How Effective is Fraxel Repair for Dynamic Wrinkles?

I am 25 years old and after years of harshly treating my acne I am left with some mild scarring and bothersome dynamic wrinkles from smiling - these are not nasolabial folds, but instead lines that extend at abou 45 degree angles from the fold. These really bother me. What is my best option? I assume fraxel repair - but would consider traditional c02 if that offered better result potential.

Doctor Answers 8

Laser and Fillers For Wrinkles

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Carbon Dioxide lasers work very well to treat static wrinkles and scarring. In younger patients, fillers and botulinum toxin products often are more appropriate as significant rhytids are lacking and the carbon dioxide laser for wrinkles is often overkill. I would certainly recommend talking with a facial plastic surgeon who offers all of those treatments to help determine what would be best in your case.

Dallas Facial Plastic Surgeon

Fraxel Repair for Dynamic Wrinkle Treatment

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Hello and thank you for the question.

Fractionated lasers such as the Fraxel Repair or the Lumenis Total FX provide excellent results for static rhytidosis and can even benefit dynamic rhytids with static elements. This is more commonly seen in an older population than yourself. Hence, I would recommend trying an injectable filler to soften your dynamic rhytids. Good options include Juvederm Ultra and Perlane.  Unfortunately there is no place for chemodenervation products such as Botox or Dysport in the lower face for the area you are describing. 


Glenn Vallecillos, M.D., F.A.C.S.

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

You might benefit more by using a filler.

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You might benefit more by using a filler. The thing is, Fraxel repair laser technology is great when it comes
to treating acne scars. It is also superb for non-dynamic wrinkles, however in the instance of dynamic
wrinkles, I would advise going with botulinium toxins in the upper face and dermal fillers in the lower face.
Pertaining to your issue, these neuromodulators should never be used because you are going to need those
muscles to eat and speak.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Dermal Fillers More Cost Effective in Treatment of Facial Wrinkles

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Although Fraxel re:pair has the ability to stimulate collagen and help smooth superficial lines, retexturize the skin and improve colour, it will not help prevent further lines from forming. In my experience, dermal fillers offer greater results and are often more cost effective. It is important to remember that neither of these treatments offer permanent results, so repeated treatments will be required in order to maintain your desired outcome. Do your research to find Cosmetic Dermatologist in your area who specializes in dermal filler injections. Similar to a pair of scissors when going for a haircut, it is the experience of the user that mainly determines the result, not just the tool itself.

Frances Jang, MD
Vancouver Dermatologic Surgeon

Fraxel Repair and Dynamic Wrinkles in a 25 Year Old With Acne Scars

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Hi TK,

Fraxel repair laser is excellent for the treatment of acne scars and non-dynamic wrinkles.  Dynamic wrinkles are best treated with botulinium toxins.  In the area of your concern, these neuromodulators should not be used as you need those muscles to be active for eating, speaking, and not drooling.  You may benefit from fillers.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Dynamic Rhytids

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Dynamic rhytids refer to wrinkles caused by muscles of facial expression.  In the upper third of the face, these are evident as transverse lines on the forehead (frontalis muscle), lines between the eyebrows (corregator and procerus muscles), and crow's feet (lateral orbicularis oculi muscle).  While a resurfacing laser could help, these respond best to a chemodenervation agent (Botox) or a browlift where these muscles are surgically weakened. However, the lines you describe, lateral to the nasolabial folds, do respond to laser resurfacing.  While traditional CO2 would give an excellent result, there is a long healing time and oftentimes a waxy appearance to the skin.  The Fraxel Re:Pair would also give an excellent result with a shorter healing time and the neck could also be treated; thereby eliminating the telltale "line of demarcation" between the face and neck.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 59 reviews

Does laser work for dynamic wrinkles

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Usually dynamic wrinkles are best treated by either fillers or botox or a combination of both.  Laser does a better job on the fine wrinkles, while it doesn't really do all that much for deeper ones or ones that occur when you smile.

In the meantime, you should consult a board certified cosmetic surgeon to see if fillers can help.  Typically, that would be the best choice in this area.  Good luck!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.9 out of 5 stars 50 reviews

Laser For Treatment of Dynamic Wrinkles

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Dynamic wrinkles are formed when you contract the facial muscles.  Although laser can improve the appearance of dynamic wrinkles, they are usually best treated with Botox.  The problem with using Botox in the area of the Nasolabial fold is that too aggressive use will effect your smile.  Your concern may be best treated with combination therapy (laser, Botox and filler).

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

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.