Under-eye hollow and shadow on very thin face. Will laser/CO2 tightening help?

Question

I have a very thin face and body due to genetics. (I am healthy with no health issues.) My under-eye region, like the rest of my face, is losing fat. Will laser/CO2 tightening help? I don't want temporary fillers under my eyes. Will Sculptra, Radiesse or fat grafting help?

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

William Groff, DO · Answer

Thank you for your question. If you do not want fillers in this area (which is usually the first course of treatment), I might recommend fat grafting in the area. This treatment typically produces longer-lasting results than dermal fillers. However, fat is also more unpredictable and cannot be reversed if you don’t like the results. If you opt for this option, make sure you are working with a board-certified dermatologist who has extensive experience injecting fat into the tear trough area.

Alan B. Brackup, MD, FACS · Answer

Thank you for your photo and question. My first thought is fillers or surgery. You mentioned the Co2 laser vs fat grafting. I would lean more towards fat. The laser will tighten skin- but laxity is not an issue for you. You need to either remove the bag or fill the hollow. Hope this helps.

Jason Emer, MD · Answer

start eye rolling at home and use restorsea 10x, restorsea eye serum, and cosmelan 2 a few times week. in office fillers (I do not like permanent fillers or fat here), lasers and peels will help.
There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.

Under-eye hollow and shadow on very thin face. Will laser/CO2 tightening help?

Answers (4)

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