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.
