Commentary: Dual-depth fractional carbon dioxide laser resurfacing for periocular rhytidosis.

BACKGROUND Laxity and rhytidosis of eyelid skin as a result of photoaging is a frequent cosmetic concern. Fine lines and deep wrinkles may not be optimally addressed with traditional ablative carbon dioxide (CO(2)) resurfacing. Modern devices allow for surface fractional ablation and deep fractional ablation with narrow treatment columns that target deep dermal layers. OBJECTIVES To examine the efficacy and safety of a combination of deep fractional CO(2) ablation and superficial fractional ablation of eyelid and periorbital skin for improvement of rhytidosis and redundancy. MATERIALS AND METHODS Fifteen patients underwent dual-depth fractional CO(2) resurfacing of eyelid and periorbital skin. Blinded, independent investigators evaluated rhytidosis and skin redundancy as evident in pretreatment and 6-month post-treatment digital images. RESULTS Excellent post-treatment improvements were noted for eyelid skin rhytidosis and redundancy, which improved 53.1% and 42.0%, respectively. No serious complications were noted, and the recovery profile was favorable. CONCLUSION Dual-depth fractional CO(2) resurfacing of eyelid and periorbital skin, including areas within the boundaries of the orbital rim, is safe and effective for the treatment of eyelid photoaging.