Ematrix, Affirm, Fraxil Repair, CoolLaser, Thermage, Cooltouch? Which is superior for collagen production?

Hi! I've tried Ulthera, Total FX, Pelleve and chemical peels administered by reputable Dr's-----ALL gave ZERO result ! I do not yet have set wrinkles, but I have premature collagen loss and laxity beginning on the brow , crowsfeet and undereye area. I do not like Botox or fillers, I am only interested in other options. Which of the treatments listed above are better for the orbital area?

Doctor Answers 2

Not good options for collagen production

As you have become aware, most of these so-called skin tightening methods do minimal. If you do 5-10 of them over a yr, you may see a little improvement but it will usually break the bank before that happens.  This is not to say that someday we won't have a laser that actually does something that is noticeable. Sincerely, David Hansen,MD 

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Alternatives to Botox and Dermal Fillers

Hi Anna.  A photo would really help and also an in person evaluation.  With that said, the technologies you are speaking about are very different.  

For example, Thermage is a radiofrequency technology.  It uses radiofrequency to heat soft tissue to create a tightening effect.  Even though it is available for the eyes and body, the only place we have ever seen any value in it is under the neck.  In addition, the results do not tend to last very long (6 months at most).  Ulthera is much like Thermage.

Cooltouch and Affirm are non-ablative (no downtime) lasers that seeks to use heat generated by laser light to stimulate the production of new collagen.  Although these technologies can sometimes improve the surface texture of the skin, it would be very difficult to get rid of wrinkles around the eyes with this type of technology because there is no downtime.

Total Fx, Ematrix, Fraxel and CoolLaser are all similar in that they are "fractional ablative" technologies.  These lasers poke tiny holes in the skin during treatment using heat generated from the laser light.  The body then fills in these tiny holes with new collagen to create a smoother surface texture.  There is a recovery period associated with these treatments, so from that perspective they have a better chance of achieving your goals compared to the options above.  While these are all similar fractional laser technologies, how you use them will have a big effect on the result.  If you do a very superficial resurfacing, you will have little downtime and little result.  Also, if you do not use a mode called "coagulation" under the eyes, there will be a lesser chance of improving the thin tissue in this area.  

While we understand that you do not want Botox and fillers, it's likely that these are the best options for you.  The reason is that the key issue in the crow's feet area is muscle contraction and this is exactly what Botox addresses.  The key issue under the eyes is typically volume loss and this is what dermal fillers address.  So, you can continue to search for the holy grail with lasers, but as you've experienced, it's unlikely you will find it.  These are marginal options at best when compared to the injection treatments for around the eyes.

For examples of laser and injection photos for our Los Angeles based patients, try the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

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