Puffy under eyes and the skin feels thin and loose, how can I correct it? (photo)

Question

Not sure if this qualifies as bags, but under my eyes they're puffy and the skin feels thin and loose. It's worse when I'm smiling, as pictured. My eyes are big, and while it has been this way I notice it's worse as I get older (I'll be 30 soon). Aside from under-eye filler, what else can correct this or improve it? CO2 laser? Not sure if I want to constantly get threads.

Jason Emer, MD · Answer

under eyes do well with plasma pen in the office and at home rolling and peels (see link).
fillers can be used to camouflage the area or improve the hollows.

at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin roller with anteage MD ampules) should be started now.

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 lower eyelid blepharoplasty with or without fat pad repositioning 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 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.

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

Puffy under eyes and the skin feels thin and loose, how can I correct it? (photo)

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