Erbium/CO2 or RF microneedling?

Question

I'm 42 and have pretty decent skin for my age, but would like to erase some very fine lines on the side of my face near my mouth (not dynamic lines) and improve pore size on my cheeks. I'd also like to tone up the area around my mouth (very mild laxity starting). Note: I have fair, thin skin by genetics, but use sunscreen daily. If I could only pick one treatment, which would be better for the above concerns- RF microneedling or combo Erbium/light CO2 resurfacing? Thank you.

Mitchel Goldman, MD · Answer

Thank you for your question. The concerns you mentioned are due in part to collagen loss, which occurs naturally over time. Less collagen leads to skin laxity and the formation of static lines in the lower face. The best solution is to restore collagen levels, which can be done with a fractional laser or RF microneedling. I encourage you to schedule a consultation with an experienced, board-certified dermatologist for an in-person assessment and customized treatment plan.

Jason Emer, MD · Answer

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see linkt) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Shobhan Manoharan, MBBS, FACD · Answer

Thank you for the question.

If it is largely fine lines that you are looking at, often combining fractional Co2 or Erbium with injectable fillers gives excellent results.

RF needling is not a bad option either but I tend to use it as a maintenance tool.

Erbium/CO2 or RF microneedling?

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