on the orbital rim; do not apply it directly under the eyes as that is too close. Consult your last treating physician as well, as he knows the exact condition of your skin and can help you find the right path of treatment. “Dr. D”
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Please understand that some of these changes are now likely permanent.
Our lower eyelid skin is very delicate. Not well understood is that the lower eyelid and midface tissue are part of a complex glide system so that when we smile, tissue heaps up in well a natural way. As one manipulates these tissues with various procedures including resurfacing procedures, the fine loose tissue responsible for the gliding and smooth sliding function of these delicate planes is damages. The fine scar tissue associate with these manipulations like laser resurfacing effect how these planes slide and glide. Instead of the natural sliding one begins to see a particular type of tissue heaping that is unnatural. It is not possible to restore this sliding effect. Chemical peels can be helpful. Overall though, I would advise caution and would recommend letting these tissues rest for a year before pursuing more "help," for this region.
The Punctuated Phenol Peel Can Work Well For Fine Crinkles and Hyperpigmentation
The Punctuated Phenol Peel uses full strength phenol (NOT TO BE CONFUSED WITH the Baker's Phenol Peel formula used for deep peels) in a dot-like, fractionated grid pattern to treat fine crinkles, superficial lines and wrinkles, creypyness and pigmentart blotches.
With this approach, pinpoint-sized dots of the phenol are applied with 3mm spaces between each appliction to ensure that there is sufficient normal intervening tissue to promote excellent wound healing and to reduce the risk of scarring. In general, a series of about three to four peels spaced at two to four week intervals is required to achieve optimal results.
Another option would be a trial of a treatment series (2-4 sessions) of superficial peeling agents, such as Jessner's solution, salicylic acid, glycolic acid or low strength (10%-15%) TCA.
Especially in light of all the previous treatments, it is important to consult with a board certified aesthetic physician experienced in all these options for treating this delicate region.
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Damaged skin may be a result of excessive treatments
I agree with Dr. Steinsapir that the thin crepey skin may be a result of too many treatments that has damaged your skin. Some of these changes may be permanent, unfortunately, and may only be reversed surgically if at all. Be aware that a chemical peel may cause pigmentation issues on top of further thinning of the dermis.
Loose skin of eyes
A detailed photograph but better yet an exam in person would be very helpful to evaluate the proper treatment for yout eyelid issues.
Without photos or seeing you in person, it is impossible to give you specific advice. I would suggest consulting with your local board certified plastic surgeon to discuss your options.
Problems after Restylane injections to the lower eyelid area
Really need a photograph to see your present condition. I am having a hard time understanding why you needed any other treatment besides using the Vitrase. In any event I would wait for 3 -6 months to allow everything to settle down then consider an evaluation by a plastic surgeon who is experienced with both soft tissue fillers, fractional CO2 lasers and lower eyelid surgery.