CO2 laser or blepharoplasty, or both? (Photo)

You could certainly start with just the CO2 laser resurfacing on the lower lids to see if you get the improvement you are looking for. In my opinion, your greatest outcome would come from either an upper eyelid (blepharoplasty) surgery or temporal brow lift, in combination with a lower blepharoplasty.

Thank you for your question. I have developed a proprietary treatment I call Take10, which combines different laser devices to produce the most dramatic results without surgery. The treatment is fully customized to the unique needs of each patient and can take off up to 10 years or more from your appearance. I recommend scheduling a consultation with an experienced, board-certified dermatologist and laser expert for further assessment and treatment recommendations.

upper blpeh with co2 full face + bbl + morpheus + PRP woudl be best if you want a HUGE improvement. pretreat your skin with cosmelan peel and your eyes with aerify (see link).

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see linkt) should be started now to prevent further aging.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.