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!

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.

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.

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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
5.0 out of 5 stars 68 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

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.


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.

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 63 reviews

Skin Tightening Options

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Lasers and Chemical Peels can help with tightening the facial skin. Either will work. If you want to do it with no downtime then use non ablative lasers like thermage. If you can afford the one week of downtime then  a chemical peel or Erbium laser will work well.


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.