Which is Better...Profractional, Fraxel Refine, or Fraxel Restore Dual? (photo)

Down-time is not an issue for me and I would like to know which is the most effective laser treatment for skin tightening, brown spots, and wrinkles. I have done a lot of research and still find the differences and pros and cons of the various laser treatments very confusing. Thank you for your help.

Doctor Answers 4

CO2, Profractional and Fraxel

The choices can indeed be confusing. When you consider how aggressive to be with your treatment, it is important to realize that with more downtime can also come a higher risk of complications.

Full CO2 resurfacing, the most aggressive approach, has become far less common. It has been replaced by fractionated treatments that significantly decrease the risk of pigment problems, persistent redness and scarring. The newest fractionated CO2 devices are extremely safe with downtime of no more than 1 week.

The Fraxel Dual is very effective for pigment. The Restore can improve texture, but not nearly to the same extent as CO2. The downtime is somewhat shorter than CO2, but you mentioned that this is not a concern for you.

Profractional is an Erbium laser that can also ablate skin in a fractionate manner. Because of the physical properties of the device, it tends to cause more collateral heating (leading to pain and redness) than the best CO2 devices.

When it comes to skin tightening, none of these devices is as effective as a radiofrequency device that can deliver energy deep in the dermis. The best results I have seen are pairing a fractionated CO2 treatment with ePrime, which stimulates collagen, elastin and hyaluronic acid to improve skin volume and elasticity.

Boulder Dermatologist
4.4 out of 5 stars 7 reviews

Fractionated Resurfacing

If down time is not an issue for you and your concerns are skin tightening, brown spots and wrinkles, than I would consider an full field ablative treatment with addition of fractionated resurfacing in only certain areas of the face (ie, cheeks, periorbital region). 

Full Field resurfacing treats the entire skin surface whereas Fractionated resurfacing treats only a fraction of the skin surface.  Fractionated treatments heal quicker but often require more treatments to obtain the optimal result.

ProFractional is the name for the Sciton Erbium laser with the ability to very precisely control the addition of heat to the underlying tissue layers.  Fraxel is a CO2 laser where the thermal damage is not able to be controlled as precisely.  Both lasers are very effective at achieving great results when used by a knowledgeable physician.

Again, if down time is not an issue for you, I believe you will do best with a full field ablative treatment with regional use of a fractional laser for deeper treatment in defined areas of the face.

Best Regards,

Jacque P. LeBeau, MD


Jacque P. LeBeau, MD
Pensacola Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Co2 laser resurfacing done in a traditional way would be the best for you

fractional resurfacing will give you minimal results. If that is what you want you can consider some of the more conservative approaches. But traditional resurfacing would likely give you the best results. Filling in your face with fillers and longer lasting face lift alternatives would be what I would consider.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Laser Resurfacing - Clearing up the confusion

Thank you for your question.  To summarize, you basically state that you want 3 things addressed:

1. skin tightening
2. brown spots
3. fine wrinkles

It is best to go with laser technology that addresses all these problems and have it done by someone who knows what he/she is doing, aka, knows how to use the laser to its full potential, safely.

For example, at my practice we use the Sciton Joule Erbium:YAG laser with full and fractional resurfacing and broad banded light technology.

One treatment scenario could possibly include the intense pulsed light (broad banded light) to treat the brown spots followed by a microlaser peel to resurface the superficial skin blemishes and fine wrinkles followed by a third treatment of Profractional to go deeper in the skin for skin tightening.  This addresses all three things you are concerned about.

This trifecta of treatments can safely be done at the same time in treatment packages of 3-4 treatments or more until the desired effect is achieved.

To see what treatments you are a suitable candidate for, see a board-certified physician in your area who is experience in laser skin treatments for a full and complete evaluation to make sure these treatments are right for you and that it is medically safe for you to have them.

I hope this helps. Best wishes.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 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.