Does face/neck CO2 laser ablation increase the risk of a poor outcome of a future facelift?

Question

I am 45 years old and would like to have C02 laser resurfacing on my face and neck for fine lines, acne scarring, large pores, mild skin laxity, and some dark spots from sun damage. I would like to eventually get a facelift (I think deep plane?) but probably not for at least 10 years, and an upper bleph and possibly lip lift within the next five years. What is the best order to do these procedures in? I have heard that laser treatments in the years prior to a facelift can increase the difficulty of the facelift and possibly result in a worse outcome. Is it better to do a facelift, bleph, and liplift BEFORE CO2 laser? My hesitation with doing a facelift right away is I don’t really need it yet, but I could benefit from CO2 laser resurfacing right now.

Lucian Ion, FRCS · Answer

Thank you for your question.

Laser surgery changes the characteristics of the skin, but does not have a significant impact on the deeper layers, as the radiofrequency treatments tend to have.

You can't have a good result with either order of treatment, and the CO2 laser would not limit the ability to do a deep plane facelift.

In terms of optimisation, however, if you do first a facelift and then the CO2 laser treatment, you are maximising the impact on the skin tension because the facelift controls the laxity that laser treatment adds to this effect.

Edward Buckingham, MD · Answer

CO2 laser is great for stimulating collagen and strengthening the skin and is one of the most effective skin resurfacing treatments. While certain treatments, like RF microneedling, may make surgery more difficult down the line, CO2 laser resurfacing is safe to perform before, during, or after other facial rejuvenation procedures without negatively impacting your facelift result. This is because the laser targets the skin, while a facelift is more focused on the deeper tissues that will be unaffected by the laser treatment. Good luck!

Williams Bukret, MD · Answer

Hi, thank you for your question.

A properly performed CO2 laser does not automatically make a future facelift worse or impossible. The important variables are the depth of the resurfacing, the quality of healing, the presence of scarring or pigment changes, and how aggressive the treatment is on the face and neck.

In your case, if you are 45 and do not feel you need a facelift yet, it may be reasonable to address skin quality now with CO2 laser, especially for fine lines, texture, acne scarring, pores, and sun damage. I would not recommend doing a facelift early only to “protect” a future surgical plan.

The best sequence is usually based on the dominant problem. If the main issue is skin texture, laser may come first. If the main issue is significant laxity of the lower face and neck, surgery usually comes first, with resurfacing later if needed.

I would be more cautious with aggressive CO2 resurfacing on the neck, because neck skin can be less forgiving. A conservative, well-planned treatment by an experienced physician is key.

Best regards,  
Williams Bukret, MD  
Plastic Surgeon

Does face/neck CO2 laser ablation increase the risk of a poor outcome of a future facelift?

Answers (3)

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