Best CO2 Laser- especially for crepey skin and dynamic wrinkles under eyes? (photos)

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

In my clinic, I use the CO2RE by Candela and really love the versatility of this fractionated CO2 laser device. HALO was probably not the right treatment for your indication. Plan on 7-14 days of downtime depending on the aggressiveness of the treatment. The nice things about the CO2RE device is that the aggressiveness of the treatment can be tailored to the downtime you are willing to have. 

You are indeed correct- skill sets much more important than the laser. CO2 still remains the Gold Standard for stimulation of collagen. The HALO should not have been used in your case- HALO is for minimal downtime remodelling, and with respects your elastosis and volume loss infraorbitally is too severe for conservative erbium and NA laser. The Sciton should have an ablative Erbium mode, together with modulation. Erbium fully ablative coupled with fractional (ideally CO2) is an option. Above all - remember the best results are achieved if all aspects of ageing is address, - this includes volume loss. See a specialist who can give you options- surgical, laser and dermal fillers. Wishing you well, Davin LIm. Brisbane. Australia.