Skin Tightening Laser Procedure in Mouth and Eye Areas?

I am considering some laser surgery in the face to tighten skin around the mouth and under the eyes; but I have received mixed information from 2 doctors. One says it does not work and another says it does. I had some allergy to Restylane before, so a filler is not an option. Is laser the answer before a surgery, which is too drastic right now?

Doctor Answers 13

Laser for skin tightening: does it work?

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The amount of actual skin tightening by the "best laser and the best laser surgeon" is NOT enough to replace the need for facelift to tighten and lift sagging jowls or to soften deep nasolabial and subcommissural folds, or the need for surgical lower eyelid blepharoplasty (especially if you need fat removal or repositioning, or lid tone and position improved). Let me repeat: No laser will replace plastic surgery for these areas!

However, if your overall skin tone is good in the eyelids and around your mouth, and you are bothered by crepe-like skin and fine lines around your eyes, and/or smoker's lines or lipstick "bleed" lines around your mouth, then laser resurfacing is absolutely appropriate for treating these conditions. In fact, I believe ablative combination CO2/Erbium-YAG laser resurfacing after proper skin preparation with hydroquinone therapy and Retin-A is the "gold standard" for treatment of the most severe cases of these lines. Peels of various types, and fractional lasers (the present"rage") also can make nice improvements with good technique and in proper hands, but can require multiple treatments that in my humble opinion cannot match a single laser resurfacing with this third-generation ablative laser.

The best way to summarize laser vs. facelift is to understand that laser works only on the surface (fine lines, wrinkles, and discolorations), and facelift tightens the deeper tissues and skin from the muscle layer to the fatty layer to the skin itself. Thus, do facial cosmetic surgery first, then undergo laser surgery (if needed) to deal with any fine surface irregularities or fine lines that remain after the swelling goes down. This two-step procedural approach gives the BEST overall results!

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Rejuvenation around eyes and mouth

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While traditional CO2 laser resurfacing remains the gold standard, not  too many people can afford the downtime that may be required. Combination of fractional co2 laser resurfacing, hyaluronic acid filler (Restylane or Juvederm), and Botox/Dysport can be fantastic for periorbital and perioral rejuvenation.

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

Perioral and Periorbital Laser

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Less invasive usage of the erbium laser or the profractional laser sometimes combined with fillers can provide significant improvement for the perioral and periorbital areas.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

CO2 laser for wrinkles around the eyes and the mouth

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The newer fractional CO2 lasers can offer a nice improvement in the appearance of the fine lines around your eyes and your mouth. Remember that skin resurfacing such as a fractional CO2 laser is not the same as surgery and often times they are not interchangeable. What this means is that they can treat two different things.  The laser is excellent for the very fine lines and wrinkles, where surgery such as a facelift treats the drooping jowels and the hanging neck.  Consult with a qualified physician with experience in all of these modes of treatment in order to get a better idea as to what is best for you. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 71 reviews

Fractional CO2 lasers are especially good for skin tightening

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We have good experience with the  fractional CO2 laser to tighten the skin. Botox is a good adjunct around the eyes to prevent new wrinkles.

Robert Kasten, MD
Mainz Dermatologic Surgeon

A photo will tell a thousand words, look at my before and afters for the answer....

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Laser surgery can help. I ONLY take certain patients namely-

1. You should have realistic expectations
2. You are in good health- namely your blood pressure is normal, and you eat healthy and stay relatively fit. This is important for your health but also healing. 
3. You are aware of sun protection and you are a non smoker. 

The downside of CO2 / Erbium laser is the cost and the downtime (9-12 days), the upside is the results. Review my before and after photos to gain an understanding of what can be
achieved. Always see a Board Certified Specialist for this procedure....

All the best for your quest, 

Dr Davin S. Lim
Laser and Cosmetic Dermatologist
BRISBANE, Australia. 

Laser Treatment of Mouth and Eye Wrinkles

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Lasers work best for the fine lines of the face.  The lines you mention around the mouth are dynamic rhytids, or wrinkles caused by movement.  Botox or Dysport is a great adjunct to lasers.   Lasers will smooth the skin, but if you don’t soften the muscle movements that initially caused the wrinkles then the wrinkles will return more quickly.  The under eye wrinkles can be due to a number of factors including muscle movement, skin laxity or volume loss.


Jill Hessler, MD
Palo Alto Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Laser Surgery

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Laser under the eye is a good option, and it will help with the fine wrinkles, and the lines around the mouth.  For sags and bags, you need surgery. Thank you for your question and good luck.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Skin tightening options around eyes & mouth

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You have a few options for improving the appearance around the mouth and eyes. Historically we used CO2 laser resurfacing/ablation which works quite well, though it had significant potential side effects including a long down time and potential for scarring and discolouration of the skin. In the last few years, laser resurfacing with fractionated lasers (e.g. Profractional) have gained popularity since they are much safer, with great results (although requiring more treatments than the original CO2 laser ablation), and less down time and discomfort. The addition of carefully placed botox and perhaps a different filler can also be useful adjuncts. 

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Some lasers can tighten skin

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In my experience, the CO2 laser is great for tightening skin around the eyes. I use the Deep FX fractionated laser and we see some tightening around the mouth but not as much.

The Baker-Gordon peel can do even better but that has a long healing time. I haven't seen any other device or peel that offers any real skin tightening that I can see. I hope this helps.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 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.