Which laser treatment(s) would you recommend for under eye bags and festoons? (Photo)

At least from the one photo provided, there is a possibility that these may be what has been called under-eye "puffy pillows," which are in fact lymphedema (lymphatic obstruction) secondary to the prior use of a less appropriate filler for the infraorbital area and/or one that has been too superficially injected.. If so, this problenm can be very difficult to treat. I have had, however, gratifying results in treating patients who have come to me with this using an algorithm of intralesional injections of varying combinations, concentrations, and amounts of anti-inflammatory agents. I understand the power of marketing hype and social media buzz to sway the public to seek out all kinds of relatively expensive, energy-based, "bells and whistles," like fraxel lasers and RF devices. However, these frankly lack the hard science to back up the claims, but also carry risks, especially for the development of post-treatment dyspigmentation that can be very troubling, particularly for skin of color , and difficult to treat. You would be wise to seek consultation with an experienced, board certified cosmetic dermatologist and best of luck.

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