Thank you for your question. I understand you underwent a skin pinch procedure to improve your under eye wrinkles, but the results left you unsatisfied. Now you’re asking whether Pelleve or Thermage can give you better results, and you also state that you do not want to undergo the intensity of a laser or a chemical peel because of prolonged healing time.To give you a bit about my background — I'm a Board-certified cosmetic surgeon and Fellowship-trained oculoplastic or oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years. I’ve been using CO2 lasers in my practice since the mid-90s when they were first introduced, so I have a lot of experience with it.Now that you’ve addressed extra skin with the skin pinch removal, you’re concern now is an issue of skin quality around the eyes. It’s important to remember that eyelid skin is very thin — only half a millimeter in thickness — which means you can only do so much to it.When you heat the skin with a thermal device, the skin responds by tightening the skin and and a collagen production response. However, with eyelid skin, you have to consider the percentage of skin that is affected by the thermal energy, and the percentage that is affected by anything that you do superficially. In our practice, we try to improve the length of downtime by combining CO2 laser with platelet-rich plasma (PRP). PRP is derived from your own blood, and is made up of a concentration of the growth and healing factors that are necessary for wound healing. It greatly improves overall skin quality and texture and reduces the need to deliver high doses of thermal energy. In addition, we do not use a fully ablative CO2 laser but rather a fractional CO2 laser. This means that there are fewer areas of ablation, which allows for faster healing. With this combination, our patients get definitive results and look good in about a week.If you have a lighter skin type, I would recommend the CO2 and PRP combination. If you have a darker skin type, or one that has more melanin, we usually combine PRP with Pelleve. The reason I choose Pelleve is because I can better customize the intensity and be conservative with the treatment.Sometimes, people think that more energy and heat delivered means better results, but in reality, when too much heat is administered, the skin and the crucial fat underneath gets cooked and breaks down. In order to avoid this, we use PRP routinely in our practice, alongside laser treatments.I recommend you explore these treatment options and accept that a certain amount of downtime will occur to get improvement. You can also look into chemical peels, which work by taking off the top layer of skin and allowing a new layer of better quality skin to come through, or retinols and the like.I hope that was helpful and I wish you the best of luck!
