Is surgery my only option? Could CO2 or something else fix me up? (Photo)

Question

I admittedly was about overfilled, but this woman convincing me to dissolve has been entirely regrettable. I now have this eye wrinkle on one side. I didn't know the old cheek filler would go too while treating eyes. Do I had o get surgery? Would CO2 or something else fix me up?

Shanthala Shivananjappa, MD · Answer

Can Laser Resurfacing Help Instead of Surgery?
In my experience, it is possible that UltraClear Laser-Coring can significantly soften under-eye wrinkles and fine lines while also helping improve skin texture and firmness. Unlike CO2, UltraClear allows for precise tissue removal and collagen remodeling without excessive thermal damage, making it an excellent alternative to surgery for many patients.
What About Overfilled Under-Eye Fillers?
If your under-eye area is overfilled, the filler should be dissolved first. Once that’s done, UltraClear Laser Coring can further refine the area, improving skin tightness and elasticity. Many of my patients who have had botched under-eye filler removal saw a natural, lifted appearance post-laser—without the need for additional fillers.
In fact, several of my patients have mentioned that after UltraClear, they looked as if they had cheek fillers, even though they didn’t. The laser’s ability to firm and tighten the skin creates a subtle volumizing effect, giving the appearance of more lifted, youthful contours.
Should You Consider Surgery Instead?
While surgery (like lower blepharoplasty) is the best option for severe skin laxity and excess fat pads, it’s worth consulting an experienced oculoplastic surgeon. UltraClear laser is worth trying first because it offers remarkable improvements in skin quality and wrinkle reduction, often delaying or eliminating the need for surgery.
I recommend getting a consultation with an expert in surgery, laser, and filler correction to determine the best approach for your case. Also, if you’re interested, check out our patient video, where I removed botched fillers and performed UltraClear Laser Coring, resulting in a more refreshed, youthful, and lifted look without adding more fillers.
Hope this helps, and I wish you the best on your journey!
Sincerely
Dr. Shanthala

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Stefan Weiss, MD · Answer

Depending on your goals, CO2 can tighten the fine lines/wrinkles inferior to the lower eyelid, improving skin texture and promoting a more youthful appearance.

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