I am considering some laser surgery in the face to tighten skin around the mouth and under the eyes; but I have received mixed information from 2 doctors. One says it does not work and another says it does. I had some allergy to Restylane before, so a filler is not an option. Is laser the answer before a surgery, which is too drastic right now?
Skin Tightening Laser Procedure in Mouth and Eye Areas?
Doctor Answers (12)
Rejuvenation around eyes and mouth
While traditional CO2 laser resurfacing remains the gold standard, not too many people can afford the downtime that may be required. Combination of fractional co2 laser resurfacing, hyaluronic acid filler (Restylane or Juvederm), and Botox/Dysport can be fantastic for periorbital and perioral rejuvenation.
Perioral and Periorbital Laser
Less invasive usage of the erbium laser or the profractional laser sometimes combined with fillers can provide significant improvement for the perioral and periorbital areas.
Laser for skin tightening: does it work?
The amount of actual skin tightening by the "best laser and the best laser surgeon" is NOT enough to replace the need for facelift to tighten and lift sagging jowls or to soften deep nasolabial and subcommissural folds, or the need for surgical lower eyelid blepharoplasty (especially if you need fat removal or repositioning, or lid tone and position improved). Let me repeat: No laser will replace plastic surgery for these areas!
However, if your overall skin tone is good in the eyelids and around your mouth, and you are bothered by crepe-like skin and fine lines around your eyes, and/or smoker's lines or lipstick "bleed" lines around your mouth, then laser resurfacing is absolutely appropriate for treating these conditions. In fact, I believe ablative combination CO2/Erbium-YAG laser resurfacing after proper skin preparation with hydroquinone therapy and Retin-A is the "gold standard" for treatment of the most severe cases of these lines. Peels of various types, and fractional lasers (the present"rage") also can make nice improvements with good technique and in proper hands, but can require multiple treatments that in my humble opinion cannot match a single laser resurfacing with this third-generation ablative laser.
The best way to summarize laser vs. facelift is to understand that laser works only on the surface (fine lines, wrinkles, and discolorations), and facelift tightens the deeper tissues and skin from the muscle layer to the fatty layer to the skin itself. Thus, do facial cosmetic surgery first, then undergo laser surgery (if needed) to deal with any fine surface irregularities or fine lines that remain after the swelling goes down. This two-step procedural approach gives the BEST overall results!
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CO2 laser for wrinkles around the eyes and the mouth
The newer fractional CO2 lasers can offer a nice improvement in the appearance of the fine lines around your eyes and your mouth. Remember that skin resurfacing such as a fractional CO2 laser is not the same as surgery and often times they are not interchangeable. What this means is that they can treat two different things. The laser is excellent for the very fine lines and wrinkles, where surgery such as a facelift treats the drooping jowels and the hanging neck. Consult with a qualified physician with experience in all of these modes of treatment in order to get a better idea as to what is best for you.
Fractional CO2 lasers are especially good for skin tightening
We have good experience with the fractional CO2 laser to tighten the skin. Botox is a good adjunct around the eyes to prevent new wrinkles.
Laser Treatment of Mouth and Eye Wrinkles
Lasers work best for the fine lines of the face. The lines you mention around the mouth are dynamic rhytids, or wrinkles caused by movement. Botox or Dysport is a great adjunct to lasers. Lasers will smooth the skin, but if you don’t soften the muscle movements that initially caused the wrinkles then the wrinkles will return more quickly. The under eye wrinkles can be due to a number of factors including muscle movement, skin laxity or volume loss.
Laser under the eye is a good option, and it will help with the fine wrinkles, and the lines around the mouth. For sags and bags, you need surgery. Thank you for your question and good luck.
Skin tightening options around eyes & mouth
You have a few options for improving the appearance around the mouth and eyes. Historically we used CO2 laser resurfacing/ablation which works quite well, though it had significant potential side effects including a long down time and potential for scarring and discolouration of the skin. In the last few years, laser resurfacing with fractionated lasers (e.g. Profractional) have gained popularity since they are much safer, with great results (although requiring more treatments than the original CO2 laser ablation), and less down time and discomfort. The addition of carefully placed botox and perhaps a different filler can also be useful adjuncts.
Some lasers can tighten skin
In my experience, the CO2 laser is great for tightening skin around the eyes. I use the Deep FX fractionated laser and we see some tightening around the mouth but not as much.
The Baker-Gordon peel can do even better but that has a long healing time. I haven't seen any other device or peel that offers any real skin tightening that I can see. I hope this helps.