Extremely crepey wrinkled skin under my eye caused by overfilled tear trough filler. What treatment for my under eyes? (Photo)

Question

Ive have extremely crepey wrinkled skin under my eye caused by overfilled tear trough filler, ive fibroblast, whilst the immediate results were amazing, as time went by it looked worse, it then got better again but I don’t feel getting a second session is worth it. This area makes me super self conscious to the fact I wear sun glasses all the time, and I’m wondering what treatment is best to address my issues, I’m considering c02 laser, is this my best option?

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

Erik Peterson, MD · Answer

CO₂ laser resurfacing (including deeper fractional versions like DeepFX) can really help crepey, wrinkled under‑eye skin by removing damaged surface layers and stimulating new collagen deep in the skin, which tightens and smooths texture over time. It’s often considered a strong option for improving crepey texture and fine lines that haven’t responded to skincare alone.
That said, CO₂ lasers have downtime (redness, peeling) and are more intense than gentler options, so they’re usually recommended when other, less aggressive treatments haven’t given the result you want.
Other things worth discussing with a board‑certified dermatologist or oculoplastic surgeon:
Prescription‑strength retinoids (like tretinoin) can gradually thicken and strengthen skin with consistent use and are a good foundation for long‑term improvement.
Less aggressive energy‑based alternatives like RF microneedling or fractional non‑ablative lasers can also boost collagen with less downtime than full ablative CO₂.
CO₂ can be a great option if your main issue is texture and laxity, but it’s not your only choice. A specialist can assess your skin’s thickness, previous filler effects, and help you pick the best approach and downtime level for your goals.

Extremely crepey wrinkled skin under my eye caused by overfilled tear trough filler. What treatment for my under eyes? (Photo)

Answers (2)

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