Best Laser for Limited Wrinkling Around the Eyes and Lips?

I saw a plastic surgeon today who suggested that putting me to sleep (no pain!) and doing a full-face and neck non-fractional treatment with the Sciton laser (erbium) would give me a better and longer-lasting result than a full face and neck fraxel re:pair treatment. He admitted that he has only done two Fraxel Re:pair treatments so is working on limited evidence.The laser price is the same for both although the cost to be put to sleep adds $2500 to the bill over and above the laser cost. I am a 51 year old woman with some limited wrinkling around the eyes and lips. What will give me the best results?

Doctor Answers 8

"Best Laser"

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There is NO "Best Laser"

There hundreds of medical lasers on the market. Some lousy, some outdated, some formerly great.and there are good lasers. The factor common to most medical lasers out there which are taking up room in doctors' offices and salons is that they are expensive tools (between 70,000 and 200,000) which have yet to be completely paid for. The need to pay for these investments, especially in a poor economy, is acute and the direct result are the non-stop BOMBASTIC puffery claims and "mine is the Best" comments that abound everywhere in the media and the Internet.

When we clear the cobwebs of marketing hype and BS which surround us several basic generalities apply;
1. All CO2 lasers conduct heat to adjacent tissues and result in much more prolonged redness and a higher rate of unintended skin bleaching than do Erbium lasers.

2. The introduction and use of Fractional CO2 lasers (lasers that heat skin with a varying concentration of dots of varying depth) was a brilliant way to make something bad - less bad. By not the treating the entire surface but instead poking patterns of holes/wells in the skin Fraxel, the first fractionated laser, shortened resurfacing recovery. Although the results of fractional resurfacing were NOT as dramatic as similar (complete) resurfacing, the results were good AND the treatments could be repeated for improved outcomes.

3. Although Fraxel was the first giving its name to fractionated treatment the way Xerox gave its name to photocopying, better, more accurate AND less painful lasers have supplanted it. The best fractionated treatments with most accuracy are afforded by the SCITON JOULE - PROFRACTIONAL TREATMENTS which are based on Erbium. The Erbium energy is 10 TIMES more specific for water and does not heat the adjacent skin nearly as much as Fraxel. Research it and check it on You Tube.

Your particular result would depend on WHICH resurfacing treatment you chose, which laser is being used and WHO will be doing it.

Instead of being put to sleep, you MAY be better off having a MicroLaser Peel (30 to 40 micros) with a Profractional Treatment (350 or 400 microns) which will NOT require general anesthesia. Asses the results at 4-6 weeks and if needed you may repeat it.

Dr. P. Aldea

Memphis Plastic Surgeon

Fractional Ablative Erbium Best for Laser Resurfacing Eyelid Wrinkles

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The eyelids are very thin and delicate structures. CO2 Laser Resurfacing is risky on the eyelids.

Fractional Erbium Ablative-2940 laser resurfacing is the safest laser technique for the eyelids. Heat production and this the risk of pigment loss or scarring is less with the Erbium than with the CO2.

Demarcation lines between treated and untreated skin are much less likely with the Erbium than with the CO2, thus treating only the eyelids and lips and not the whole face

Best Laser for wrinkling around the eyes and lips

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For limited wrinkling around the eyes and lips, 2 or 3 treatments with a Fractionated CO2 Laser would be sufficient, especial;ly if Botox is administered 7-10 days prior to the Laser treatment.

One traditional CO2 or Erbium  Laser resurfacing  treatment  will also be quite effective.

I wouldn't advise a total face laser resurfacing if your concern is the presence of limited wrinkling around the eyes and lips.


Eugene Mandrea, MD
Chicago Dermatologist
4.6 out of 5 stars 5 reviews

Expertise is key

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There are many lasers for this procedure, but more than the type of laser is the expertise of the practitioner and whether they can offer you fat removal as this is oftentimes the problem. A surgeon who can offer you a fat removal procedure, a blepharoplasty, and/or laser is the best choice for this problem.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Best laser for limited wrinkling around the eyes and lips

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I agree with Dr Aldea's posting. Why not try Botox and a peel (VI Peel) first to see if you like the result with out as much down time. Also try fillers for lips.

From MIAMI Dr. B

Laser treatment for wrinkles around eyes and lips

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We have the Madonna lift here for which we use the Affirm CO2 laser. It could take up to a series of 3 to 5 treatments and they can be done every 2 weeks. You are completely awake and have minimal downtime. The results are amazing.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Less downtime and risk with fractional

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My guess is that he is talking about a fully ablative erbium resurfacing. What it boils down to is that the risk of what he is proposing is greater - anesthesia, hypopigmentation, and scarring are much greater than the Fraxel re:pair which is done in the office. Also, the healing time and wound care are much longer with total ablative technology vs fractional ablative technology. If everything goes perfect, and your healing time is not prolonged (less than 2 or 3 weeks), you might get a better result. Total ablation has been around longer than fractional ablative. However, the trend is towards fractional which will give close to comparable results, with less downtime and less risks. All the buzz at meetings and all the laser companies want to market is fractional lasers.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Improving periorbital and perioral wrinkles

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Either treatment with the erbium, traditional CO2 or Fraxel can effectively treat those areas. What you have to consider is the degree of improvement varies since each laser has a differing depth of penetration. If you have fine lines than any treatment would work well for you. If you have deep lines, then the traditional CO2 laser would work the best. If you have mild to moderate, than the erbium or Fraxel can work but both might require multiple treatments depending upon how bad your wrinkles are. Another important point to consider is your skin coloration and type of skin. If you are fair complected, then there are no significant issues to worry about. However, if you are dark complected the traditional laser might cause hypopigmentation and this can also occur with the Fraxel laser. The erbium lasr is less likely to result in pigmentary changes. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

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.