Facelift vs nonsurgical "tightening"

If your main problem is the sun damage with fine wrinkles, sun spots, pigmentary changes, enlarged pores, etc, you may do well with laser resurfacing.  I have not use the Pearl fusion, but have used the Fraxel re:Pair extensively.  It does give a mild amount of skin tightening.  However, if your primary problem is skin sagging and laxity the amount of tightening you will see with anything other than a face/neck lift will be minimal.  Many patients actually eventually doing both treatments - i.e - facelift followed by some form of skin resurfacing (chemical or laser peels, Fraxel, etc.).  The Fraxel does have the greatest versatility and depth of treatment compared to other lasers and it is a fractionally ablative laser so that the "down time" is much less than fully ablative treatments (deeper chemical or laser peels).  You certainly should seek a consultation with an experienced surgeon with whom you can define your dislikes with your face, your goals and expectations and then he/she can advise you the best mode of treatment to achieve your goals.  Good luck.