Can Laser Resurfacing and Wrinkle Fillers Be Combined?

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!

In a society of instant gratification, waiting for laser results can take several weeks, and the full results even a few months after.  Injectables such as fillers and Botox / Dysport are an excellent choice to couple after a laser skin resurfacing procedure, best about 2 weeks post laser,  to compliment an amazing result.

The laser will tighten your skin and collagen you already have during this healing but there are other places in your face where volume has been lost  and replenishing that volume with fillers or relaxing wrinkles from muscle contraction is a great choice for an optimal outcome.

The answer is YES! These are two of the best options to combat the signs of aging. You would want to start with a skin resurfacing laser treatment(s), such as the Affirm CO2 laser. This would help erase wrinkles, tighten the skin, even out your skin tone, and also stimulate collagen. After your laser treatment(s) we would then inject the filler of choice, which would give you immediate facial volume. There are several options for fillers these day, we have fillers that could last 6 months up to 2 years. Consult with your physician to see what the best is for you.

Most lasers do not go deep enough to cause a problem with HA's. In terms of timing, it really depends upon the laser procedure. If it is an ablative laser, I like to fill in the lines first and then "peel" the skin. Once swelling comes in afte a "peel" it can be difficult to see the areas that you want to fill.

With the increased popularity of both laser procedures and fillers such as Juvederm this question as to the suitability of combining the two often comes up. Also I receive questions about the use of fillers with other procedures such as light peels. Such procedures often compiment one another. We use laser and other light based therapies to tighten the skin, the most powerful being the CO2 or carbondioxide laser. Fine line control is complimented by the appropriate use of fills to contour folds and improve facial shape.

My own preference is to begin with laser therapies, and use the fill after to fine tune the overall result. HA fills work very nicely however we will also use structural fat grafts in their place if more volume is need, or greater longevity is desired.

HA fillers have become so broadly used we often find that candidates for laser, or facelift for that matter already have them and we find no problems or safety concerns with them, and they can be safely combined at the same time.

The key to success with fillers is precise placement for best aestheics and product longevity. I prefer to perform the procdure personally. My best advice is start with laser and use the HA after your skin has quieted down.

All the best to you.

We frequently combine Active and Deep FX, which is a CO2 laser, and is indeed attracted to water, with filler injections such as Restylane or Juvederm. We usually recommend to get the fillers two - three weeks after the laser resurfacing procedure, because some tightening with laser may affect the filler placement. However, we had some patients who had fillers already and then had the laser resurfacing, and it turned out great for all of them.

The Active FX beam does not go as deep as the filler placement, but Deep FX might go fairly deep. I would say, the main risk is losing filler faster with the laser treatment. However, since it is extremely difficult to quantify, and you get some tightening with the laser, it might not matter much in the long term. In any case, if we are extremely concerned about maximum longevity and preservation for the filler, we would do the laser treatment first, and fillers a couple of weeks later.

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.

True, certain lasers are attracted to water. However, the fillers are placed at a much deeper level than the laser penetrates and won't be affected. There are studies which support this. If given the option to do fillers or laser resurfacing first, I would do the laser first, wait for the healing process, than proceed with the dermal filler because the amount of filling might change after undergoing the laser resurfacing.

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.

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.