Carrie L. Morris, MD, FACS

I would say that there are factors that could come into play for this. Was it the same Aesthetician or Physician? Was it the actual only FDA approved SkinPen or was it an off brand? Aside, from this I have been using the SkinPen for over 3 years and haven't heard of anyone with these issues before.

It does seem that you have ptosis of your midface on the left side. Possibly due to chronic pulling or sleeping on that side or a past trauma, etc... A midface lift on the left side would help improve the volume loss of the left cheek and lessen the subsequent nasolabial fold created by the midface descent. This may help improve your lid cheek junction transition by resuspending your lower eyelid at the same time.

Usually after the first treatment most patients notice a difference in their skin, whether it be their pore size or their scarring is less prominent. Some pt's don't notice a difference in the skin until after they have healed from their last session. Now, with your scarring it shouldn't be more prominent, it could be the person doing your treatment may be going too deep into the skin. This is possible with Skin Pen because when you go to deep into the skin it can be too abrasive and start creating the bad collagen. Using a growth factor with the treatment will give you better results.

If you truly have a prominent fat pad of your lower eyelid (difficult to tell from the photo), then the only solution is a lower blepharoplasty. Filler will not solve your problem and only look worse. However, it appears that you have both a fat pad (volume excess) and a tear trough (volume loss). In this case, I recommend lower blepharoplasty first, then 6 weeks or more later after the swelling has resolved, filler to the tear trough.

I do appreciated some degree of crepiness of your lower eyelids. I also see the fullness, although mild, that you are talking about. An appropriate surgical candidate for a blepharoplasty has to do with the condition that is present rather than age. It is actually best to have surgery earlier in life, since it is often less complicated, which means less down time, less surgical risk, and less money! Also you are able to enjoy the results longer during the prime of your life. The duration of results for a lower blepharoplasty is about 25 years.