Rhinoplasty and co2 laser - which procedure should be performed first and how long should I wait in between?

Question

Is it best to do rhinoplasty or co2 laser skin treatment first? How long to wait in between the two procedure ?

Semih Yildiz, MD, FEBOPRAS · Answer

If the CO2 laser will include the nose or central face, I generally prefer completing the rhinoplasty first. Rhinoplasty changes the nasal skin envelope and creates prolonged swelling; treating that skin with an ablative laser shortly beforehand can add inflammation, pigment change, infection risk, and delayed healing. After rhinoplasty, wait until the incisions are fully healed and most swelling has settled—commonly at least 3 to 6 months, and often 6 to 12 months for aggressive laser treatment directly over the nose.

If the laser is limited to areas away from the nose, it may be possible sooner, but the rhinoplasty surgeon and laser physician should coordinate the timing. If CO2 resurfacing has already been done, allow complete re-epithelialization and resolution of redness and sensitivity before surgery; for a fully ablative treatment, this is often several months. The exact interval depends on laser depth, your skin type, history of pigment change or abnormal scarring, medications, and whether an open rhinoplasty is planned. Avoid scheduling the procedures close together and obtain an in-person skin and nasal examination before setting dates.

Mune Gowda, MD · Answer

The answer depends on the individual patient and their skin. For instance, if a patient has thick skin, I recommend doing the CO2 laser first to treat the skin and prepare it for a better result with rhinoplasty, which would ideally take place 6 months to a year following CO2 laser treatment. In the case of a patient with thin skin, they could do the treatments in either order, depending on their goals and convenience.

Todd Christopher Hobgood, MD · Answer

If you're planning to undergo both rhinoplasty and laser skin resurfacing, it's generally best to do the rhinoplasty first. The reason is that rhinoplasty creates swelling and incisions that need time to heal, and you don't want to expose freshly healing skin to the intensity of a CO2 laser.

If you get the laser treatment first, it usually won't interfere with surgery; however, your skin may need several months to recover before undergoing an operation. Typically, 3 to 6 months is a good time frame between these 2 procedures (whether you have rhinoplasty first or laser resurfacing).

Eric M. Joseph, MD · Answer

If you are on the fence about this, it may be reasonable to move forward with rhinoplasty, if you have severe dissatisfaction with the appearance and or function of your nose. If you are pursuing CO2 laser for resurfacing, you could certainly have that done first, and when you're healed, move forward with the rhinoplasty. The choice is most definitely yours. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You could have rhinoplasty first and then CO2 laser two months after, just completely avoid the nose with the laser. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Justin Buro, MD · Answer

Hello! Thank you for your question. This is a tricky but important question. When patients are considering both rhinoplasty and CO2 laser resurfacing, timing is very important to ensure safe healing and the best results.
In most cases, it’s best to perform the rhinoplasty first. Surgery creates swelling and can temporarily change the skin’s thickness and circulation. If you do CO2 laser before rhinoplasty, much of the benefit of the laser may be lost once the skin stretches and remodels after surgery. Additionally, performing a laser treatment too soon before surgery can impair wound healing.
After rhinoplasty, I typically recommend waiting at least 3–6 months before undergoing CO2 laser resurfacing. This allows enough time for swelling to settle, the nasal skin to revascularize, and scars to mature so the laser can be used more effectively and safely. If you are planning to laser the nose itself, fractional CO2 would be safest. 
Of course, the exact timing depends on your goals, the extent of laser treatment planned (full-field vs. fractional CO2), and your individual healing response. When you are ready, make sure you are seeing a experienced plastic surgeon who is well versed in both procedures. hey can design a treatment plan that sequences the surgeries safely while maximizing your results.
I hope that answers your question. Best of luck! 
Justin Buro, M.D.

Rhinoplasty and co2 laser - which procedure should be performed first and how long should I wait in between?

Answers (6)

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