Would laser resurfacing or filler and Botox be a better procedure for under eye skin that bunches with expression? (Photo)

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. 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

Hello SM. The reality is that the procedures you have identified help with different issues. If you are looking to tighten the crepey skin under the eye, either surgery or laser resurfacing is the way to go. If you would like to get rid of the indentation seen in the middle of the photo, you're better off with surgery or dermal filler injections. Botox (Dysport) can help with the fine lines present right at the cheekbone as well. Sometimes one procedure or another will achieve your goals. In this case, you may need multiple procedures to really achieve yours.

Thank you for your question. Based on your photos, it appears you have developed some crepey skin under the eyes, as well as the lines you mention. Laser resurfacing would rejuvenate and tighten up the skin in the area to create a more youthful appearance. You will also likely need some Botox in the outer corners of the eyes to treat your crow's feet there. I encourage you to schedule a consultation with an experienced, board-certified dermatologist for further assessment and treatment recommendations.