Fraxel laser or Blephoraplasty? (photos)

I have under eye bags and wrinkles. I am unsure which approach to take to remove/reduce them: fraxal laser, or blephoraplasty? I would be grateful for your recommendations.

Doctor Answers 7


Thank you for sharing these interesting photos. Although I cannot see your full face, you appear to be quite young with good skin texture. Laser would not help at all; as other have explained, this is really only to remove fine lines. In younger patients like yourself Filler is a much better option which is lower risk with rapid recovery and outstanding results in most cases if administered by an expert. In addition, "Fraxel" is now a relatively old fractional CO2 technology and there are much better systems out there which allow for more rapid recovery and better treatment. In conclusion, I would be a little concerned about the advice you have received as the treatments advised are not the best options and even if laser were indicated, the technology platform advised is not great. I would ask an oculoplastics expert for an opinion. Best of luck!

London Oculoplastic Surgeon
5.0 out of 5 stars 1 review

blepharoplasty procedure for under eye bags

A trans-conjunctival approach lower blepharoplasty can accomplish removal of the fatty deposits located underneath the lower lids creating the  puffy look.  The incision is completely located on the inside of the   eyelids.  For many  before and after examples of blepharoplasty, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Laser or lower lid blepharoplasty

Your photograph shows prominent tear troughs and minimal fat pad prolapse. I agree with Dr. Steinsapir's recommendation that you would benefit from filler in the cheek. CO2 laser skin resurfacing is a great option for improving the skin quality and may tighten the skin very slightly... Best wishes in finding an experienced injector in your area.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

First you need a diagnosis.

Please put your finger on the top of your "bag".  What you are feeling is your orbital rim not a knuckle of lower eyelid fat.  This issue will not be helped with lower eyelid surgery.  Fraxel will help the quality of the skin but not fix the bag.  I would recommend under eye filler for you instead of lower eyelid surgery.  The key is finding the right injector.  Lower eyelids are fussy and you need a truly experienced injector for the lower eyelid.  Treatment last well over a year for many.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

You need both

Blepheroplasty is the only way to get rid of eyelid bags. Excess skin is also reduced with blepharoplasty.  Fine wrinkles then can be improved with Fraxel or a phenol peel. Thus you will need both to achieve all your stated objectives.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Bags in the Lower Eyelids

Hello,Fraxel and other laser procedures are designed to improve the quality of the skin while only subtly altering the shape.  The shape of the lower eyelid is mostly related to the shape of the bone and fat and how it sits relative to the eye itself.  In your case, I see that you have a shape issue, not so much a quality of skin issue.  You have what are called "tear-troughs".  These are the sunken circular areas below the "bags".  The treatment for this is filling of the tear-trough area and reshaping of the fat.  To some extent this can be done non-surgically, but for best and most permanent results you would want to look at surgical options like tear-trough implant surgery.Regards,Dr. A

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 29 reviews

Lower eyelid bags: treatment

 Thank you for sharing your question and posting photographs. Laser skin resurfacing will not remove your bags. This method of treating the skin will improve the quality (texture, elasticity and color) of your skin, but not give enough tightening to remove the bags. Hiding the bags with injection of dermal fillers or blepharoplasty are the best treatment options. See an experienced Oculoplastic Surgeon for consultation.  Good luck,

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.