Fraxel Repair or Mixto CO2 for Smoker's Lip Lines?

Question

Hi and thanks for any help. I want to get Laser Resurfacing done on my face. I am 50 and the lines on my upper lip make me look older as I used to smoke. I have on over bite so I can't fill them.I went to a dermatologist who does the Fraxel Repair. He is one of only a few Drs here in South Florida who has that laser. Now I find out about Mixto CO2 Laser and it's supposed to be cheaper, although money is not my first concern.Maureen

Rian A. Maercks, MD · Answer

Profractional erbium laser is much better as it creates focused ablation channels in your skin without extensive heat damage and coagulation thus recovery is dramatically reduced and effects are maximized by treating all the way through all of your skin into the subcutaneous tissue on 6-12% of your face.  There is a robust collagen response and modest skin tightening with very little redness.  The laser is made by Sciton, the best manufacturer of lasers and is very expensive so it is a less common find but it is the choice of elite plastic surgeons for many reasons.  I hope this helps!  

	 

	All the best,

	 

	Rian A. Maercks M.D.

Joel Schlessinger, MD · Answer

While the use of a laser like Fraxel or Mixto are good if used on a person's face in its entirety, use of it for a selected area will most likely result in a disaster.
The reason for this is that it will probably change the color of the area compared to the rest of the face, so you now will have a clown-like whitish area around your mouth rather than the smoker's lines. Are you seeing the problem yet?
If your surgeon hasn't told you this yet, then you need to find a different surgeon - one who is proficient in fillers and doesn't use the excuse that you have an overbite in order to steer you to more lucrative procedures. 
Good luck.

Armando Soto, MD, FACS · Answer

Hi there-
While I personally prefer one of the lasers you mention over the other, because I don't think the preference has anything to do with the outcome you could expect from either (provided the procedure were performed by a well-qualified and Board Certified Dermatologist or Plastic Surgeon), I don't think it matters. 
Both are fractional carbon dioxide lasers and both, in the right hands, are capable of achieving a pleasing improvement in the texture of the skin.
In other words, you should understand that the person holding the instrument is infinitely and undoubtedly more important to your safety and your outcome than which machine he or she prefers.
It's really not unlike any other human endeavor which requires a lot of study and application over time- what's between the ears of the person doing this on you is a lot more important than what's in their hand. As long as you choose a well-qualified and experienced provider, you should be able to achieve equally good results with either laser. 
This also brings up another issue- please be careful that the costs are not lower because you are compromising on the skill of your provider. Cut rate prices can sometimes (but not always) indicate a lack of experience, training, credentialing, etc...
Please be careful.

Michael A. Persky, MD · Answer

Hi Maureen,
Both Mixto and Fraxel repair fractionated CO2 technologies are very effective treatments for laser skin resurfacing.  It is more important to choose the physician performing the treatment.  Choose your physician carefully and enjoy your new skin.
Be well.
Dr. P

D.J. Verret, MD · Answer

Fraxel has a fractional carbon dioxide laser treatment, similar to Mixto. I would agree that both are effective and your bigger concern should be who is performing the procedure. I would disagree with Dr. Schlessinger though. I regularly perform only perioral or periorbital laser resurfacing without significant problems. As long as you stay within facial subunits (ie between the lines around the mouth or the natural area around the eyes) you can perform isolated laser resurfacing.

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