Fractional CO2 Laser After Restylane and Sculptra?

Hi Curiousco,
If you are contemplating having both fillers and Fraxel re:pair, it is best to have the laser treatment first. There have not been definitive studies to show the effect of Fraxel re:pair on Restylane, but one would think that the heat of the laser may cause the filler to possibly break down faster. Additionally, the laser treatment stimulates the patient's own collagen production, stimulating increased volume so that less filler will be needed after the treatment.
Sculptra is not effected by the laser as it is placed deeper below the skin.
Good luck and be well.
Dr. P

Lasers and filler injections can definitely performed in the same patient. I typically would not perform them at the same treatment session due to the possibility of moving the filler around during the laser treatment (if the fillers were placed first), or affecting the placement of the fillers based on the appearance of the skin (if the laser was performed first). I typically would like to place filler injections, and then come back sometime in the next week or two to perform the laser treatment, but this depends on the patient and where the fillers are being placed (and also where the laser is being performed). In some cases, we may perform both treatments during the same session without any issues.Be sure to see a physician specializing in facial aesthetics for any facial injectable treatments or any aggressive laser resurfacing.All the best,

Yes, a fractional CO2 laser treatment while having fillers on board is safe and does not diminish the effect of the volumizer.  However, I would recommend allowing the swelling from the filler treatment to subside prior to the laser treatment so any increase in swelling after laser can be attributed to the laser and not the recent filler treatment.  Usually 1-2 weeks in between the two treatments is good as long as the swelling from the filler has subsided. 

Facial fillers such as Restylane and Radiesse are offered in my plastic surgery practice and in Los Angeles, they are common among all cosmetic specialists.  I have been asked to perform these fillers in combination with fractional CO2 and prefer to stage the two treatments in order to avoid post-inflammatory side effects.  I do recognize and treat melasma in conjunction with facial fillers or fractional CO2 and believe most patients should optimize skin health with the Melaquin AM and Melaquin PM system. 

Fillers can absolutely be done before or after laser resurfacing treatments.  I often recommend patients undergo the laser procedure first followed by filler a month or so later, but its also fine to do fillers and follow up with laser.  On some occasions, I will treat patients with fillers and perform their laser resurfacing procedure at the same time. Discuss this with your treating physician, as some of the details will depend on what type of laser you are having done and where the fillers are being injected.

Yes, you can get fractional CO2 after fillers, including restylane and sculptra.  These fillers work in the dermis, the middle layer of the skin, and the CO2 laser works mainly in the epidermis and superficial dermis, so one will not disrupt the other.

Most patients will be concerned that they may effect the results of a filler like Restylane or a volumizer like Sculptra if a fractional laser procedure is done after that have had these products placed. This has in fact been looked at with skin-tightening devices and shown that there is no effect on the products as we are usually placing these products deeper than where the laser impact is, and so thereby not affecting the product. If the product can be injected after the laser procedure, this then should not be a problem.

I generally have patients wait a week after injections for Fraxel Laser.  There is absolutely no reason why you can't have Fraxel after the injections.  Between the injections and the Fraxel you should look great.  It might be easier for you to get the Fraxel first and then do the injections the following week.

 Yes is the answer to your question about combining a filler such as Radiesse, Restylane or Juvederm after fractional Co2. The important thing as far as doing these two procedures, is timing. If you have had filler, and now would like to enhance your skin's appearance further, just make sure you give your skin a bit of time to ensure any swelling post injection has had time enough to resolve. This varies slightly from person to person, but generally after 2-4 weeks it is safe to proceed. Ideally, if you know you want both treatments, I would opt to do the laser treatment first to see how much improvement can be achieved by laser then enhance that with a filler for the ultimate result. 

Dr. Manolis

One might assume that, because the injectables are placed much deeper than the laser, there should be no interaction. However we don't know this for sure.

I would suggest having the laser treatment first. Its superficial tightening might also guide the possible need for the injectable fillers.