Fraxel Repair or Lift for the Whole Face and Neck?

I had an endoscopic brow lift in 2004. It still looks great. However, my mouth wrinkles are bad and neck needs a little help! I have some sun damage all over. I'm confused about going with Fraxel Repair for the whole face and neck or some type of lift. Please help. I am 56 years old.


Doctor Answers 19

Fraxel vs Face/Neck Lift

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Thank you for your question. Based on your photograph I do not suggest Fraxel treatment has it will not give you much improvement. From what I can see your platysma muscle bands are very prominent and would not respond well to non-surgical treatments. I would recommend a facelift/necklift. I may have Fraxel treatment after surgery to help with lines, skin texture and sun damage. Please find an expert in your area to help determine the best treatment plan for you. Best of Luck!

Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

Fraxel Repair vs Erbium results + neck lift

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Because of the nature of old CO2 laser technology Fraxel cannot deliver significant results without basically becoming an expensive nonfractional CO2 treatment with prolonged redness and swelling because of extensive thermal and coagulative damage.  This is why I use only an Erbium beam which allows focused and controlled treatment of the skin through exact microchannels preserving 90% of the skin to help quickly regenerate and lay down collagen.  As far as your neck you will want some variation of platysmaplasty to correct your banding and laxity.  A laser will not give you satisfactory results for your neck.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Fraxel resurfacing vs facelift or necklift

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Fractional resurfacing will give a modest improvement in sun damage and fine wrinkles. The effects of Fraxel tend to fade greatly after 6 months when all the swelling abates.
It is not, in my opinion a substitute for CO2 laser resurfacing performed conservatively plus a facelift and necklift.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Fraxel vs face/neck lift

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Fraxel is an excellent technique to get rid of sun damaged skin. It can be done on the face and the neck to eliminate freckles and fine lines. It s not used to tighten skin.

A comprehensive face/neck lift is done to remove fat in the neck both above and below the platysma muscle as well as tightening the platysmal muscle in the front and the back portion of the neck. Additionally, excess skin is addressed; the neck, jowls, facial muscles, and fascia are tightened.

The Fraxel laser is used for surface irregularities of the skin, while the face/neck lift is used to tighten the structures underneath the skin and the skin itself.

Botox or surgery for your muscle bands

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Hello Grace,

Looking at your picture you have a platysmal muscle band, more evident on the right than the left.

If that is your main concern then the best option is surgery (platysmaplasty, necklift) or specific injections of Botox.

Fraxel is excellent for addressing issues with skin quality but will not have any impact on deeper muscle issues or excess skin.

Thank you.

Kamran Jafri, MD
New York Facial Plastic Surgeon

Fraxel Repair vs Facelift

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Fraxel repair is appropriate for improving skin quality. However, a facelift is indicated to treat the neck bands, contour abnormalities, and jowls. If you can do only one procedure at this time, decide what bothers you the most. The ideal would be both surgeries at different times.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Fraxel will not give much improvement on your neck

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Based on your neck photo, Fraxel will not give you much improvement. I would recommend a facelift/necklift. You could consider Fraxel after the surgical procedure, as it would help with lines and skin texture and sun damage.

Neck and facelift are completely different from Fraxel Repair

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As you can see from many other responses, physicians can readily recommend surgical lifts for support of deep structures. In the photo of your neck, the platysma muscle bands are prominent and would not respond to non-surgical treatments. If you had jowl pouches, they would only improve with internal (SMAS facelift) support.

On the other hand, if skin texture is your issue, surface laser treatments are the answer. Your all-over sun damage would best be treated with laser resurfacing (various brands) and the Fraxel should help when used by an experienced doctor. Lines around the mouth can be difficult to smooth completely, but carbon dioxide laser has shown better results than Fraxel, but the recovery is longer.

In summary, both the Fraxel and the lift surgery can help you in different ways. Both may be your answer for the best results.

Sutton Graham II, MD
Greenville Plastic Surgeon

Neck sagging Fraxel vs. surgical lift

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Your photograph reveals banding of the neck muscle, the platysma, and some irregular fatty deposits and horizontal skin creases. Fraxel RE:store and even the more aggressive Fraxel Re:pair would not give you enough improvement, unless the latter were done with liposuction of the neck and Botox injections of the muscle bands, which would have to be repeated every 5 months or so. You would probably get a much better and longer-lasting result with a neck lift.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Fraxel vs Lift

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If gravitational aging in your face (deep nasolabial folds, jowls, saggy neck skin) is your main complaint then you would be better off with a face/neck lift. However, your complaint of sun damaged skin and wrinkles around your mouth suggest that you might be just as happy with a laser treatment such as the Fraxel Repair.

Looking at your picture I would suggest a full face and neck Fraxel Repair treatment which would address both the wrinkles around your mouth as well as the sun damaged (dyschromia) skin. I would also recommend combining the Fraxel Repair with neck liposuction which will slim down your neck and give you a more youthful contour.

The Fraxel laser can also be combined with Thermage with is a radiofrequency device which tightens underlying tissue giving you a nonsurgical lift. Both Fraxel and Thermage are owed by the Solta Corporation and they complement each other very well (Fraxel for skin and Thermage for underlying soft tissue tightening).

The Fraxel Repair is ablative and more effective for wrinkles. The Fraxel Restore is nonablative and has been upgraded with an additional laser wavelength to target abnormal pigment in the skin.

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.