Crow's feet and wrinkles on lower eyelid.

Question

Good day, I heard laser treatements ( including CO2 ) are not very effective in treating crow's feet as wrinkles will appear again in few months of treatment. Is this correct, and what is best permanent solution for wrinkles in this area. Thank you

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Shirat Ling, DO · Answer

You will continue to age, so there is no permanent solution for wrinkles...just treatment and prevention. Wrinkles around the eyes are due to movement of the muscles of expression, so any of the neuromodulators (Botox, Xeomin, or Dysport) would be appropriate to relax the muscles, and prevent future wrinkles. The effects of these medications is around 3 - 4 months, so you will need to repeat treatments to keep the wrinkles at bay. 
Once these muscles are relaxed, it does give your body a chance to repair itself...and there are a few options to help stimulate your own collagen production to fill these wrinkles. After performing 10,000 treatments, I have seen fabulous results with the CO2 fractional laser treatment of the eye area. You do need to be patient, as results can take up to 6-9 months to appear, with thickening and tightening of the delicate eye skin. I find adding PRP to the CO2 laser speeds up recovery and results. I often recommend this treatment before injecting dermal fillers in hollow tear troughs. 
Other treatments, which are more superficial, with less down time, are available. For people with instantaneous tightening, with continuing results, I recommend the Pelleve radiofrequency treatment. I have used this effectively for the upper lid as well. Microneedling is also another treatment for this area (and the rest of the face, neck, and decollete) with a day of down time; this treatment could also be combined with PRP for added benefit. Multiple monthly treatments of both of these are recommended, as they are more superficial in their benefits.
And, of course, protect your investment with appropriate eye skin products between procedures. I recommend PCA Skin eye cream or gel, which have a retinol especially formulated for the sensitive eye area (upper and lower lid), that stimulates collagen production. Wear sunglasses and reading glasses (or increase the font on your phone) to prevent unnecessary squinting. Change the way you insert contact lenses (or get Lasik). Wear different types of goggles when you swim; control your allergies, etc.

Lisa Jenks, MD · Answer

The wrinkles in the crow's feet are caused by repeated underlying muscle movement.  The best solution for these is Botox.  However, it is not a permanent solution as Botox needs to be injected every 3-4 months for best results.  A CO2 laser can definitely improve the appearance of existing lines around the eyes, but unless the muscle movement is diminished by using Botox, the lines will continue to worsen after a CO2 treatment.It is important as we age to use a medical grade eye cream.  I prefer eye creams that contain polypeptides which stimulate collagen and elastin production.  Unfortunately, there are no permanent solutions in this area.Best of luck to you.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes, CO 2 laser is my favoured treatment for wrinkles at rest, namely static wrinkles, especially on the lower eyelid. However if you have true ' Crows Feet' these are dynamic wrinkles, namely wrinkles on movement that can make static wrinkles worse. A face to face consult with a Plastic surgeon or Dermatologist will give you the best plan. Most of us would perform both, namely prevention and treatment with laser for the best outcomes. Dr Davin Lim. Brisbane. Australia.

Crow's feet and wrinkles on lower eyelid.

Answers (4)

Answer: Static vs dynamic wrinkles.

Answer: Static vs dynamic wrinkles.

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Everything you need to know about CO2 Laser

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Crow's feet and wrinkles on lower eyelid.

Answers (4)

Answer: Static vs dynamic wrinkles.

Answer: Static vs dynamic wrinkles.

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.