Fraxel Laser on Eye Area After Juvederm and Laser Eye Surgery?

Question

Is it okay to have Fraxel Laser on the eye area a month after having Juvederm to the tear troughs, and a year after having laser eye surgery (because of the eye shields that are placed in the eyes at time of treatment)?

Michael A. Persky, MD · Answer

Hi,
It is safe to have even Fraxel repair of your eyelids one month after Juvederm and one year after Lasik surgery.  The heat of the laser may cause the Juvederm placed in your eye hollows to dissolve sooner.  Your cornea should be well healed after one year so that the corneal shields used during the treatment would be safe.  To be absolutely sure, check with your Lasik surgeon.
Good luck and be well.
Dr. P

John L. Burns Jr., MD · Answer

There are three Fraxel lasers: ReFine, ReStore, and Repair. The ReFine and ReStore lasers are "non-ablative" meaning that the top layer of the skin (epidermis) stays intact. The Fraxel RePair laser is a fractionated CO2 laser which targets water in the skin and ablates or removes tissue. It is the more aggressive Fraxel which is usually done by doctors and not physician extenders.   
Microthermal/treatment zones are created which penetrate into the deeper layer of the skin (reticular dermis). Usually, Juvederm would be injected deeply into the skin but it is possible with the very thin skin of the eyelid that it may be more superficial. If the Fraxel laser is used aggressively so that it is programmed to penetrate deeply, it could target the hyaluronic acid in the filler and cause it to weaken and absorb quicker.  
 
Generally, if a patient wants Fraxel and a filler, I will do the Fraxel laser first and then do the filler.
 
Eye protection is typically recommended with any of the Fraxel lasers. If an eyeshield is a concern since you had eye surgery, you could request to have an external eye patch used which is just as safe and won't come into direct contact with your eye.

Scott Trimas, MD · Answer

Fraxel laser treatments are safe to use in the area under the eyes. However, eye shields should be used to protect the eyeball during the procedure. It should not have any impact on the juvederm you received a month earlier or the laser eye surgery you had.

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