Which procedures other than facelift or Botox would minimize the appearance of fine lines, sagging skin and large pores? (photo)

Question

Hi im 43 with fine lines, big pores, and saggy skin. I was thinking about C02 Laser resurfacing I have but I read that it causes saggy skin since it burns the fat under the skin. I already have a slim face and a bit of saggy skin so what is the right procedure for me so I can have the best results that does not include botox or face lift. Some people advised me to do microneedling and I need to know which one is better for me. Thanks in advance!

Ryan Rebowe, MD · Answer

I think you are on the right track with microneedling and laser treatments. I personally would not recommend stepping all the way up to CO2 just yet based on the amount of fine lines and wrinkles that you have, however microneedling and Erbium/YAG lasers I think would give an excellent result. You can always "step up" to a CO2 laser following those procedures, however this is typically substantially more cost and down time.

Nick Slenkovich, MD · Answer

Hello, my name is Lauren, and I’m the aesthetics injector at Colorado Plastic Surgery Center. The CO2 laser treatment is a highly effective option for addressing fine lines and minimizing pore size. It works by removing the outer layers of damaged skin, which stimulates your body’s natural collagen production, leading to smoother, rejuvenated skin. However, if you're concerned about sagging skin and prefer non-surgical options, microneedling could be a great alternative. Ultimately, the best course of action is to schedule a consultation with your provider for a thorough skin and facial assessment to determine the most suitable treatment for your needs.

Carey Nease, MD · Answer

You are a very good candidate for CO2 laser resurfacing. I recommend a fractional CO2 and my favorite device is either the Tetra Pro or Helix. Both are fantastic and have only about 5-7 days of down time. You are not correct that the laser causes fat necrosis under the skin and will not make your face more narrow or thin. It simply removes the outer layer of damaged skin and causes collagen remodeling and thus thicker, clearer skin and smaller pores. Hope that helps!

Patrick Felice, MD · Answer

Both do different things. CO2 lasering is the gold standard in minimizing wrinkles, decreasing pore size, and toning skin. There is no evidence to suggest it dissolves fat. Also, because it affected the elastin fibers by shortening them, it tightens the skin.Needling is limited in that it affects only the superficial layer of skin. I can improve fine lines and pores but has no real affect on the elastic fibers.
Hope this helps.

Nelson Lee Novick, MD · Answer

The one, three-quarter face smiling photo is unfortunately insufficient for a proper evaluation. However, generally speaking, in the hands of an experienced, board certified cosmetic dermatologist filler expert, the use of appropriate HA fillers can both contour the face, I..e. create a more feminine ogee curve, as well as diminish smile lines, improve the under-eyes and define the jawline and provide lift where necessary. These treatments typically yield immediate results and engender little to no significant post-treatment downtime. 
On the other hand, ablative CO2 laser treatment is an aggressive approach that runs the risks for infection, scarring, permanent dyspigmentation, and even a permanent abnormally glossy orange peel appearance; it also typically engenders significant post-treatment downtime. . 
You would be wise consult with an experienced, board certified cosmetic dermatologist filler expert. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Mahmood Siddique, DO · Answer

I would recommend microneedling if you already have a slimmer face. Microneedling encourages the production of collagen and elastin which adds volume to your face. CO2 would also be a good option as it won't cause saggy skin like you are worried about if it is done correctly. Either option would be a good one, but I am leaning more towards the microneedling for collagen production. Microneedling can help reduce the appearance of fine lines, wrinkles, and scars, leading to smoother and more youthful-looking skin.

Stefan Weiss, MD · Answer

CO2 laser is the gold-standard for addressing fine lines and wrinkles. From the picture a series of 3 non-ablative CO2 treatments should help you achieve the results you seek. It does not burn the fat under the skin nor does it create saggy skin. In fact, just the opposite. It results in long term skin tightening.

Which procedures other than facelift or Botox would minimize the appearance of fine lines, sagging skin and large pores? (photo)

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