What can help crepey, saggy skin, hallowing and discoloration under the eyes? (photos)

Question

What Can Be Done for Crepey, Saggy Skin, hallowing and discoloration Under the Eyes? I do get Botox for my crows feet. I also had a medium chemical peel done under my eyes to try to help this problem, which only made it worse and now I have hallowing and discoloration under my eyes also because of the chemical peel. I have tried volbella and Botox and chemical peel and nothing has helped. I am only 32, I used to smoke but stopped 5 years ago and also used to tan a lot when I was younger.

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

Jason Emer, MD · Answer

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.  Best, Dr. Emer.
Best, Dr. Emer.

Camille Cash, MD · Answer

You will benefit most from a combination of procedures.  You can consider fillers or fat transfer to help with the hollow area under the eyes.  Laser treatments and/or microneedling can address skin tone and texture.  See a board certified plastic surgeon in your area to learn more.

Elba Pacheco, MD · Answer

Hi and thank you for reaching out for an opinion. Your best option includes laser resurfacing (Erbium or CO2) which will address the crepey skin portion of your complaint, and tear trough filler to address the hollowness. Find a reputable Oculoplastic surgeon who is experienced in these two treatments and you should be able to obtain the results you seek. 
Best wishes, Dr. Pacheco

Robert Singer, MD · Answer

Most expert experienced
artistic plastic surgeons have a variety of procedures, both non-surgical and
surgical, at their disposal to produce excellent cosmetic results in the
appropriately selected patient: temporary fillers, micro-fat grafts, and
blepharoplasties. Each has benefits and drawbacks and depends on desired
outcome and individual anatomy.
In a patient with your inherited anatomy, a blepharoplasty including micro-fat grafts to the tear
troughs will produce the best and longest lasting cosmetic result.
Following the advice of anyone who would presume to tell you what to do without
seeing photos and without taking a full medical history, examining you, feeling
and assessing your tissue tone, discussing your desired outcome and fully
informing you about the pros and cons of each option would not be in your best
interest. Find a plastic surgeon that you are comfortable with and one that you
trust and listen to his or her advice. The surgeon should be certified by the
American Board of Plastic Surgery and ideally a member of the American Society
for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with
that surgeon in person.
Robert Singer, MD FACS
La Jolla, California

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