More wrinkles 2 years post blepharoplasty and co2 laser resurfacing (I am 30 years old)? (photo)

I had a lower lid blepharoplasty and co2 laser resurfacing procedure two years ago. I am now 30 years old and have significantly more wrinkles than before the procedure...mostly seen when I smile but they can also be seen when I am not smiling when the light hits just right. Is there any type of cream (such as retin A or similar) that can be used to help the crepey/wrinkled skin that is under my eyes now? Other recommendations? Thank you for your time.

Doctor Answers 4

Eyelid wrinkles

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You are young and aggressive treatment is not wise. Topical products with retina-A may be useful and safe. If the wrinkles are worsened by squinting/smiling, then botulinum toxin injections may help (for dynamic wrinkles).

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

You do have some fine wrinkling in this area.

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Retinol preparations should help and they can be used safely around the eyes at the lower strengths. You may also benefit from some fillers, as it looks like you are volume deficient there. Did they remove fat with the bleph? Some botox may also help to decrease the smiling wrinkles.

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Lasers have thinned skin in some people while improving wrinkles. It's best to build up the skin & be aware of health factors

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Before lasers were used, the standard to reduce wrinkles was chemical peels. Chemical peels were used superficially, medium or deep into the skin. This was based on the idea that if you took a certain level of the skin such as the upper levels of the dermis called the grenz zone, an area of the skin that has a lot of collagen, comes out resulting in a newer fresher looking skin.

In the mid 90s, the CO2 lasers were the first lasers to become better than chemical peels. CO2 lasers use thermal energy that cause skin tightening and stimulate production of collagen. From that point forward, there have been different types of lasers and variations of CO2 lasers with the ultimate goal of improving the appearance of wrinkles and generating more collagen.

Unfortunately, I have noticed that a lot of people who underwent laser treatment had thinner skin even though they had an improvement in the appearance of their wrinkles. This is why I always ask my patients about their lifestyle. I let them understand that there are factors that contribute to the appearance of the skin. These factors include smoking, excess sun exposure, not enough sleep and stress. All of these factors contribute to the skin becoming thinner.

To improve skin quality under the eyes when laser cannot be used anymore, I use regenerative medicine in my practice. I apply something called platelet-rich plasma. This is taken from the patient’s own blood and is spun down to be able to get the platelets and the growth factors that are necessary for healing. A simple cut in the finger becomes a clot or scab and then the skin heals over due to the platelets and growth factors in the skin.

In other fields of medicine like in orthopedic surgery, the benefits of platelet-rich plasma for wound healing is already well established. Right now, it is extremely popular for professional athletes to get injections of platelet-rich plasma for areas that have had a lot of impact, stress and inflammation. In the aesthetic field, we have been using platelet-rich plasma for many indications. We use it for acne scars, fine lines and wrinkles. We also use this in our hair loss division and combining it with extracellular matrix to reverse hair loss and to thicken hair. This is a remarkable technology that we have been developing over the past couple of years and now we have had consistent results.

For someone like you, platelet-rich plasma is something we would consider. One of the advantages of platelet-rich plasma is that it can be injected several times in a year, and we can observe the benefit from it. We usually would wait for a couple of months and then use some topicals. Topicals can be beneficial with a limitation. Retinoids can be considered but you have to very careful about the strength and the type of retinoid that you use. I also suggest alternative medicine like the use of fish oils and supplements to help with your overall health as well. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Treating crepiness of lower lid skin

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A retinoid gel such as retin A will help. If you have not tried before it may be worthwhile to try being treated with small doses of Botox or Dysport injected into the orbicularis underneath your eyes may also help to improve and soften the appearance of the fine lines. This is an area that most injectors do not commonly treat, so it's important to choose a physician with expertise to achieve the best results.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.