Im 40 w/ fair skin.I have some fine lines and laxity. They are much deeper under my eyes.I have had under eye bleph.I am looking at getting laser-resurf all over face.I am not concerned with downtime.I am more concerned with a good result.There is one doctor in my area with the non-frac Co2 laser. They said its aggressive and advised could do just around eyes. Would it be ok to get the more aggressive non-frac in eye area and maybe a frac-laser on rest of face?Results be uneven with demarcation?
Can You Get Good Result Combining Non Fractionated Laser with Fractionated?
Doctor Answers (3)
Ablative and non-ablative laser resurfacing on the face at the same time especially for eyelids
Utilizing multiple devices for treatment of my patients' faces is very common. Having a multitiude of energy sources for resurfacing, allows a physician to select the best treatment per cosmetic unit. Certainly CO2 ablative, nonfractional laser resurfacing can be done on lower eyelids, provided the elasticity of the skin will allow healing wtih a minimal risk of contraction and complication of pulling the eyelid down and away from the eye. The rest of the face can be treated by non-ablative or ablative fractional laser, such as Fraxel Restore or Fraxel Repair, respectively, depending on the photodamage quality of the skin in that region. Portrait plasma resurfacing of the eyelids is an equally good treatment for skin texture and has a similar postoperative period as Fraxel Repair.
Combinations in laser resurfacing match the needs with the treatment
It is commonplace to mix and match both ablative full field and fractional treatments to go after the most wrinkled parts of the face with full field and provide a quicker healing intervention on the areas that don't need such aggressive treatment. In addition, fractional non-ablative can be overlapped on fractional ablative areas to enhance the wrinkle smoothing effects with very little change in recovery time. A demarcation is always possible with any laser treatment but not common with these kinds of combined treatments.
Combining fractional and non-fractional lasers
laser resurfacing of the lower eyelids whether with non-fractional CO2 or erbium (this is called full field resurfacing) will give excellent results. Fractional resurfacing with CO2 or erbium will give good results but not as good as with full field. Combining full field around the eyes and fractional on the rest of the face is very common in our office. There should not be any color or textural step offs or demarcation. On some patients we will do light full field and fractional in the same areas as the full field gives better textural correction while the deeper fractional will get better collagen remodelling.
Bottom line - we tailor the procedure to the pathology (degree of lines and wrinkles) and the patients downtime. This is done by combining technologies to get the best result. best advice for this is to seek out an experienced laser practicioner.