Laser Resurfacing Wrinkles - Around Eyes and Mouth

I am considering Laser Resurfacing for lines around my mouth and around my eyes. Would CO2 Laser resurfacing or the newer Total FX be more effective? I would like to know the pros and cons of each procedure.

Doctor Answers 18

Laser treatment for wrinkles around the eyes & mouth

Great question. As you know there are several lasers on the market that work well for skin resurfacing for periorbital and perioral wrinkles. The main difference is how effective the laser will be and the downtime it takes. As a general rule, the longer the downtime, the better the results. CO2 laser is more effective with a single treatment, has longer recovery time and has potentially higher risks.TotalFX laser resurfacing requires less downtime but usually requires multiple sessions to achieve the desired results. Both are effective options to treat the wrinkles around the mouth and eyes. You would need to discuss your goals and expected healing time with your physician. It is probably a good idea to seek consultation with a couple of doctors who use different lasers, since each physician will have a different preferential bias. All the best.

Combined non-ablative and Ablative Erbium Laser resurfacing

Older flat beam CO2 laser resurfacing removes lines and wrinkles but recovery is horrible and the skin is usually left white or hypopigmented.

Most experienced doctors today are using fractional laser resurfacing--the active FX and Deep FX are fractional CO2 lasers.

I have used most of the lasers that have been available in the last 15 years and continue to work hard to improve results, lessen downtime, and avoid complications.

Like Dr. DiBernardo I now use Fractional Erbium, because it is effective and pain and downtime are significantly less than with fractional CO2.

Recently we have achieved the best wrinkle removal and skin rejuvenation results that I have ever achieved by combining Non-ablative fractional 1540 Erbium resurfacing with ablative fractional 2940 erbium laser resurfacing done at the same session.

Recovery time is 5-7 days, only topical anesthesia is required and the results are excellent. 

Fractional Laser Resurfacing for Mouth and Eyes

TotalFX IS CO2 laser resurfacing delivered fractionally to facilitate shorter post treatment recovery, while maintaining the benefits of CO2 laser treatment.

TotalFX combines narrow column delivery of CO2 laser energy to the dermal layer (DeepFX) for long term collagen remodeling and more shallow, epidermal delivery for skin surface refinement. TotalFX can be used effectively in one treatment session to improve lines and wrinkles around the mouth and eyes.

Fractional CO2 for Wrinkles Around the Mouth and Eyes

Thank you for the great question. There are many brands and models of CO2 laser, and though there may be subtle differences in the delivery systems or power, the technology is very similar. Fractional CO2 is my go-to treatment for fine lines, wrinkles, and pigmentation issues around the moth and eyes. It can be used alone or in combination with other surgical on non-surgical rejuvenation procedures. Recovery is generally about a week, depending on how aggressive the treatment is. Pre- and post-laser care are generally easily managed. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 94 reviews

Laser resurfacing

There is really no debate over which laser is most effective in reducing wrinkles in appropriate patients, especially around the mouth and eyes - full CO2.

Any other laser is not as good, but many avoid the real CO2 laser because of the history of long healing and recovery that used to be the case.  Today, however, withe the use of the Oxy-mist treatment, effective, multi-pass CO2 laser resurfacing patients are healed within ONE WEEK, and have less subsequent redness which fades faster (within weeks instead of months).

Oxy-mist treatments use Amino-plex spray delivered with medical grade oxygen, and the results are WOW in many patients.  The dramatic improvement in skin tone, skin texture,  skin appearance, and wrinkles is long lasting.  I have many patients who are more than ten years after full CO2 laser resurfacing, and still look better and more youthful than they did before the procedure.

Laser resurfacing around the eyes and mouth

Periorbital and perioral Fractional CO2 laser resurfacing (around the eyes and mouth, respectively) can be quite satisfactory. There is really no need to consider the traditional CO2 laser resurfacing as the additional clinical benefit does not quite justify much prolonged recovery period, demarcation of treated areas and increased risks of infection and/or scarring. The make of a FDA-approved Fractional CO2 laser resurfacing does not make as much difference as the experience of the board-certified aesthetic physician as there are subtleties of depth of penetration and/or energy emitted of Micro Fractional CO2 laser resurfacing.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

Laser Resurfacing Wrinkles - Around Eyes and Mouth

There are multiple lasers that can treat this area effectively. Consult in person with three experienced and expert treating physicians to understand your options. Choose the one that can honestly and effectively meet your needs. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Best Laser for Fine Lines

There is no definitive answer to your question, because each patient's skin condition and needs are different. Total FX is a fractional CO2 laser that can be effective, but you will likely require multiple treatments. I use the Halo hybrid fractional laser, the first and only laser to combine 2 laser wavelengths in a single handpiece. That allows me to adjust the treatment's intensity based on the patient's cosmetic goals.

Otto Weiglein, FRCSC
Burlington Plastic Surgeon
5.0 out of 5 stars 4 reviews

CO2 laser can work well for lines around eyes and mouth

The areas around the mouth and eyes are excellent areas to treat with ablative laser resurfacing (of which the two main types are CO2 and Erbium). Total FX is a type of CO2 laser that can be used to great effect to reduce wrinkling around the mouth and eyes. I typically combine a variety of different lasers to achieve the best effects in these areas (both ablative and non-ablative as well as both CO2 and Erbium). In particular, the eye area tends to be very responsive to ablative laser resurfacing but the treatment settings and treatment technique of the laser surgeon are the most important factor in ensuring optimal results. You can see typical examples of CO2 laser resurfacing around the eyes and mouth on my profile pics. Hope that helps!

Douglas Wu, MD
San Diego Dermatologist
5.0 out of 5 stars 31 reviews

It depends on several factors..

This is a tough one to answer because we do not have the photos. CO2 fully ablative has advantages over Total FX in fractional mode- namely if performed correctly, only one treatment is needed. The disadvantage isthat downtime is longer, and risks are greater. 

TOTAL FX in deep fractional mode treats more deeply, with a higher safety margin, however you may need several treatments for optimal outcomes. 

How do I approach this common question of which is better?  I conduct a fusion of Ebrium laser to reduce the depth of wrinkles, THEN perform CO2 Fractional straight after to achieve collagen contraction and stimulation - all in the one treatment. 

See my before and afters in my gallery for a full explanation. 


Dr Davin Lim 
Laser Specialist, Brisbane 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 56 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.