What's the best treatment for under-eye wrinkles and crepiness?
Can you recommend a solution to the horrible crepiness and wrinkling under my eyes?
Please don't say CO2 laser.
$6300 later and it did NOTHING.
Laser was not effective and I was also told a lower bleph isn't an option as I have no
fat in that area so I would get hollowing and an unflattering roundness to my eyes.
Retinoids had little effect also.
There has to be a way to address this.
It's awful and so aging.
Thank you for your question!
You’re asking of the best way to treat under eye wrinkles and crepiness and your question
clearly communicates your frustration with the laser treatments that you had undergone
with the CO2 laser and you’ve clearly got some opinions about blepharoplasty which my
result in the rounding of the under eye area.
Well, I can tell you that as a practicing cosmetic surgeon and a board certified cosmetic
surgeon, practicing in Manhattan and Long Island for over 20 years.
My background is also in fellowship-certified training in oculofacial plastic surgery.
So eyelid surgery and eye rejuvenation has been a center of my practice for over 20 years
and I can certainly understand your frustration.
This is a challenge in our field for a variety of reasons but I would also present the understanding
that when the majority of treatments have to do with some type of thermal energy, there
is naturally a limit to what that thermal energy can accomplish.
In the 90s, we were using the original, very aggressive CO2 laser and it created a lot
of good tight results but it unfortunately led in many different ends and created undesirable
results.
And so, the pendulum swung towards less aggressive lasers such as the erbium laser which I have
used for many years.
But the one thing observation that I made over this time frame is that when I look at
people who came for consultation like yourself and they would always recount their history
where they did a chemical peel on one point, they did one type of laser and they did another
type of laser.
And essentially, at a certain point, their skin was even that it has started.
And that’s where the challenge is.
For the past several years, in our practice, we have been in the forefront of certain regenerative
medicine and technology that we have been using to help people like yourself.
Now, it’s not necessarily a cure but we have been able to help people with something
called platelet-rich plasma.
The idea is if we just look at the basic issues with aging, what happens to the skin?
The skin loses collagen; it loses blood supply, it become irregular and when we’re healing,
let’s just think of wound healing, like a cut, what happens?
You have regenerative new collagen, you have to regenerative new blood supply.
And so we’re basically using the technology that your body already has and concentrate
it and we inject it under the skin.
Now, it’s not a onetime treatment.
Generally, when someone has this much crepiness as you are describing and as your photo presents,
we have seen that with strategic placement, we have been able to significantly improve
skin quality without going to lasers.
In the modern world, people want quick results, immediate results.
This is something you have to understand is not possible.
When you are treating skin, I say it’s comparable to muscle building.
You want to treat, get the results and then build on that foundation.
You can’t make the skin beautiful overnight.
There are certain limitations especially when someone has reached a certain age or has a
certain amount of sun exposure and if they have been smoking.
They have to eliminate a lot of those potential toxic reasons for the crepiness.
Now, it doesn’t mean that everything can be resolved so easily with just one treatment
but it is a significantly beneficial modality that can make a difference.
So with that understanding, think about regenerative medicine.
We’ve also done this PRP with acellular matrix which is something we use for hair
loss.
We don’t necessarily place in under the eyelid at the same time in the same concentrations
but we found that essentially, what we’re trying to build rather than heat.
Very often, when someone’s skin is a little bit thicker or if it makes sense, we’ll
combine the effect of the PRP with the benefit of laser at the same time.
So with that understood, I understand your frustration but learn more about this modality
and see what you can do from a more holistic approach because clearly there’s only so
much you can do to build the collagen and that is certainly a frustrating thing but
I would agree that I would not recommend more and more lasers because you’re probably
not going to get a significant improvement.
So I hope that was helpful, I wish the best of luck and thank you for your question!