What would help me with under eye tightening? (photos)

Question

I have tried filler to help this area. Would C02 laser help to tighten under my eyes? I am wanting to get it by my upper cheeks as well.

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

Falguni Patel, MD, FACOG · Answer

thanks for your question. if you are looking for skin tightening we usually suggest the morpheus8 which is micro-needling with RF. this tightens the skin, improves tone and texture, and stimulates your bodys natural collagen.

Jason Emer, MD · Answer

see our IG post and stories today, yes co2 can help. plasma pen is less downtime option combined with other light lasers like moxi.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging (see link).

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant or moxi regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8/pixel8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Travis James, DO · Answer

It is hard to fully assess with the pictures posted but CO2 or erbium yag resurfacing can help substantially with under tightening. If you have under eye bags the result is much more variable but if it is just fine lines this can help. I would recommend you see someone who will place eye shields to be able to go up closer to the eye and help resurface the eye lids. Good luck. Dr. James

Patrick Flaharty, MD FAACS · Answer

There are several ways to tighten the skin in the lower eyelid. In our practice we use a 35% trichloroacetic acid peel (TCA) for mild wrinkling in the lower eyelid and ablative laser resurfacing (fractional CO2 or Sciton TRL) for more advanced degrees of wrinkling. A third option is a pinch technique which entails trimming out a small amount of skin from the lower eyelid just under the lash line. Given your young age and early aging changes I would recommend either a TCA peel (if you want to improve the texture and tone of the skin) or a pinch technique (if you want to tighten the skin). Consulting with an oculoplastic surgeon would be a great way to learn more about this procedure.

Anshul Gambhir, MD · Answer

Thank you for your question. It is difficult to tell based off the photos but it doesn't appear like you are in need of under eye tightening! However, CO2 laser for the under eye area is a treatment that can help tighten the under eye area. There is usually about 4-7 days of downtime with this procedure and although there will be some immediate results, full results will take several months. Hope this helps!

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and photos.  It would be best to talk to your dermatologist about options in person.  They will be able to assess your skin type and make sure you are a good candidate for laser vs other procedures.  One method we love for tightening the under eye area is RF microneedling.  You can safely get closer to the eyelid margins as it is not laser specifically and poses no danger to the eyes.  The microneedling itself stimulates new collagen growth and can be custom tailored to each patient, and the radiofrequency energy helps tighten the deeper layers under the epidermis for long-lasting results.  You can have the entire face treated, or just the area around the eyes, the neck, or the chest.  Please see an expert and best of luck!

Sheryl D. Clark, MD, FAAD · Answer

Hello TeBaker:

Fractional CO2 is great for fine lines, wrinkling, and brown spots. Radio frequency treatments such as ThermiSmooth or Secret RF are better for deeper wrinkles and skin tightening. They are often performed together for optimal results.

Your under eye area looks pretty great to me, so make sure you really need a treatment before you proceed!

All the best from New York City, 
Sheryl Clark MD, FAAD

What would help me with under eye tightening? (photos)

Answers (8)

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