Can Laser Resurfacing Make Under Eye Bags Worse?

Question

Can laser resurfacing make under eye bags worse?  I heard the after you tighten the skin the bags can be more prominent and more noticeable.  My derm says will help.  What is the truth?

James R. Gordon, MD, FACS, FAAO · Answer

Laser resurfacing has minimal impact on lower eyelid bags. It does tighten the skin slightly, but not enough to remove the bag. In order for the bag to be removed, a laser assisted lower blepharoplasty needs to be performed. Laser resurfacing makes the skin overlying the fat appear less wrinkly, sun-damaged and more youthful. It should not worsen the appearance of the bag. I hope you find this useful. Good luck.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Matthew Richardson, MD · Answer

Laser resurfacing generally does not make under eye bags worse. If anything, laser resurfacing will offer some degree of tightening of the skin, which should improve the appearance of the lower eyelid area. If significant improvements are made with laser treatments of lower eyelid wrinkles, it is possible that eye bags might become more noticeable simply because the other surrounding issues have improved.I usually find that a combination of treatments customized for each patient works best to improve this area (laser, filler, surgery, topical treatments, etc).All the best,

Raymond E. Lee, MD · Answer

Laser resurfacing will help with the fine lines and crepiness of the lower eyelid skin. It will have minimal effect on the actual bags. This should not be confused with lasers used for blepharoplasty (eyelid bag surgery) which is used as a cutting and cautery tool. One can even get a blepharoplasty with a laser to make incisions and remove bags and at the same time a laser to resurface the skin

Jeffrey Ridha, MD · Answer

While laser resurfacing will not remove under eye bags, the skin can be somewhat tightened, especially with a correctly performed treatment, and improve the overall appearance of the lid and lid-cheek regions.  It does not take the place of blepharoplasty, but when performed correctly, should definitely not make things look worse.

Jose Barrera, MD · Answer

Laser skin resurfacing for lower eyelids bags or wrinkles can be very effective depending on the laser treatment, the energy level, depth of delivery, and density of application.

Anil R. Shah, MD · Answer

LASER resurfacing for under the eye wrinkles is an effective means of improving skin texture. However, the LASER is not designed to deal with herniated fat from the lower lid and volume issues. A comprehensive approach to your lower eye and upper cheek transition will provide you the best aesthetic result.

Scott Trimas, MD · Answer

Laser resurfacing for lower eyelid wrinkles alone can make existing bags appear worse. I will tell you from personal experience and having treated many patients with the CO2 laser for lower eyelid wrinkles, that if you have bags before the procedure underneath your eyes that they will indeed appear worse after you have healed up from the resurfacing, The reason is because when you have both eyelid wrinkles and excess fat of the lower eyelid, the fat is slightly less noticeable due to the wrinkles camouflaging them. If you remove the wrinkles, it is like pulling a curtain tight or lifting the drapes in front of the movie screen, that is, you can now see the screen below the curtains or in the case of eyelids, you see the bags. My advice would be to do both procedures at the same time, that is, a lower eyelid surgery with the CO2 laser if you have both problems and fix both at the same time. We as do many other surgeons often perform lower eyelid fat removal at the same time as we resurface the skin with the laser or some physicians prefer a chemical peel instead of the laser.

Steven H. Williams, MD · Answer

The comments below are great but be sure to consider skin type as well.  Patients with darker skin may have issues with CO2 laser resurfacing.
The laser targets water in your skin and is "an ablative" therapy actually causing superficial destruction of the top layers of your skin.  It will not change the fat or any of the other contents below your skin.
Complications can include changes in pigmentation and in very rare cases scarring requiring surgery.  Make sure you see a board certified plastic surgeon or facial plastic surgeon and have all of your questions addressed.  I hope this helps.

Mark Berkowitz, MD · Answer

I LOVE laser skin resurfacing the lower eyelids!!! As an Ocular Plastic Surgeon I gave up the scalpel blade 15 years ago for the CO2 (carbon dioxide) laser. The laser can be used to gently remove the fullness (fat) in the lower eyelids.  
Once the fatty tissue is sculpted the same laser can be used to resurface or smooth the skin.  The results are beautiful.  The laser causes a gentle tightening and contraction of the skin helping to further diminish the under eye bags and wrinkles.

Can Laser Resurfacing Make Under Eye Bags Worse?

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