55yo Female Ex smoker, severe facial lines around mouth, cheeks & eyes. Would a Face Lift or CO2 Laser be best for me? (photos)

55 year old female. Ex smoker. With severe facial lines around mouth, and cheeks. Eye area as well. Contemplating a face lift or CO2 laser, but really feel I need more information on both procedures. I have read that the CO2 laser can cause hyper pigmentation on some skin types, and being fair skinned worried about burning. Face Lift, its elective surgery and while I understand the concept and idea behind it, I am not convinced it would remove the deep lines, on my cheeks, and eye area.

Doctor Answers 6

Face Lift vs Laser (or both)

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You probably need both:
Here is why: You age in 3 ways redundant skin and underlying supporting structure laxity,volume shifts (loss of volume in the cheeks, gain in the jowls and submental), and skin surface aging - wrinkles, large pores, age spots). It is important to understand that facelifts are meant to remove major folds and wrinkles, not fine wrinkles. A facelift which removed every line and fold would be too aggressive and would result in an unnatural result. The goal of our surgeons is to make your facelift look as natural as possible. Face lifts do not change the quality of the skin and volume issues are best managed by fillers or fat transfer. Skin aging is accelerated by smoking .

Fine lines and wrinkles are better addressed by skin treatments such as chemical peels or microdermabrasion, which we also offer at our office. Many of our facelift patients enhance their surgical result with these nonsurgical procedures.

Face lift or laser for smoker

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Thank you for your face lift and CO2 laser question.
  • Congratulations on  stopping smoking! Best thing you could do.
  • Your photo shows that you have significant loosening of deep facial tissues and significant skin damage.
  • Face lifts tighten the deep tissues, the Co2 laser or phenol/croton oil peels treats the skin. 
  • Assuming your skin is your chief concern. -- 
  • Start with a therapeutic skin care program prescribed by your Board Certified plastic surgeon and based on Retin A/tretionon. The Obagi Nuderm system is one good option.
  • After 6 - 8 weeks, have either a CO2 facial laser or a phenol/croton oil peel. Both will hurt afterwards but will remove the damaged skin and improve (not erase) the sever facial lines.
  • Then  have a face lift for jowls, descent of tissues. You will look really good.
  • Hope this helps. Best wishes.

55yo Female Ex smoker, severe facial lines around mouth, cheeks & eyes. Would a Face Lift or CO2 Laser be best for me?

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If your main concern is the lines on your face, a CO 2 laser is needed.  My recommendation would be a facelift for the excess skin, and a full face CO 2 laser after you have healed from the surgery.  This will give you the best cosmetic result.  Consult with a highly skilled Plastic Surgeon for a consult to discuss your goals and expectations.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

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Facelift or CO2 laser for face?

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It is difficult to tell from your photos if you might be a good candidate for a facelift but you do appear to be a good candidate for CO2 laser treatment of your face.  A facelift primarily improves sagging skin of the lower face and neck.  CO2 laser treatment would primarily address lines and any brown pigmentation on the face.  If your main concern is the lines, the laser treatment would provide more improvement than a facelift.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews


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CO2 laser and Facelift surgery address different aspects of facial aging. I like to tell patients that a facelift addresses the jowls, jawline, and neck area with restoring definition and positioning of tissue.  CO2 is a deep laser that sometimes is used in conjuction with a facelift to help fine lines of the face and mouth area.  It is hard to tell from you pictures your neck and jaw lines.  However, CO2 laser can be helpful in helping the fine line around your mouth; which may be related to your smoking. You should see a plastic surgeon to see which procedure is best for you. Good luck.

Combination of face lifting and resurfacing

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I do see that you have some very significant lines around the mouth and cheeks, and in your situation, a combination of face lifting and resurfacing is probably ideal. Face lifting restores the structure and should be done first and then following this something to really improve the quality of the skin, such as laser resurfacing, chemical peels, or even in more severe areas, some additional dermabrasion. That way you can have the structure corrected and the surface giving you the very best outcome.

Joseph Hunstad, MD
Charlotte Plastic Surgeon
4.7 out of 5 stars 56 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.