What's the best laser for Skin Resurfacing in, 2016, to tighten skin, improve texture, pores and wrinkles?

Specific concerns are the eye and nose area. Also, do they promote rosacea like broken veins?

Doctor Answers 6

There is no single best laser, but diagnosis can help determine the best treatment for you and your particular problem

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Thank you for your question. You submitted a question without a photo asking about the best laser available in 2016 to for resurfacing, improving skin texture, and tightening pores and skin. You are interested particularly in the eyes and nose area, and are also concerned about the possibility of lasers causing blood vessels to form, or the onset of rosacea.

I can give you my opinion on how I approach that question when people ask that exact same thing in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. I began my career with the first CO2 Lasers for ablation in the early to mid 90s, and have many lasers in my office. I can describe how I make these decisions and give you some guidance on how and what you should consider when thinking about laser treatments.

The question you ask results in almost a knee jerk reaction by physicians who are all thinking, with the best interest of the patient in mind, but usually also because they own or lease a particular laser. There are many choices for what can be used for resurfacing, improving skin quality, and improving pores, but the first question is really proper diagnosis. There has been this natural evolution of improvement in the types of lasers and modalities to apply these lasers. There also has been radiofrequency technology as an alternative to lasers. When you get down to it, you have to understand what your desired outcome is. You have to think will laser be the right solution instead of thinking which is the best laser. We’ve learned a lot about what can be accomplished  with laser alternatives. For example, with tightening skin, improving texture, improving texture, improving the appearance of the skin, you are talking about increasing collagen, improving the quality of the skin, the blood supply, and the skin looking smoother.

I found that what I used to do with more aggressive treatment like a fully ablative CO2 laser, I now do differently but not with laser alone - I’ll do a combination with platelet-rich plasma (PRP)and place it under the skin. PRP is a concentration of your blood of wound healing factors that stimulate repair when you get a cut because your body knows how to restore collagen and blood supply as a response to injury. With platelet-rich plasma (PRP), we are concentrating those same growth factors from your own blood, so instead of using heat to try to stimulate a healing response, we are actually using your body’s own growth factors to stimulate a comparable response. When you do something like platelet-rich plasma (PRP), you can actually be more conservative with a laser -  instead of fully ablative, we’ll do fractional (depending on skin type) with fractional Erbium or fractional CO2.

I try to not talk about the brand name of the laser, but rather the category of the laser. We have several lasers in our practice which are all very adjustable, including  non-ablative lasers called Nd:YAG that can improve the texture of skin quality by going through the skin and into the deeper layers to stimulate new collagen formation. It is very important that you get an understandings of what your options are by proper evaluation.

Literally every week, I see people who tell me they got the “best laser” last year, but they didn’t get the result they wanted. Often people are going from one laser in one doctor’s office, to a laser in a medispa, then going to another place basically bouncing from one laser to another because they keep seeing promotions of different brands of lasers. What is really critical is the physician who communicates with you about your skin condition.

Often, it is better to prepare the skin before doing a laser, so don’t hang your hat on a single laser as the best laser of this particular year. It is really about the doctor who makes the diagnosis, makes the recommendation, performs the laser, and then treats you after the laser. This is really a tool, which is a very exciting and capable tool, but it is part of a spectrum of many different technologies now available. I would say you can certainly get ideas of what’s out there, but it is an art to help people improve their skin,and variables have to be factored in before you decide what is the best laser. That’s why with a busy practice like ours, we have multiple lasers with different applications in different scenarios.  

Meet with doctors, figure out what your particular skin issues are, understand what the treatment plan would be and what you can expect. I think you just have to understand if there was just one best laser, everyone would own the same exact laser, but rather it really is about what is the best approach that’s right for you. I hope that was helpful, I wish you the best of luck and thank you for your question.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

What's the best laser for Skin Resurfacing in, 2016, to tighten skin, improve texture, pores and wrinkles?

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Thanks for your query. Different laser are designed to cater different problems . For skin resurfacing and tightening THERMI RF is the latest and the best in the market as it provides unbeatable results and for broken veins IPL works better.
All The Best

Ajaya Kashyap, MD
India Plastic Surgeon
5.0 out of 5 stars 217 reviews

Laser Resurfacing

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Thank you for your question. Removal of facial wrinkles and deep lines specifically around the eyes and nose are common uses for laser skin resurfacing. Specialized lasers including Erbium and CO2 are innovative for 2016. I suggest that you consult with a board certified facial plastic surgeon as your surgeon will have a certain preference and expertise with the laser at their office.  Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Skin Resurfacing

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Hi and thank you for your question! This depends on the amount of downtime you're comfortable with and your skin type. We have found the most dramatic results have come from our Sciton Contour Erbium laser. This has shown very impressive results in the thinning, crepey skin around the eyes and for pores. This depth of the laser is tunable, so we can decide how much downtime but on average a week to two weeks will allow for the best result. Best, Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Another good option

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Thanks for submitting your question!  I'm a fan of the 1540 nonablative fractional laser.  This is a fast, comfortable treatment in the office that does not promote rosacea.  Usually, in 3-4 days, you can reapply make up and return to your normal routine.  This is a much faster recovery than the CO2 laser which is significantly more aggressive, although a good treatment as well.  Hope this is helpful to you!

Best Laser for Skin Resurfacing

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As an oculoplastic surgeon who has had the same issues addressed, I can vouch for the MiXto CO2 laser. This model has a patented handpiece which allows more comfortable application of the laser in an office setting. Prior to this, an effective CO2 laser application had to be done in a surgery center setting. If you choose another laser, make sure that it is a CO2 laser - that is the best wavelength to penetrate the skin and induce collagen. The laser does not induce rosacea or broken veins, but you will find - with optimal settings for pores and wrinkles - the skin remains erythematous (red/pink) for weeks. Usually the peeling process takes 5-7 days, but the erythema lingers (looks like you have been out in the sun). After the peeling, the skin is baby smooth, and ready for makeup. The laser may be combined with surgical procedures - such as blepharoplasty - that have similar down time. The postoperative recovery is easy with regard to comfort. My patients feel like doing more than they should, but are encouraged to recuperate at home without aerobic activities. Sun precautions and skin care afterwards are very important. Best wishes with your decision. 

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 12 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.