Will microneedling with PRP fix my under eye bags? Or would filler or lower eyelid surgery be better options? (Photo)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi @doihavetohaveusername. The upper cheek is a major support for the under eyes. So when there is volume loss there, not only do the cheeks reflect this, but the under eye can as well with the development of tear trough and under eye hollows. Addressing the volume deficit in the cheeks with the use of a volumizing hyaluronic acid filler would be a reasonable place to begin. Best of luck, Dr. Nima!

Based on your photo, you may benefit from a combination of treatments. Filler would allow for an instant temporary result. PRP treatment would be effective as well, but this would require multiple sessions with a more subtle result.

You may benefit from a lower blepharoplasty with fat repositioning which would smooth out the contour of your under eye permanently. I would recommend further consultation with a board certified facial plastic surgeon to discuss which option would be best for you.

In regards to melasma treatment, this is dependent on the type of melasma you have. Some patients may need a combination of different therapies to obtain maximal results. Microneedling in combination with creams is effective in that it allows for better absorption into the skin. If you have acne scars as well, microneedling therapy will allow for the skin to rebuild certain tissue factors to help smooth out your skin.

Laser treatments are also effective in treating melasma, specifically Picosure. It is the only laser that is FDA approved to treat melasma. @drdonyoo

Hello and thank you for your question and photos. For a quick result, add filler in the tear troughs and a little filler through the front of the cheek. This will soften the darkness under your eyes (volbella) and the voluma will fill and lift the front of your cheek while supporting the under eye. If you are patient that does not mind waiting, prp for the under eyes, after 3-4 treatments, can be beneficial. PRP creates new blood vessel growth, creates collagen and strengthens skin. Results are seen as soon as 1 week, but will continue to improve over 6 months. Results from the treatments typically last 1 year. Downtime after prp can be up to 1 week of swelling/bruising. Filler results for most patients last 9-12 months. We do have patients that do both procedures to maintain the under eye and cheek areas. Hope this helps.
Good luck to you!