Lower blepharoplasty with laser resurfacing?

Thank you for your question. Lower blepharoplasty is an ideal procedure for restoring volume and diminishing dark, under-eye hollows. Combining this surgery with laser resurfacing treatments can improve your skin’s laxity, texture, and pigmentation to further enhance your results.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to answer any questions you have and help you decide on the best treatment plan.

Hello @eyedocco, thank you for your question. To make an informed recommendation, more information is needed. A consultation is vital to establishing a surgical plan that meets your needs, meets your expectations, and takes into account what is realistically possible. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. 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 lower eyelid blepharoplasty with or without fat pad repositioning 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 (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells 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. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

In general, a CO2 laser will be more effective at improving the quality of the dark skin under the eye and improving the overall quality of the skin itself. However, it will not do anything for the hollow appearance or the protruding fat (which are interrelated problems). If you would like to address both, it would be wise to consider Co2 laser first and then lower lid blepharoplasty in order to ensure the skin isn't tightened too much. Alternatively, a transconjunctival bleph (from internal incision) can remove and redistribute the fat with tightening of the skin from the CO2 laser.

CO2 laser resurfacing is a type of skin treatment that uses a high-energy laser to remove the outer layer of skin and stimulate collagen production. The procedure can help improve skin texture, reduce wrinkles, and tighten the skin. It can also be effective in treating skin discoloration, such as dark under-eye circles.

Skin tightening procedures, such as a skin pinch or blepharoplasty, can also be effective in reducing the appearance of wrinkles and improving the contour of the temporal lid area. However, these procedures may not address skin discoloration or dark under-eye circles.

The choice between CO2 laser resurfacing and other skin tightening procedures will depend on your individual goals, anatomy, and other factors. It is essential to have a consultation with a board-certified plastic surgeon who can evaluate your unique situation and recommend the best approach for you. The surgeon can also discuss the potential risks and benefits of each procedure, as well as any potential impact on the lower blepharoplasty procedure. It is also important to consider the cost and recovery time associated with each procedure before making a decision.


I hope this helps,
best of luck !

Thank you very much for your question. The best procedure to correct dark hollows underneath the lower eyelids is a transconjunctival lower blepharoplasty with arcus margin Alice release and fat grafting.

The problem with resurfacing the lower eyelid is that it delays recovery, can cause loss of pigment in the skin and the worst possible complication of lasers resurfacing of the lower eyelid is that the technique can shorten the lower eyelid pull the corner of the eyelid down into what is called an ectropion. The ectropion exposes the cornea causes tearing and require surgical correction if the cornea gets dry.

Up in my opinion you are correct that skin pinch of the lower eyelid will help tighten the lid. Most importantly a canthopexy is the best way to tighten the lower eyelid and avoid ectropion following eyelid surgery.