CO2 Lasers for Facial Wrinkles and Skin Tightening?

I'm a 40-year-old chinese woman who has sagging skin, nasolabial folds, and marionette lines. Will CO2 Lasers work on these problems and tighten skin as well?

Doctor Answers 14

CO2 laser for sagging skin, nasolabial folds & marionette lines

The fractional CO2 laser is a great laser because it allows for treating pigmentation, wrinkles and general sun damage on the face. The laser also causes vaporization of the skin, which will lead to tightening. I am always cautious when patients come in for a consultation and say they want the fractional CO2 exclusively for sagging skin. Although it does help tighten the skin, it works well in patients who just need a little bit of tightening. Patients who have significant sagging of skin will be very disappointed if they do the CO2 exclusively for that purpose. In addition, deep Nasolabial folds and marionette lines are secondary to bone, muscle and fat loss that have occurred over the years. The fractional co2 laser treat the superficial portion of the skin, it does not address the losses that have occurred. Although I do see quite a bit of improvement in the marionette lines after a fractional co2 treatment, the result int he Nasolabial fold is not as great. I would highly recommend a combination treatment of fractional co2 and fillers.

Santa Monica Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

C02 laser for Asian skin

C02 laser for Asian skin can  be used, especially if it used as a fractional resurfacing mode.  Erbium laser is typically preferred for Asian skin.  In some instances, a combination of both can help as well. Seek consultation from a laser expert in Asian skin to help discuss the risks and benefits for laser resurfacing for your specific skin.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 118 reviews

Not for significant sagging skin

Although the CO2 laser does a wonderful job at fine lines and wrinkles, its primary purpose is not for significant sagging skin, nasolabial folds or marionette lines. The latter two would be best treated by fillers or facelift.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.0 out of 5 stars 22 reviews

CO2 laser for skin tightening and wrinkles

The fractionated CO2 laser will do wonders for the skin.  I would not, however, bank all your hopes on this procedure.  If you have deepening nasolabial folds and marionette lines, then I would recommend dermal fillers or fat grafting in conjuction with the CO2 laser (usually done afterwards).

CO2 laser for tightening and wrinkle reduction

To properly address this question, one needs to understand the aging process from top to bottom. Starting at the top, our skin ages from environmental insults and time, which causes wrinkles, pigmentation, and lack of elasticity. This portion of aging is best addressed with resurfacing, whether that is peels or laser. CO2 laser is hands-down, without question, the gold standard when it comes to resurfacing. In addition, technology with CO2 lasers, that includes fractionation, has made them significantly more effective with fewer side effects than they had when originally developed and put into practice. Results with proper use of a CO2 laser are both dramatic and stunning.

When it comes to tightening, the CO2 laser vaporizes tissue and causes collagen remodeling, which no doubt give some tightening and significant wrinkle reduction. If you are after strictly tightening, there may be better options that you could speak with your physician about. That being said, I have definitely had patients who needed a facelift but did not want to take even a minimally invasive surgical route, so we decided to do CO2 resurfacing, and although they probably still would have benefited from a lift afterwards, they were very pleased with their overall results and tightening.

The sagging of our midface, lower face, and neck actually results more from the soft tissues and bone below our skin aging. Our soft tissues lose volume, what volume is left in there redistributes to a lower position, and the entire fat pads descended down our face. This is addressed with surgical lifts and with revolumization.

The bottom line is, yes you can get some tightening from a CO2 laser, but that may not be your best option if that is your main goal. With Asian skin especially, you need to seek out someone who is a true expert (as opposed to a self proclaimed expert), as pigmentation changes are more common with even slightly darker skin types.

To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut, MD, FAAD, FACMS, FASDS
Spokane Dermatologic Surgeon
5.0 out of 5 stars 40 reviews

C02 Laser for Asian Skin Tightening

Fractionated C02 can be performed on Asian skin, however, it is really important to go to an experienced specialist with a reputable practice. If you are looking for solely a non-surgical option to tighten skin, C02 laser can help. During the procedure, a high-energy beam of laser light is used to smooth out lines, wrinkles, and scars, remove brown spots and other irregularities. It also stimulates formation of new underlying collagen to continue improvement over time for a skin tightening effect.
However, if skin tightening was one of your main concerns and you wanted it to be done non-surgically, I would likely recommend a combination treatment plan of C02 laser, Ulthera and some injectable Fillers.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.5 out of 5 stars 70 reviews

Facial Skin Tightening

Thank you for your question. I would suggest Ultherapy for facial skin tightening. Ultherapy deposits focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will actually begin to lift and tone over time. Collagen is a natural protein that gives skin its youthfulness by keeping it firmed, toned and elastic. Plus, the treatment is completely non-invasive and does not require downtime. I have seen excellent results with the treatment.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 93 reviews

CO2 laser for sagging skin and wrinkles

The CO2 laser can give amazing results for sagging skin and deep wrinkles and sundamage; however, at age 40 you may not need fully ablative CO2 with 2 weeks of downtime and significant risk.  I usually save this procedure for very wrinkled, sundamaged persons and those are usually older than 40.  A fractional CO2 laser treatment can give you great results with less down time and risks.

Fractional CO2 and Dermal Fillers

The Fractional CO2 will help to smooth out wrinkles of the face, and will also help to even out skin tone and improve texture.  However, in order to correct the volume loss that occurs in the nasolabial folds and marionette lines, a dermal fill such as Juvederm is the best option.  When used together you will see even more significant result. I hope this helps you.

Neil J. Zemmel

There are better options than CO2 lasers

While facial resurfacing laser do result in skin tightening, I would not use it as a first choice in marionette or nasolabial folds. I agree that a better option is some type of facial filler - such as temporary dermal fillers or more permanent fat.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 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.