Which nonsurgical procedures would help me achieve more youthful eyes? (photo)

Question

I'm a 32 yo F and my under eyes are hollow, dark, sunken, and a bit crepey. I have looked into Halo and CO2 as options (I am afraid of fat transfer/filler). What would be the best recommendation to give my eyes the most youthful restoration without surgery?

Nelson Lee Novick, MD · Answer

I certainly understand your concerns about fat transfer. I gave up performing this many years ago. For one, the results do not last much longer than those obtained with robust HA fillers, since much of the transferred fat, separated from its original blood supply, generally does not survive. Secondly, that which does survive is much like a permanent filler, i.e. if there are any adverse reactions or undesirable results, there is no dissolving enzyme to get rid of it as there is with natural HA fillers. Regarding the so-called light and energy-based gizmos out there, like fraxel lasers or RF devices, the fact is that, unfortunately, the hard science to support their use lags well behind the heavy marketing hype and social media buzz out there to promote these expensive, here-today-gone-tomorrow bells and whistles. Sorry. 
Frankly, from the photo provided, there appears to be significant volume deficit in the outer mid-cheek region and since the upper mid-cheeks are a major structural support for the under-eyes, the use of an appropriately robust HA volumizing filler for the cheeks would likely not only contour a more ideal, feminine, heart-shaped face, but secondarily improve the under-eye area. The results of treatment are immediate, on-the-spot and typically engender little to no significant downtime. And, finally, before considering expensive, invasive, aggressive surgery, you would be wise to consult an experienced, board certified cosmetic dermatology filler expert. Hope this helps to save you a great deal of time, money and frustration. Best of luck

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

Which nonsurgical procedures would help me achieve more youthful eyes? (photo)

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Which nonsurgical procedures would help me achieve more youthful eyes? (photo)

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Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.