Ablative Laser Vs Laser Skin Resurfacing?

Between these two, which is stronger for under eye lines: Ablative laser or Laser skin resurfacing?

Doctor Answers (10)

Laser Resurfacing

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Ablative laser usually refers to the old school style of resurfacing which was a scorch and burn approach to tighten the skin.  The results were great…sometimes, but pigment loss was high, the skin was tight, and demarcation lines were noticeable. Now we have the Fractional/Fractionated types of lasers.  Laser skin resurfacing is a general term which can mean ablative (100%) or semi-ablative (5% 10-30% or more)where lasers ablate deep narrow channels of skin and allow some untreated skin to remain.  This results in quicker healing time, less pigment risk, and better scar treatment.  All the CO2, Erbium, Erbium Glass, and similar are a form of ablation/semi ablation, the percent depending on the manufacturer, model, make, and operator programming the laser for you. Seek the expertise of a Board Certified Dermatologist or Plastic Surgeon to offer you all of your options. In the right hands, these lasers can offer you an improvement in under eye lines.*   

Ablative laser resurfacing much more effective.

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I think of this as "real" laser resurfacing.  You need some anesthesia, and there is a five day recovery, but you see improvement that can be impressive.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Ablative is stronger than non-ablative resurfacing

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Non-ablative and ablative are subsets of laser resurfacing (a more general term).

Non-ablative means that the skin surface is not removed or injured, and that energy (laser, heat, or radio energy) is delivered into the dermis (the fibrous layers of the skin). Non-ablative is typically done as a series of treatments with little or no downtime.

Fractional methods are intermediate in terms of recovery and results. These methods are technically ablative, but only ablate a portion (fraction) of the surface area.

Ablative laser treatments have a longer history and more established record of results. The treatments can be made deeper, and the results more significant. Along with this, the healing time or downtime is longer. The traditional CO2 laser or phenol peel has the most dramatic results, but higher risks. The ErbiumYAG laser is currently the most favored for eyelid skin resurfacing.

Also inquire about pre- and post-op skin care, HA fillers or other adjunctive techniques.

Sutton Graham II, MD
Greenville Plastic Surgeon
4.5 out of 5 stars 2 reviews

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They are essentially the same

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A better question and the one you might have wanted to ask is, what is the difference between non ablative and ablative resurfacing for the skin?

Nonablative is usually done through radiofrequency, or other wavelengths that go deeper in the skin to stimulate the deeper tissues to tighten up the skin. Wavelengths from 1300-1600 achieve this non ablative skin tightening. Radiofrequency is another way of doing this via thermage, etc. These devices although not removing the layers of the skin, can cause significant swelling and redness and this can lasts a couple of days to more time.

The ablative lasers such as co2 (Active fx, etc), and erbium yag lasers remove the top layers of the skin (ablate) and allow stem skin cells from within the hair follicles to resurface the treated areas to rejuvenate skin by decreasing wrinkles, tightening skin, decreasing pore size, removing unwanted pigmentation and removing precancerous skin cells. The strength of ablative or non ablative lasers really depend on what energy use and can be set by your doctor.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 40 reviews

Combined ablative Erbium 2940 laser and non-ablative 1440 Erbium laser aree best for under eye lines

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Ablative lasers remove the surface of the skin and require a week or so of healing and downtime.

Non-ablative lasers do not ablate (vaporize or remove) skin but heat the deep portion of the skin to stimulate new collagen to grow.

The newest (and safest) lasers are called fractional lasers-they treat small microscopic areas of the skin so there is less downtime and less risk. (read reference below for detailed description)

The best wrinkle removal results require ablation. The Erbium lasers generate less heat and are safer with quicker recovery.

Currently the very best wrinkle removal with the least downtime is with the combined treatment with the Lux2940 ablative fractional laser and the Lux1440 fractional non-ablative laser done at the same setting-see photos below.

Avoid the CO2 laser on the eyelids-too powerful-Erbium is safer.

See before and after photos of fractional laser resurfacing: Set 1 and Set 2

Ablative laser

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 A laser resurfacing machine is an ablative laser. Many different forms of ablative lasers can be used to resurface the eyelid skin to give it a better look and tighten the skin.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Lower Lid Laser Resurfacing

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I like to use fractional ablative lasers for resurfacing of the skin. I use a combination of the Deep F/X for lines and wrinkles and the Active F/X for superficial spots and stains. I find this combination to be very effective- In addition, because it is fractional, it is still gentle enough for the lower lid area. Of course, consult with your physician/surgeon to determine what is the best therapy for your condition and your skin. Thank you.

Julio F. Gallo, MD
Miami Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Laser skin resurfacing is "ablative"

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Ablative resurfacing or laser skin resurfacing implies that the skin is removed. This may be full field in which 100% of the treated skin is removed or fractional in which a fraction ie 5-60% of skin is removed. these lasers may be erbium, carbon dioxide or ysgg.

Non-ablative or sub-surface remodeling does not remove or "ablate" skin, but rather causes sub surface skin wounds which heal with new collagen production. This also may be full field or fractional. The original fraxel laser is an example of this.

For eyelid tightening, the ablative or resurfacing lasers are "stronger". Full field is usually deeper with better results and longer healing times than fractional devices.

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 28 reviews

The Ablative Laser is What you use for Skin Resurfacing

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Skin resurfacing is done with an ablative laser. It really depends upon the settings, your skin type, your physician, and the type or wavelength of the laser. Ask your physician. We use an erbium laser for resurfacing and combine it with non-ablative lasers to remove some of the pigmented lesions. We have found a combination approach is often more powerful. I like the idea of CO2 or the Sci ton combination peel for the under eye region. Again see you plastics surgeon or dermatologist to see what they get the best results with as this is the most important aspect.

Charles Perry, MD
Sacramento Plastic Surgeon
4.5 out of 5 stars 16 reviews

Laser resurfacing of the eye skin

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Laser skin resurfacing is a heading that encompasses both ablative and non-ablative resurfacing. Ablative resurfacing would include the older carbon dioxide laser and medium depth chemical peel. Non or minimally-ablative laser skin resurfacing involves Fraxel RE:store and Fraxel RE:pair. These procedres are not as “strong” as the CO2 laser. Despite which laser might be used you will have lines recur after the treatment as squinting will promote more lines to form. There is a risk of scarring with the more aggressive lasers so you want to be mindful that the “strongest” is not necessarily the best for you. See an experienced laser surgeon who has done all of these procedures so they can tell you what is best.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.