Fraxel: I have severe bunching of crepey skin under my eyes, and abnormally thick lines around my eyes. (photo)

In my practice we use fillers, lasers, microneedling/PRP to the under eye with great results.  TCA peels can be used and so can fractional co2 which are both more aggressive.  fraxel does great but nothing will get rid of this completely.  these are normal aging lines, sometimes worsened with botox around the eyes.  you will want to start the proper skin care -- retinols, glycolics, vitamin C etc.  I suggest seeing an expert.  Best, Dr. Emer.

Hi Hamleteng. You are a good candidate for Dysport (or Botox) at the crow's feet (outside of eyes) and underneath you would need laser resurfacing and probably filler as well.  The effectiveness of fractional resurfacing depends on how experienced your practitioner is and how they do the treatment.  If you are concerned with outcome, ask for before and after photos of previous patients that had the same procedure done at that practice.  That should give you an idea of what to expect.To see an example of one of our recent Los Angeles patients that had the same type of lines under her eyes and underwent fractional resurfacing, click on the link below.  

This is a hard area to address, but fraxel will likely help improve this without making it go away completely.  We usually combine this with non-invasive treatments that tighten the skin laxity in this area for an enhanced result.  Fillers may or may not be needed to improve this area depending on what it looks like in real life.  Please consult with a board certified specialist who can assist you with achieving the results you seek. 3-dimensional computer imaging can help you visualize what you may look like after surgery and serve as an important communication tool with your surgeon.

I don't think that Fraxel will improve this problem much. Whatever you decide, Botox is needed. Fractional ablative resurfacing is a better option. Fraxel is non ablative. Laser such as CO2 and Erbium are needed for ablative resurfacing. Fillers will also help and Belotero is a good one for this area.

I think this area is hard to completely treat. If Fraxel were to be chosen I would go for the RePair- namely the CO2, but even then, I don't think its the best Co2 laser for THIS area. I would combine another Co2 for higher power, medium density, then address volume with HA fillers. If you are not keen on fillers, energy based microneedling combined with PRP can help- however you will need a few treatments. I am not a fan of Botox for static lines, as this can make the area worse by ' bunching ' of wrinkles under the eyes. All the best, Dr Davin Lim Laser and aesthetic dermatologistBrisbane, Australia.