Laser/Chemical Peel and Botox/filler combination

I have had botox now (2 years) around my eye area and Juvederm too hoping that the static lines from sun damage/smoking would be erased. I'm only 28, Irish fair skin type and have been using sunscreen daily and refissa nightly now going on two years. I think these are more preventative. So I'm wondering if I have a TCA Peel or Erbium laser done on my lower eyelids where the fine lines are and maintain my botox/filler/sunscreen/retinoids program will these lines be fully corrected. PERMANENTLY

Doctor Answers 2

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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A combination approach with lasers, fillers, skin care and microneedling/PRP for treatment of under eye wrinkles yields optimal results. I suggest continuing on your skin care and treatment regimen and adding microneedling/PRP with Clear + Brilliant. I suggest you speak to your dermatologist for the best long term treatment options that are individualized to your own skin. Best, Dr. Emer

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Treatment of Fine Lines from Sun and Smoking

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You are definitely on the right tract. You need to make sure the sun block you use is a zinc oxide one of at least 8% and that you use it every day and reapply it if you rub or wash it off. I would also switch from Refissa, as it contains mineral oil which reduces or prevents the absorption of the tretinoin (the retinol) and, thus, markedly reduces the ectiveness of it. You did not say whether you have quit smoking. If you have not, you absolutely must do so or you will never improve the lines. Filling any deep lines and using Retin-A can, over a year or 2, significantly reduce the lines as long as you remove the muscle component with Botox. A peel or laser can significantly speed the process if the other things you are doing are optimal. An Erbium laser is not, however, a good choice. Make sure you see someone who is an expert in skin rejuvenation to guide you through the process. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon

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