Best treatment for thin eyelid skin, orbital discoloration, and indented scar after bleph and CO2? (Photos)

Question

I’m 29 years old and would really appreciate advice on my eye area. I had an upper blepharoplasty for ptosis about 4 years ago, followed by a revision with lateral canthoplasty around 3 years ago. This left me with uneven eyes and scarring, including an indented scar on my left orbital area. To treat the scarring, I had 4 CO2 laser sessions, with my last session about 6 months ago. While it improved texture, it caused thinning, dryness, and crepey skin. Now I have thin eyelid/orbital skin, a bluish tint on the right outer orbital area, and a persistent indented scar on the left. I’m currently doing Rejuran. What would you recommend to improve skin thickness, reduce the discoloration, and treat the indentation?

Anna Chacon, MD, FAAD · Answer

You’ve been through quite a bit in a very delicate area, and what you’re describing makes sense given your history. After multiple procedures and CO2 laser, it’s not uncommon to see skin thinning, barrier disruption, and that bluish hue (which is often from underlying vessels showing through thinner skin).

Here’s how I would think about it:

Skin thinning / crepey texture:
You want regenerative, not aggressive treatments at this point. What you’re already doing (Rejuran/polynucleotides) is a good direction. Other options that can help:
PRF (platelet-rich fibrin) for gentle collagen stimulation
Very conservative microneedling (low depth) if tolerated
Medical-grade barrier repair (this is underrated but very important)
Bluish discoloration:
This is often vascular + thin skin combined. Once the skin thickens, it improves. In some cases:
Very gentle vascular lasers (low settings) can help
But I would be cautious given your history—less is more here
Indented scar:
This is the one area where targeted treatment helps:
Subcision (very delicate in this area)
Possibly micro-aliquot filler or PRF gel to lift the depression

The key takeaway: avoid aggressive resurfacing moving forward. Your skin is asking for repair and rebuilding, not more injury.

Best treatment for thin eyelid skin, orbital discoloration, and indented scar after bleph and CO2? (Photos)

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