Alethia Pantazis, MD

There are many ways to treat scarring. It is important to get a consultation and have your area of concern evaluated for the best treatment plan. In the case you describe with a "dent" a filler can be used to elevated the indented portion. The filler itself will not break down a scar nor remodel the collagen and elastin but it may improve the appearance immediately. Platelet rich plasma can be injected into the area and bring growth factors to he area which will aid in remodeling. If there is scar tissue that needs to be broken down microneedling or and energy based resurfacing device is recommended. The difference between microneedling and resurfacing in most cases is the number of treatments needed less for the energy based devices.

It is a good sign that you had a good result for the first treatment. However pitted scars such as those seen from acne may require more energy and depth. This can be dangerous in darker pigmented individuals when using traditional CO2 or Erbium ablative lasers. You could keep hitting it superficially but it will take numerous fractional treatments. I find that Opus plasma fractional resurfacing is excellent for these scars and approved for all skin types

Using fillers under the eyes can be challenging and it is important to have this done with a provider who feels comfortable in the area. The filler should be "settled" by now. I'm not sure what your undereye area looked like before the filler but right now from your pictures I am seeing what looks like filler outside and below of the orbital rim. this could be your own under eye tissue and may have been present before the filler was placed. Often if you add more filler in this situation, you will increase the undereye fullness. In some cases, placing filler into the tear can mask the shadow of the tear trough but you run the risk of exacerbating the fullness. Fortunately, if that fullness was not present until after adding the filler you can dissolve hyaluronic acid which is what Belotero is made up of. If that fullness was there even before using filler a low eyelid blepharoplasty may be a better option.

Dark circles around the eyes can be caused by many things. Some genetic, some age related, some environmental and wellness related. The skin around the eye is very thin and the vessels underneath and around can be more apparent with certain skin tones. A shadow from an under-eye-bag can be the culprit for the undereye darkness. Although this can be genetic and present in early childhood it also appears with aging, typically requires a lower lid blepharoplasty.

In some cases, there is also an association with a systemic or eye allergy, When it is caused from an allergy it can improve with avoiding the allergen or taking allergy medications. Metabolic reasons such as low iron has been associated with under eye darkness. The treatments can vary per individual but in many people, we can reduce and even eliminate the dark circles with platelet rich plasma and/or under eye fillers. I feel that this works best when combined. But some people only need one or the other. If the darkness is from an under-eye bag a surgical lower lid blepharoplasty may be recommended. The opus plasma is a device that may also be used to tighten the skin under the eye and aid in rebuilding collagen and elastin. This building of collagen and elastin is also the reason why the platelet rich plasma works well.

Emsculpt Neo is great for multiple body areas. It is FDA cleared to treat the abdomen, buttocks, thighs (both inner and outer as well as front and back) calves and arms (both the biceps and triceps). Each person's body is unique and a consultation with the provider who is treating you can aid in determining how the results will look. Some of us just need assistance with one area. Others need it in multiple areas. We all have different goals for our body and this device is very versatile. The settings may be altered to attain more of less fat reduction and more or less muscle building/toning.