51 year old- what is best treatment for my eye wrinkles? Under eye filler or laser?(photo)

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

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Thank you for your question and for providing a photo. When the skin has begun to thin, laser resurfacing or RF microneedling is an excellent choice for smoothing fine lines and wrinkles by stimulating collagen production. If the lower eyelid has excess skin, it can be removed and tightened through an eyelift procedure, also known as blepharoplasty. This surgery requires a small incision under the eyelashes to rejuvenate the skin and create a level transition from the lower lid to the upper cheek area. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your concerns and make the most beneficial suggestion for you.

Botox can help with the crows feet wrinkles. Because you don't have any bags/hollows, and it doesn't appear that you have a lot of excess skin on your lower eyelids, I would recommend a laser/energy based device. This will "iron" out your skin to make it smoother. I recommend going to a cosmetic dermatologist for a in person consult to see whats best for you.

There are a number of things to consider that make it difficult to answer here without more information and an exam. Wrinkles are caused by several things including laxity of the skin as well as thin skin without elasticity. However, there are some generalizations that can be made. First, at 51 you have not been making collagen or elastin in the skin for about 25 years, This thins the skin and makes it wrinkle. Therefore, you need to be on tretinoin (Retin-A) and Obagi's ELASTIderm to stimulate collagen and elastin in the skin no matter what else is done. If the skin is lax, then what you need is a lower blepharoplasty to remove the excess. If the tissues are relatively taught but just wrinkled, a laser or leveling peel will work nicely to smooth the wrinkles and stimulate collagen. This gets the job done quickly but does have a 2 week down time. Another option is to add a series of microneedlings to the tretinoin and ELASTIderm. This is slower but has essentially no down time.