What are your thoughts on a touch up following UltraClear CO2 under eye laser & Kybella? (Photo)

Based on your photo, you would be an excellent candidate for both upper and lower blepharoplasty. The amount of under-eye bags and hollowing you’re experiencing is best corrected surgically, as lasers or Kybella are unlikely to provide the improvement you’re looking for.
Clarifying the Treatment You Received
One necessary clarification: Did you have UltraClear laser or CO2 laser? These are two completely different technologies, and it’s unlikely both were performed simultaneously. UltraClear is a 2910 nm fiber laser, while CO2 lasers use a different wavelength and a more aggressive approach. Understanding which laser was used is crucial in assessing your results.
Also, when was the Kybella injected—was it done on the same day as the laser treatment or at a separate appointment? Kybella can cause significant swelling and inflammation, affecting how your under-eye area heals. If the two treatments were performed too close together, that could explain why you’re not seeing the improvement you expected.
Risks of Laser Treatments Around the Lower Eyelid
Another important consideration is that treating the lower eyelid with aggressive laser resurfacing carries the risk of complications like ectropion (a condition where the eyelid turns outward, leading to irritation and exposure issues). This is why it’s critical to see an experienced plastic surgeon who is also highly knowledgeable in laser technology. This ensures you get the best of both worlds—a surgeon who can address eyelid laxity while also considering skin resurfacing safely.
Here is why Surgery is the Best Option for You in my opinion,
In your case, doing UltraClear, CO2 laser, or Kybella under the eyes may not be the most effective solution. Lasers can help with skin texture and mild tightening, but they cannot remove or reposition excess fat, which is often necessary to correct under-eye bags. Kybella is not routinely used for the under-eye area, as it can unpredictably dissolve fat, sometimes making hollowing worse instead of improving it.
Instead, a well-performed upper and lower blepharoplasty would likely give you the best and longest-lasting results. If your primary concern is under-eye bags, I highly recommend consulting with a board-certified plastic surgeon who is also experienced in laser technology. This way, you can explore the safest and most effective approach for your needs.

I hope this helps.
Sincerely
Dr. Shanthala