29F with prominent under eye creases when smiling, genetic under eye hollows & strong cheeks. CO2 Laser or Lower Bleph? (Photo)

Question

29F with prominent under eye creases when smiling and genetic under eye hollows and strong cheeks. The under eye area has bothered me for years- specifically the big fold of skin that pushes up when I even remotely smile. I have used tret for 5 years, SPF & solid skincare routine, and get crow’s feet botox 2-3 times a year. I have tried under eye filler (now dissolved), cheek filler to help structure the face (didn’t help with this), PDGF (which helped a bit with the hollowness when not smiling but not when smiling), and jelly roll botox (which hasn’t helped with the big fold). Would a CO2 laser or something help tighten the skin? Or am I a candidate for a lower bleph/skin pinch? I am OK with a little bit of crease and folding and don’t expect it to be perfectly flat.

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

29F with prominent under eye creases when smiling, genetic under eye hollows & strong cheeks. CO2 Laser or Lower Bleph? (Photo)

Answers (1)

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