What is best to tighten loose crepey skin on my cheek/crows feet area...laser or deep chemical peel? Or recommendations? (photo)

Thank you for your question and for the photos. I would recommend fillers to add volume to the area along with Botox to soften the wrinkles and Ultherapy to help tighten the skin. All these treatments would help minimize your wrinkles and help with your overall appearance. It is imperative that you schedule a consultation with an experienced physician for optimal results. Hope this helps. All the best.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I would probably not recommend a deep chemical peel for this delicate area. Laser devices and RF microneedling can be highly effective in rejuvenating the skin around the eyes and minimizing the appearance of lines and wrinkles. Injections of a neuromodulator like Botox can be combined with laser treatments to put the finishing touches on your rejuvenation efforts. I encourage you to schedule a consultation with a board-certified dermatologist who can examine you and create a customized treatment plan that meets your needs and goals beautifully.

Profound RF in combination with laser skin resurfacing is highly recommended.     Profound RF is the first FDA approved device for elastin production.  Elastin is the spring in our skin, accounting for the skin's ability to snap back and not sag.   Profound RF, via a single 1 hr treatment, will tighten sagging skin on the cheeks, lower face and neck.   Laser skin resurfacing stimulates collagen production, helping to improve skin texture and fine lines.   Lasers however do not promote elastin production.  I recommend scheduling a consultation with a qualified physician who has expertise in Profound RF/Laser skin resurfacing.  
Regards, Dr. Mahmoud

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Crepey skin is thin and looks finely wrinkled like crepe paper. 
Sun damage is the most common cause of crepey skin, but it certainly isn't the only cause. Crepey skin can also result from aging, a lack of moisture, excessive weight loss, or any combination of these.
Prevention is always more important than treatment. Long term sun protection, a good moisturizer and oral anti-oxidant are indispensable. 
Dermatological treatments that can treat crepey skin include: Topical treatment (retinoid, chemical peel, peptides), Energy based devices (eg: laser, radio frequency, ultrasound), Injectibles (Calcium Hydroxyapatite, PLLA, peptides).
There isn’t a single best modality to improve crepey skin. Combination will always give a better result. 
Decision on which treatment suits you the most, will depend on individual acceptance towards treatment downtime, frequency, cost and the associated risks. Do have a consultation session with a certified physician, to check on your skin, to analyse the pros and cons of each treatment modality. Cheers.

Absolutely laser. Find an experienced provider who offers deep laser resurfacing and is comfortable placing eye shields so they can work right to the lash line. 

Deep crows feet lines are a challenge. Without question the best preventative measure is to avoid sun damage and wear sunscreen daily. We can go back and erase our past but wearing sunscreen is something occasion people should do to get sun exposure Who want to prevent wrinkles.I’ve seen stunning results from both laser and chemical peels. You’ll probably find that more senior providers will be more likely to pull out the chemicals and younger providers will lean towards the laser. The public seems to also have an ongoing love affair with the word laser and anything that is associated with technology or the latest and greatest gadget. i’m sure they’ll be plenty of providers who recommend a variety of toys they’ve recently purchased. when botulinum toxin is used to treat crows feet we we can or partially paralyzed the orbiculares oculi muscle. This is the muscle we use to close our eyelids. The zygomaticus muscles used to lift the corner of the mouth when we smile are not treated with botulinum toxin or a paralyzed appearance is created. Therefore people who are prone to crows feet will still form those lines when smiling but not so much when squinting after being treated with products like Botox.It’s important to recognize that Botox does not illuminate wrinkles but rather weakens muscles minimizing the ability for that individual anatomic muscle to contract the skin causing wrinkles. Deeper wrinkles or not treated as well with skin treatments like laser while fine wrinkles do better. Another option is injecting fillers directly into the lines. Again, this works better for deep lines than superficial ones but can give a very nice results in the area of concern here.In regards to the results from laser or chemical peels the more intense the treatment the more impressive the results can be but aggressive treatments will regardless lead to higher risks of complications and longer recovery times.This is true for both laser treatments and chemical peels.Some providers lean towards a more aggressive single treatment while others prefer to do series of lighter treatments.Well aggressive treatments do have some drawbacks including higher chances of undesirable outcomes they can give very impressive results.The list of devices available for this is endless. in the end your best option is to find the best provider and let him or her guide you in the right direction.Inquiring about treatment options is going to be key. Much depends on what you’re willing to go through.Perhaps the best place to start is a commitment to sunscreen for life, continued use of botulinum toxin, appropriate use of HA fillers with moderate intensity laser treatments either as a single treatment or on a ongoing basis. There are multiple other modalities such as micro and macro needling with or without energy sometimes called RF or radio frequency.in the end the clock can be turned back only so far. It can however be slow down for the future with the use of sunscreenBest, Mats Hagstrom MD