Doctor recommended CO2 for discolouration then either filler, bio filler or fat transfer. What would you recommend? (Photo)

Question

I'm looking at fractural CO2 for dark circles. I have a natural crease/line that makes my under eye seem hollow. A doctor that recommended CO2 for discolouration (3 rounds) then either filler, bio filler or fat transfer for the under eye shape.

Erik Peterson, MD · Answer

Hi! Dr. Peterson here
For under-eye concerns, it’s important to separate color issues from volume or contour issues. Fractional CO2 can help improve skin texture, fine lines, and pigmentation, but it won’t restore lost volume or change the shape of a natural crease.
For hollowing or a deep tear trough, options like hyaluronic acid fillers, biostimulatory fillers, or fat transfer are usually more effective. A consultation with a board-certified dermatologist or dermatologic surgeon can help you decide which combination of treatments will address both color and contour safely.

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

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