Fraxel Should Be Done Before or After Fillers?

I want to have fraxel (2 or 3 sessions) to even out my skin tone, minimize wrinkles, pores, small scars, age spots, but I also need injectable fillers like restylane, radiesse, juvederm in my nasolabial folds, cheekbones, under my eyes. My question is what should I do first. If I have fillers and botox first and then fraxel laser, is there a risk that the fraxel laser will destroy the fillers? How many weeks should I wait between fillers, botox and fraxel? Thanks a lot, I read conflicting info

Doctor Answers 10

Fraxel is Best Before Fillers, but After Botox

Fillers should be injected a few weeks following Fraxel laser skin resurfacing. The thermal damage from the laser could break down the filler if it is placed prior to laser. In addition, a strong laser treatment could change the contour of the face; therefore, it is best to judge the volume and location of filler placement after laser treatment. Botox should be injected 1 week prior to the laser procedure. This will help diminish facial movement and allow the skin to heal with better results. Botox injections should not immediately follow any procedure that cause skin swelling or it may risk migration to other undesirable locations. I hope you find this helpful.

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Fillers and Fraxel Laser Treatment

Thank you for your question. In clinical studies, there was no difference which is done first, lasers or fillers. However, some providers may have a certain preference and I would follow their protocols. Botox may be performed at any time as well.  I would recommend a consult and treatment under the supervision of a Board Certified Dermatologist or Plastic Surgeon for best results and safest treatment options.  I hope this helps!

Fillers after Fraxel

I would recommend having the Fraxel then fillers.  The heat and healing process involved with Fraxel can cause fillers to absorb faster and not last as long.  If you do decide to get fillers or Botox first, wait at least 2 weeks before Fraxel to minimize this effect.

Angela Sturm, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

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Fillers After Fraxel

We recommend that fillers be put in after the Fraxel treatment. It is possible that the thermal injury and inflammation after laser treatment could accelerate the breakdown and absorption of the filler. In addition, the laser treatment would be expected to give some improvement and diminish the amount or location of filling injections needed.

Brian Dubow, MD
Los Angeles Dermatologic Surgeon

Timing for injections and Fraxel

I always tell my patients that if you are going to have Botox or Restylane/Juvederm first, then you should wait atleast a week for the skin to heal.  Conversely, if you decide to have Fraxel first, then you can do your injections 1 to 2 weeks later on your post-Fraxel check-up that I do on every patient.

Fraxel, Fillers, Botox. Which comes first.

Timing is always an issue when rejuvenating the face with these products.  In general fillers and Botox can usually be done at the same time, but the potential swelling after a laser or fraxel procedure has the potential to move the freshly injected product, whether it be filler or Botox out of position.  I prefer to have Botox in place a week before any laser work as it will allow me to assess and treat skin as it appears when rested.  This is the same with fillers.  If you can relax a line with Botox, you may not have to fill or you may be directing your fillers to other areas.  Does Fraxel go deep enough to impact fillers?  Most likely no.  The only exception is Belotero which is the newest and most superficially placed filler for fine lines.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox, filler and Fraxel

Ideally, Botox should be injected at least one week before Fraxel treatment so the new collagen is remodelled into smooth skin.  Fraxel does not melt fillers so they can be injected 2 weeks before Fraxel or at least 2 weeks after Fraxel once the skin has healed.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 18 reviews

Timing of Botox and Fillers with Fraxel laser skin resurfacing

I suggest to my patients a very intuitive schedule for Fraxel and injectables.
I prefer to do Botox and/or Dysport prior to the Fraxel series of laser skin resurfacing. The reasoning is that I want the muscles that cause the skin to wrinkle to be ‘at rest’ during the Fraxel skin resurfacing. This allows the new collagen to form as a result of the Fraxel treatments, without the muscle forces acting on the skin which cause the skin to wrinkle.
After the Fraxel series is complete, I evaluate the patient for fillers to complete the overall result, and to maintain their youthful enhancement, along with good skin care.

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Fraxel will not affect fillers

Fillers of all types can be used safely with Fraxel as it does not penetrate deeply enough to hit the fillers , even at its strongest settings. Fillers are placed deeply , underneath the skin,while Fraxel works from the skin surface down. So there is absolutely no concern about Fraxel hitting the filler. It is best to have Botox in place prior to starting Fraxel as it puts the muscles that cause expression lines to be at rest and allows better new collagen formation. Much like a splint allows better healing of a sprained ankle by putting it at rest.Botox can be added at any time but shouldn't be done on the same day as Fraxel as the Fraxel procedure and/or swelling could change the distribution of the Botox 

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon
4.5 out of 5 stars 12 reviews

Fillers and Fraxel Treatments...

We always recommend you wait at least 2 weeks after gettting Botox  or filler injections and vice versa for if you get Fraxel done first and then want to get fillers or Botox.

Dr. Grant Stevens            Marina Plastic Surgery Associates           Marina del Rey, CA The Institute

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 76 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.