Pro Fractional Laser for Puffy Eyes?

Question

I went for a consult to get Blepharoplasty (lower eyelid surgery) for puffiness under my eyes. The doctor said he does not recommend surgery but recommends pro fractional laser treatments for my eyes and face instead. Does pro fractional laser treatment reduce under eye puffiness?

Vivek Bansal, MD · Answer

Does the doctor offer lower blepharoplasty surgery? Typically, puffiness under the eyes is from herniated fat pads, and surgery is the only real option. Laser will help tighten the skin, but the bags are fat.

Michael Orseck, MD · Answer

The Profractional laser can help puffy lower lids if it is due to excess skin.  The profractional laser does not treat puffy lids due to muscular or fatty excess.

Mark Berkowitz, MD · Answer

Profractional Laser, Mixto, Fraxel, Pixel or other Co2 lasers can help tighten or resurface the delicate lower eyelid skin.  without a face to face consultation, it is impossible to state whether this is all that is necessary for you. Laser resurfacing does not remove or contour fat or puffiness.  The puffiness can be improved by a traditional or laser blepharoplasty.
In my practice, I use the Mixto laser to contour the fatty tissue as well as to tighten the skin.  The profractional does NOT change the fat, as it is not an incisional laser.  If you want tightening of the skin without removal of fat, thermage may also be of benefit to you.  Does your doctor even perform eyelid surgery?  If not you may want to get a second opinion. Best of Luck.

Glenn Vallecillos, MD, FACS · Answer

Thank you for the question.

	Without being able to see your photograph or examine you in person, it is difficult to make an accurate assessment. In general,  fractionated lasers are effective for  resurfacing the skin lending to skin tightening and removal of rhytids or wrinkles over time.  Puffy eyes or bags are typically attributed to pseudoherniation of fat bags that lie in within your orbit. This requires a surgical procedure for correction, and a laser would impart no improvement on such a condition.

	Regards,

	Glenn Vallecillos, MD, FACS

Claudio DeLorenzi, MD · Answer

ProFractional laser therapy is good for inducing deep collagen formation and reducing the appearance of wrinkles. It is usually combined with some form of flat beam laser treatment for the upper layers of the skin. It does NOT help puffy eyelids, which are generally due to fatty tissue bulges. These are easily treated with an eyelid operation to redistribute the fatty tissues and sometimes to remove a portion of them.

Robert Kasten, MD · Answer

may be useful if loose skin is the main culprit. Very often deep fat cushions also need to be treated with an operation.

Brooke R. Seckel, MD, FACS (retired) · Answer

Pro Fractional Laser therapy is a skin treatment. Puffy eyes are caused by protruding fat underneath the lower eyelid. This Fat must be surgically addressed.

	The Pro Fractional Laser only treats the surface of the skin and cannot effect the Fat causing the puffy eye or eye bag.

	My guess is that you saw a Dermatologist who does not do Blepharoplasty Surgery.

	See a Plastic Surgeon who is certified by the American Board of Plastic Surgery

Joseph Rabson, MD (retired) · Answer

When most people talk about puffy eyelids they are referring to the bags in the lower eyelids caused by fat under the skin and muscle layer. The profractional laser would not reduce this kind of puffiness, and surgery may be more appropriate.  However, your doctor evidently thinks that tightening the skin a little will give you the result you want and probably does not feel that surgery will be helpful at this time. 
Perhaps your puffiness is not bad enough to warrant surgery. He may be totally correct.  However, without seeing you in person, and making a diagnosis of your problem, it is impossible to say.
Personally, I would strongly suggest you ask your surgeon to show you before and after photographs of other patients with your exact condition treated with the Profractional before going ahead.  Consider a second opinion with another surgeon. You may get a different answer. Good luck!

Pro Fractional Laser for Puffy Eyes?

Answers (8)

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