How Close Can the Fraxel Restore Laser Go Under the Eye?

We routinely go just below the eyelash line and get all the lower eyelid skin to respond to the laser. This can be done carefully without injury to the eye. There is no problem doing this 2 months after juvederm injection for a tear trough deformity. If you are not very olive skinned or afro-american pigmentation should not be a problem.

I have very good results with Fraxel Restore laser beneath the lower lids. It is dependent on intensity of treatment (mj or depth of treatment) ,treatment level (amount of surface area treated) and number of treatments performed. Fraxel significantly improves the texture and fine wrinkling around the eyelids, even after one treatment, although a series of 3 or 4 is usually recommended.  If a new patient tells me they tried Fraxel elsewhere but didn't see improvement, I ask them....was it REAL Fraxel, who did the treatment (a technician will not be as aggressive....PS in Florida, only a physician or physicians assistant is legally permitted to do  laser....many facilities do not follow these statutes), and what were the settings (those well trained will feel comfortable recommending aggressive settings, thereby getting better results).

BOTOX is a good adjunct to the fine wrinkles, known as crows feet, although this is an off label use of BOTOX,

I am not a proponent of Injectables fillers in the lower lids. Perhaps this is because I have had several patients come to me in second opinion with horrendous results....excessive swelling that persists for months, or even rock hard "foreign body" types of responses in the "nasojugal groove" or tear trough. This is a very sensitive area and Injectables can result in problems that may persist for months, if not longer.  The key as a plastic surgeon is to avoid over resection of fat in the lower lid when we perform a lower lid Blepharoplasty.