Laser Resurfacing Wrinkles - Around Eyes and 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.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

There are many different name brands of lasers available on the market today. I personally use Fractional CO2 laser skin resurfacing and Erbium:YAG laser skin resurfacing most commonly in my practice for wrinkles around the mouth. Another option is a deep chemical peel, which I also perform, but is used by far fewer doctors today.I pick the recommended treatment based on the patient, their available down time, skin type, and severity of wrinkles. I then discuss the expected postoperative result and course with each patient. Be sure to see an expert specializing in facial aesthetics.All the best,

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!

Lines
around the mouth are often deep and a difficult area to treat. Considerations
for treatment around the mouth include:



The
skin around the mouth is relatively thick and requires different laser settings
to be effective. 

Laser
resurfacing of this area may need to be coupled with additional treatment such
as volume enhancement around the lips. Volume enhancement around the lips can
be non-surgical with a hyaluronic acid filler or surgical with fat transfer.

Lines
around the mouth are generally more challenging to treat that lines elsewhere
on the face and a discussion of realistic expectations from the treatment.

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.

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. 

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.

This patient recognizes that there are several lasers that can help fine lines around the mouth and eyes.  These areas are very different in need and thickness and will require different laser techniques.  Since most lasers are versatile and very adjustable the laser treatment can and should varied between the two areas. There would be much (legitimate) debate as to which laser is best and the outcome would probably depend more on the skill and experience than the laser used.Although there are many treatments for fine lines and
wrinkles few can compare with the laser. Peels, dermabrasion as well as
fillers have been for this. The laser because of its versatility can
treat both deep and shallow levels of skin, meaning collagen as well as pigment
and lesions.

It should be noted though that the laser is simply another instrument in the
armamentarium of the practitioner and thus its benefit is only as good as the
person doing the treatment. Lasers work by generating heat when the beam
strikes the skin. The heat will cause a wide range of responses depending
on a number of factors including the energy level, the wave length of the
laser, the duration and concentration of the laser beam. All of these
except the wave length of the laser can be adjusted. Responses vary from
redness and swelling to micro ablations of tissue with most showing some
coagulation of the protein (collagen and elastin of the skin). Collagen
is shortened when heated as in a coiled bed spring. Furthermore over
ensuing months new collagen may be produced to replace the lost
and damaged collagen of the aging skin. There is a limit as to how
deep and aggressive a treatment the skin will tolerate, which is a very good
reason to choose your laser surgeon carefully.

I use both an Erbium laser and a Microfractional Carbon Dioxide to get the Best results. The erbium laser gently planes down the ridges or hills on each side of the "valley" and the Microfraction co2 laser provides the tightening and removes pigment. This  "Microfractional Plus"  treatment can reduce lines up to 90%.