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How Thin & Wrinkled Eyelid Skin can be Improved after Previous Surgical & Laser Treatments


More wrinkles 2 years post blepharoplasty
and co2 laser resurfacing (I am 30 years old)? I had a lower lid blepharoplasty and co2 laser
resurfacing procedure two years ago. I am now 30 years old and have significantly more
wrinkles than before the procedure mostly seen when I smile but they can also be seen
when I am not smiling when the light hits just right. Is there any type of cream (such
as retin A or similar) that can be used to help the creepy/wrinkled skin that is under
my eyes now? Other recommendations? Thank you for your time. Thank you for your question! You are 30 years old and 2 years ago you had
blepharoplasty and CO2 laser and you believe that your skin has become thin, wrinkly and
more crepey than before. So you’re looking for options and this is something that we
have seen for many years. Not necessarily specific to one type of laser. But just to
go over to some of the history of the though process of why ablation is part of the rejuvenation
of skin. For many years, pre-lasers, the standard was chemical peels. So we would do chemical
peels, superficial, medium or deep. And the idea was that if you took a certain level
of skin, up to the upper levels of the dermis, then the new skin that comes in has an area
of collagen called the grenz zone, it would be covered by fresher newer looking skin.
Now in the mid-90s, the CO2 laser became the first lasers to become the step beyond chemical
peels. One of the key elements of that is the thermal energy delivery which provided
a certain amount of tightness and a certain amount of collagen stimulation. And from that
point forward, there has been different permutations of different types of lasers, variations of
the CO2 laser and with the ultimate goal of improving the appearance of wrinkles and generating
more collagen. Now a certain group of people, even though
they had gotten an improvement of wrinkles, I notice that the skin has gotten a little
bit thin. Now moving on to this time frame, I have always asked my patients about their
lifestyle in addition to the solutions we offer. We have to understand are there factors
that are contributing to the skin to become thin. These factors include such as lifestyle
aspects such as smoking, excess sun exposure, not enough sleep, stress. All of the things
are factors that can contribute to the skin becoming thinner. Now that being said, in terms of alternatives
for improving skin quality under the eyes when you feel you can’t laser some more, a
lot of our colleagues will keep using heat. Basically laser energy is converting light
energy to heat and that heat induces a certain tissue response. So what we’re focusing now
is regenerative medicine. And in our practice, we’ve been applying something called platelet-rich
plasma. This is a part of your own blood where we take your own blood and we spin it and
we take the part has the platelet and growth factors that are necessary for healing. So
when you think about healing, you think about a cut. A simple cut in your finger first becomes
a little clot or scab and the skin heals over. This healing process is due to the platelets
and growth factors in the skin. So in other fields of medicine in particular, orthosurgery
or orthopedic surgery, the benefits of platlelet-rich plasma for wound healing is already well-established.
And right now, it is extremely popular for professional athletes to get injections of
platelet-rich plasma for areas that has had a lot of impact, stress and inflammation. In aesthetic field, we have been using this
platelet-rich plasma for many indications. We’re using it for acne scars and fine lines
and wrinkles. In our hair loss division, we’re actually combining this with extracellular
matrix to reverse and to thicken hair that is thicken. This is a remarkable technology
that we have been developing over the past couple of year and now we have had consistent
results with this. So platelet-rich plasma is something that
we would consider for someone like yourself if you come to our practice. We would be injecting
it and we would allow the skin to benefit from it. Usually we would wait for a couple
of months and we would use some topicals. Topicals can be beneficial with a limitation.
And so retenoids can be considered but you have to very careful about the strength and
the type of retenoids that you use. As an answer to your question, from my perspective,
to help improve skin quality, the choices after you have exhausted the laser option
become more and more limited. So platelet-rich plasma is something that we have leveraged
quite well and what’s nice, as opposed to laser, when you get laser treatment, it is
something that you don’t want to do anytime soon after you’ve done laser because you will
allow months of healing. Yet with platelet-rich plasma, we can inject it several times during
the year. And observe the benefit and make a decision whether it is worthwhile to try
again. So consider that as an option, reflect on your lifestyle is about and see if there’s
any way you can improve your quality of life. There are other things that I suggest to my
patients which is more in the alternative medicine such as the use of fish oils and
supplements. I do believe in the use of supplements particularly when I listen to my patients
and their diet and see what we can do to enhance the supplement. Then be patient but I would
not recommend additional laser but rather consider this regenerative medicine of platelet-rich
plasma. So I hope that was helpful and thank you for your question!

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