Would Co2 laser deliver results when used on the under eyes? (photos)

Question

I would like to understand if CO2 laser would work on my under eyes. I looked into tear trough filler but I don't think it will give me the desired results (altho please let me know if I'm wrong). I'm reluctant to look into lower blepharoplasty as I had upper and it didn't heal great. I have scarring and also a lump of scar tissue on my eyelid that I hate so I'd be worried the lower would heal the same and be more visible Thank you!

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

Nadir Qazi, DO · Answer

Thank you for your question. CO2 laser resurfacing can be an effective treatment for under-eye concerns such as fine lines, wrinkles, and skin laxity. However, it is important to note that the skin around the eyes is delicate and sensitive, and laser resurfacing in this area requires a high level of skill and precision.
CO2 laser resurfacing works by removing the outer layer of damaged skin cells, which stimulates the production of new collagen and elastin fibers. This can lead to smoother, firmer, and more youthful-looking skin. However, the treatment can also be quite intense, and there is a risk of scarring or other side effects if it is not performed carefully.
In your case, it may be worth discussing your concerns with a board-certified dermatologist or plastic surgeon who has experience with CO2 laser resurfacing in the under-eye area. They can evaluate your skin and recommend the most appropriate treatment options based on your specific concerns and goals.
It is also worth noting that tear trough filler can be a very effective solution for under-eye hollowing or dark circles, depending on the severity of the issue. However, it's important to choose an experienced injector and discuss the potential risks and benefits of the treatment before proceeding.
In summary, CO2 laser resurfacing can be an effective treatment for under-eye concerns, but it requires careful consideration and should be performed by an experienced professional. A consultation with a qualified dermatologist or plastic surgeon can help you determine the best course of action for your individual needs.

Jason Emer, MD · Answer

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.

Nelson Lee Novick, MD · Answer

The use of natural fillers for treating tear troughs goes back four decades to the use of Zyderm colllagen for this purpose. Much more recently we have a whole array of natural HA fillers geared to this purpose and nonsurgically treating tear troughs with them is practically a daily occurrence in any active cosmetic dermatology practice. Since the upper cheeks are the main suuport for the under-eyes, the use of a robust filler for this region often is all that is required to achieve improvement. And, should direct treatment of the tear troughs still be required or desired, there are low viscosity, cohesive HA fillers made expressly for this purpose. The use of an ablative laser would not only NOT address the volume deficit that is the primary cause of tear troughs and bags, but, being ablative, would be expensive, have significant post-treatment downtime, and run the risk of disfiguring scarring.  You would be wise to consult with an experienced, board certified cosmetic dermatologist for this and to discuss treatment (injection of anti-inflammatory agent to shrink the bump) of the hypertrophic scar on your eyelid--which is quite simple to address. Hope this helps.

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