What Laser Resurfacing Would Be Best for my Face?

I am a very light skinned, 46 year old caucasian female. I am wanting to get laser resurfacing done on my face to take care of wrinkles around my eyes, smile lines around my mouth and deeper lines on my forehead. I would also like to get some benefits of skin tightening around my jowls and on my eyelids. I have found a derm that uses Active FX/Deep FX for $3K, a derm that uses an Erbium laser for $1800, and a plastic surgeon that uses Erbium/fractioned CO2 combination for $3K. What is best?

Doctor Answers 13

Combined Fractional Erbium Laser Resurfacing Is Best Technique for Face

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Thank you for your question.

The new, most modern effective Laser Resurfacing technique for the face is called Combined Laser Resurfacing.

This technique combines the benefits of Erbium short down time with collagen building benefits of the  CO2 Resurfacing.

For details on why this technique is superior read the link below.

There is no best laser for laser resurfacing

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As I have said many times on this forum, it is not the modality of the treatment which is important in giving patients the results that they seek.  It is the experience and the expertise of the treating physician with that particular modality that matters most of all.  IMHO, chemical peels often provide the same results as the laser, usually at less cost.  My advice is find someone experienced in the art of chemical peeling.  If you simply must have a laser, choose a doctor who has had extensive expereience with the laser he is suggesting.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Micro Fractional CO2 Laser most ideal for laser resurfacing for face

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Laser resurfacing of face is one of the best aesthetic and medical procedure for the face. Micro Fractional CO2 laser resurfacing offers the best balance of efficacy and manageable recovery period (i.e., typically one week). Traditional CO2 laser resurfacing may be more effective; however, the downtime associated with the procedure is not acceptable for most working procedures where as erbium laser may not show significant clinical benefit. You should look for an experienced board-certified aesthetic physician who not only talks about the positive but also is willing to review what can go wrong and actively steps to be taken to minimize complications.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

Laser Resurfacing Is Great for Sun Aging Lines and Wrinkles, But Still Think Fillers for Those Lip Lines

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Laser resurfacing is not just about smoothing our lines and wrinkles, but is all about skin surface collagen tightening.  There are no other facial treatments that show as much gain for you skin, pores, texture, acne scarring, and lines as does resurfacing,  But, what does laser resurfacing mean and which laser or surgeon to choose.  We offer our patients choices of either Fraxel Dual, for pigmentation and texture, or DOT SmartXide, our carbon dioxide laser  for lines wrinkles and acne scarring,  these are great choices, but remember laser resurfacing although a great pathway to improving you skin is stiil an art form, and the skill of your physician, is an all important choice.  

You mentioned deeper smile lines, and those jowels. well laser resurfacing although a great answer, is not the answer for everything, think of for those cheeks and jowels, Ultherapy for non-invasive lifting without any down time, going right back to work,  and fillers such as Juvederm for those deep lip or smile lines as well, and plan for your laser resurfacing when you have the time for the seven to ten day recovery

Douglas J. Key, MD
Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Laser Resurfacing procedures and which to choose?

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With the multiple list of items you would like resolved I would suggest a fractional CO2 laser as this will allow the removal of the lines and wrinkles while providing some tightening of the skin. You would also probably benefit from Botox Injections to relax the muscles that are causing some of the wrinkles in the areas of concern. If you would like to send me a photograph at the link below I would be happy to give a further evaluation. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Best Laser for Wrinkles and Fine Lines

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There are two points to consider regarding Laser Resurfacing:


1. The quality of the laser

2. The quality/experience of the doctor

I would consider a fractional CO2 laser for your skin type, to get the best possible result with least amount of downtime. The Ultrapulse laser (Active/Deep/Total fX) is highly regarded and what we use in our practice. The best laser however is useless unless you have an experienced practitioner choosing the parameters for you.

Finally- laser resurfacing works best on thinner patients without heavy, loose skin.  You will not get a facelift from a laser, but should still get  a great result in the right hands. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon

Laser resurfacing for wrinkles and skin tightening

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For the facial rejuvenation you seek, there is certainly no perfect laser to do everything. However, I can add some support for the Active FX treatment, which will certainly address many of the problems that you want addressed. I would seek appointments with multiple physicians who use different laser modalities; this will help you to make the best, most informed decision. Good luck.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

YAG, Erbium Skin Resurfacing, Sun Damage, Skin Tone, Laser

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The Erbium-YAG laser is designed to remove or decrease wrinkles and improve the overall skin texture of the face, neck and hands. Sun exposure, age and personal habits combine to give the skin a wrinkled, freckled or dried out appearance. Laser skin resurfacing with the Erbium laser is done under local anesthesia in the office setting with minimal discomfort compared to older Carbon dioxide laser systems, which require extensive anesthesia and a longer healing time.

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 177 reviews

Your best results will come from choosing the best doctor, rather than the right machine or price.

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As a plastic surgeon with several lasers and a busy non-surgical practice I encourage you to seek in-person consultations with several experienced, board-certified dermatologists and plastic surgeons.  Evaluate their references and photos, and allow them to evaluate the various facial issues that concern you. 

I agree that someone with your concerns may benefit from more than a single laser treatment; perhaps including neurotoxins (Dysport or Botox), HA fillers (Perlane or Juvederm).

The device itself is not the most important factor.  To put it humorously, you need to consider more carefully the witch or the warlock, than which brand of wand they use.  Best wishes.

Sutton Graham II, MD
Greenville Plastic Surgeon

Laser resurfacing for facial wrinkles

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Before you decide on which laser to have treat your skin, you must be clear on what improvement you are hoping to achieve. I doubt you will see any long term improvement of your forehead wrinkles or smile lines. These are related to your muscular motion and the smoother skin after laser will still "accordion" when the underlying muscle moves. Eyelid wrinkles are similar and best treated by botox, although the result only lasts for four months to five months. Jowls may tighten a little, but not the same improvement as a face lift, from Deep FX, Fraxel Repair, or Thermage.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 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.