I'm a 40-year-old chinese woman who has sagging skin, nasolabial folds, and marionette lines. Will CO2 Lasers work on these problems and tighten skin as well?
CO2 Lasers for Facial Wrinkles and Skin Tightening?
Doctor Answers (12)
CO2 laser for sagging skin, nasolabial folds & marionette lines
The fractional CO2 laser is a great laser because it allows for treating pigmentation, wrinkles and general sun damage on the face. The laser also causes vaporization of the skin, which will lead to tightening. I am always cautious when patients come in for a consultation and say they want the fractional CO2 exclusively for sagging skin. Although it does help tighten the skin, it works well in patients who just need a little bit of tightening. Patients who have significant sagging of skin will be very disappointed if they do the CO2 exclusively for that purpose. In addition, deep Nasolabial folds and marionette lines are secondary to bone, muscle and fat loss that have occurred over the years. The fractional co2 laser treat the superficial portion of the skin, it does not address the losses that have occurred. Although I do see quite a bit of improvement in the marionette lines after a fractional co2 treatment, the result int he Nasolabial fold is not as great. I would highly recommend a combination treatment of fractional co2 and fillers.
Fractional CO2 laser treatment will help a little
CO2 lasers can give dramatic results with skin tightening and reduction of facial lines. The problem is the more aggressive treatments are also associated with permanent lightening of the skin. This is particularly significant in olive colored skin individuals.
A safer option would be to do a fractional CO2 laser treatment(s), which has less skin lightening. I would ask for a test patch first to see how your skin responds.
Fillers are another great option alone or in combination with laser. The most effective option, I believe, is a lower face-lift or MACS lift.
CO2 laser for tightening and wrinkle reduction
When it comes to tightening, the CO2 laser vaporizes tissue and causes collagen remodeling, which no doubt give some tightening and significant wrinkle reduction. If you are after strictly tightening, there may be better options that you could speak with your physician about. That being said, I have definitely had patients who needed a facelift but did not want to take even a minimally invasive surgical route, so we decided to do CO2 resurfacing, and although they probably still would have benefited from a lift afterwards, they were very pleased with their overall results and tightening.
The sagging of our midface, lower face, and neck actually results more from the soft tissues and bone below our skin aging. Our soft tissues lose volume, what volume is left in there redistributes to a lower position, and the entire fat pads descended down our face. This is addressed with surgical lifts and with revolumization.
The bottom line is, yes you can get some tightening from a CO2 laser, but that may not be your best option if that is your main goal. With Asian skin especially, you need to seek out someone who is a true expert (as opposed to a self proclaimed expert), as pigmentation changes are more common with even slightly darker skin types.
To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.
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C02 Laser for Asian Skin Tightening
However, if skin tightening was one of your main concerns and you wanted it to be done non-surgically, I would likely recommend a combination treatment plan of C02 laser, Ulthera and some injectable Fillers.
C02 laser for Asian skin
C02 laser for Asian skin can be used, especially if it used as a fractional resurfacing mode. Erbium laser is typically preferred for Asian skin. In some instances, a combination of both can help as well. Seek consultation from a laser expert in Asian skin to help discuss the risks and benefits for laser resurfacing for your specific skin.
Facial Skin Tightening
Fractional CO2 laser for wrinkles and sagging skin. Use with facial fillers.
Treatment with Fractional CO2 laser should coincide with facial fillers for the nasolabial folds and neurotoxins for the dynamic wrinkles. With your particular skin type, I would also recommend a topical skin brightening cream(s) such as Melaquin AM and Melaquin PM to use alongside the lasers.
CO2 laser for sagging skin and wrinkles
The CO2 laser can give amazing results for sagging skin and deep wrinkles and sundamage; however, at age 40 you may not need fully ablative CO2 with 2 weeks of downtime and significant risk. I usually save this procedure for very wrinkled, sundamaged persons and those are usually older than 40. A fractional CO2 laser treatment can give you great results with less down time and risks.
Fractional CO2 and Dermal Fillers
The Fractional CO2 will help to smooth out wrinkles of the face, and will also help to even out skin tone and improve texture. However, in order to correct the volume loss that occurs in the nasolabial folds and marionette lines, a dermal fill such as Juvederm is the best option. When used together you will see even more significant result. I hope this helps you.
Neil J. Zemmel
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.