Can Laser Resurfacing and Wrinkle Fillers Be Combined?

Question

I am confused about Hyaluronic acid fillers such as Restylane, and laser resurfacing. Are they safe together? I thought Hyaluronic acid and laser are attracted to water, so wouldn't the laser cause more intense treatment in the areas where there are fillers?

Otto Joseph Placik, MD · Answer

Generally fillers are injected beneath the level at which lasers act.
You are correct that some lasers target water but not all. For example KTP lasers are targeted more for blood vessels. Other lasers are targeted for pigment in the skin (many of the hair or tattoo removal lasers).
So it really depends on which laser you are using.
Consult with your treating physcian and ask what the chromophore (target) is.
Even if the target is water there are no strict recommendations of which I am aware regarding hyaluronic fillers.
You may want to exercise caution in areas where the skin is thin and the restylane may be superficial (tear trough).
Please discuss with the individual performing the laser treatment.

Raffy Karamanoukian, MD, FACS · Answer

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Sonia Badreshia-Bansal, MD · Answer

We find them synergistic and like to laser first, get the collagen stimulated, and use fillers as a finishing element, similar to frosting on a cake and just refining the finished product.

Michael R. Macdonald, MD · Answer

The beauty of advanced aesthetic treatments today is that most can be combined if appropriate and desirable. While laser resurfacing and wrinkle fillers can be safely combined, I would generally not do these two procedures together. You might consider the laser resurfacing treatment first, and reserve any wrinkle filler treatments to address any residual problems that were not completed solved with the laser treatment.

Harold J. Kaplan, MD · Answer

Hi awalk.  The answer to your question is yes.  For the laser resurfacing we perform, it does not penetrate the skin to the same depth as the dermal fillers are placed.  

	Hypothetically, it is possible that the resurfacing (specifically deep fractional) could penetrate to the same depth.  In this case, your practitioner should ask you to hold off on the injection treatments until after the deep resurfacing takes place.

Ron Shelton, MD · Answer

Some medical professionals have studied this question, and there has been no information to conclude that there is a problem with lasers and hyaluronic acid fillers.

Diane I. Duncan, MD, FACS · Answer

Most people don't combine them because if the laser goes deep enough it will ablate your filler (if the filler is injected very superficially the laser will destroy the filler).
I would recommend doing the laser first as this is more cost effective and long lasting, wait for recovery, and consider fillers as maintenance.

Diane Walder, MD · Answer

This is a great question! In fact, we normally recommend to put the fillers in first and then wait a few weeks to do the laser resurfacing treatments. The fillers such as Restylane and Juvederm smooth out the fine lines which make the laser treatments more effective so that all of the skin is treated. Hyaluronic acid fillers do attract water and re-volumize the skin. They provide instant gratification and the laser resurfacing will help your body re-build it's own natural collagen and elastin over time. The combination produces wonderful results!

Michael Tomcik, MD · Answer

Yes Laser resurfacing, fillers such as Restylane, Radiesse, Juvederm, and Botox can be used together, just not at the same time. We will use Botox/Dysport as well as fillers 2 weeks before Microfractional CO2 laser resurfacing. Botox prevents the patient from bending the new collagen they are producing from the laser. We do "volume replacement" in the cheeks and temple areas because laser resurfacing won"t produce enough collagen or restylane to fill these areas. However we do not put fillers in the Nasolabial folds( The groove between the nose and the lips) or the lines between the lips and the chin at this time, because Microfractional laser resurfacing will lift the sagging cheeks and therfore the patient ma not need this additional filler.

Jason Lichtenberger, MD · Answer

Overall facial rejuvenation is often best achieved with a combination of Fillers, Laser resurfacing,and Botox.  For example, I often combine Botulinum toxin treatment for prominent forehead lines, fillers for volume restoration in the midface and smile lines, and Matrix fractional CO2 laser treatments for lines around the mouth and eyes.

	Fillers can be used in conjunction with laser resurfacing, often on the same day.  Occasionally it is best to wait until after recovery from the laser, however, to achieve ideal, long-lasting results.

Can Laser Resurfacing and Wrinkle Fillers Be Combined?

Answers (18)

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