Carbon dioxide lasers can be very helpful for perioral lines. It is important to note though that lines around the mouth also come from the loss of bone in the upper and lower jaw bones as well as loss of muscle tone in addition to the skin. The skin is what we see, but this is a 3 dimensional issue and not just a skin issue so laser and fillers in combination will help restore the skin texture and volume respectively. Please be advised that not all carbon dioxide lasers and not all providers are created equal. A superpulsed or ideally an ultrapulsed carbon dioxide laser is what you should consider. Make sure you do your homework on the providers in your area to make sure they have experience in dealing with lasers and fillers to make sure you end up with the optimal results.
A carbon dioxide laser will address the "uneven skin tone, large pores, oily skin and some acne scarring" that you are concerned about. Not all carbon dioxide lasers and not all providers are created equal. To address deeper scarring and deeper pores you need to consider a microablative in addition to a macroablative delivery of the laser. A superpulsed or ideally an ultrapulsed carbon dioxide laser is what you should consider. Make sure you do your homework on the providers in your area to make sure they have experience in dealing with these issues to make sure you end up with the optimal results.
Rather than excising the tattoo which would leave a scar I would consider a treatment with a Picoway laser at the 1064nm. Scars are permenant. This would not be very expensive and should completely resolve with just a couple of treatments with that tattoo.
No matter the laser make sure the wavelength is 532nm.Picoway is a very good and powerful and effective laser.
In person consultation is the key. The most important thing is the determination of how thick and deep the scars are as that will determine what the next step is. If the scar is thin the need for microfractionated (smaller fractionated lasers) carbon dioxide lasers as a scar remodeling technique vs scar revision. Scar revision could be considered if the scar is deep and thick, but it will leave another scar so if the thickness of the current scar is minimal again I would say that lasers will give you the best long term scar outcome. The thickness also matters as far as the fillers that can be used. If the scar is almost full thickness that can make the injection of fillers more difficult and an experienced person is vital. That said, it can also be very helpful too to even out volume deficiencies. I bet the scar is a little thinner than thicker as the mole removal should have been a superficial removal not deep.Thus seeing someone who can do microfractionated lasers and filler would be the best option.Not all carbon dioxide lasers and laser surgeons are created equal so make sure you discern the best in your area.
