Would Like to Know if Erbium Yag Laser Resurfacing Can Result in Loss of Facial Volume?

I have been recommended a series, six weeks apart, as I am in my sixties. A friend of mine had a single, very effective laser treatment, and although she is wrinkle free, she appears to have lost facial volume. That would be a very bad trade for me. Is this a common side effect?

Doctor Answers 10

Volume Loss After Laser Resurfacing?

As a laser expert, facial volume loss should not be caused by laser resurfacing. In fact, almost all lasers actually build up collagen and restore the skin’s natural thickness. We all naturally lose facial volume as part of the aging process, and the smoothing effect of the laser treatment your friend had may make her volume loss more apparent. We often incorporate fillers or biostimulating treatments like Sculptra™ with laser resurfacing to achieve more dramatic results.

San Diego Dermatologic Surgeon
4.9 out of 5 stars 25 reviews

Erbium Laser and loss of facial volume

LASER resurfacing procedures such as Erbium LASER should not result in facial volume loss.  The LASER is designed to actually gradually build collagen over time and smooth the skin.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 163 reviews

Laser resurfacing not a facial volume reducer

The reason your friend may appear to have lost some facial volume would be due to some tightening.  Loose tissue will look like fat.  With resurfacing, the laser energy only interacts with the surface, less than a millimeter of depth at a time.  In order for the laser, either CO2 or Erbium, to get into the fat layer below the dermis, several passes would have to be made with COMPLETE skin removal in that area.  That is not resurfacing!  There is a laser that might be able to effect the fat below, but that one is NOT used for resurfacing because of how deep it can penetrate (Neodymium:YAG).

Myles Goldflies, MD
Seattle Plastic Surgeon
4.3 out of 5 stars 11 reviews

Erbium laser resurfacing leading to facial volume loss

This is not really common with this type of laser. Other lasers that act deeply like 1200 and above wavelengths would do this more so than a surface laser like erbium yag lasers. co 2 lasers are like erbium lasers.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Facial volume changes after laser resurfacing

Treatments with an Erbium laser or any other laser used for facial resurfacing should not result in facial volume loss.  These treatments should actually stimulate collagen synthesis and add to facial volume and the youthful appearance which facial volume provides.

Best Regards,

Jacque P. LeBeau, MD

Jacque P. LeBeau, MD
Pensacola Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Lasers and loss of facial volume

Hi Kathi, The erbium yag Laser only penetrates into the skin where it is absorbed by the water in the tissue there so it just doesn't penetrate into the deeper tissue to cause any changes in the fatty subcutaneous layer. After Laser, the surface is smoother and irregularities and facial characteristics appear more noticable , much like seeing a scratch in a newly polished piece of furniture that wasn't seen when the surface was dull. People often fail to see the amazing transformation from cosmetic surgery only to notice the minutia after their procedures. I think that they look closer at themselves and they see more. It is like when you but a new car and now see them everywhere on the and are surprised there is so many. Maybe there has been other factors that have contributed to the volume loss, if in fact, it exists. 

David R. Stephens, MD
Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

Facial Volume Loss

 As we age there is usually a natural loss in facial volume or fat. This why the current state of the Art Facial Rejuvenation procedures involve Filling the Face usually with Fat Grafting. If you are concerned about possible facial volume loss over time you might want to consider fat grafting to the face at the time of your laser resurfacing. Best,

Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 9 reviews

Laser resurfacing and loss of facial volume

Laser resurfacing should not cause loss of facial volume.  Is it possible your friend happened to lose some weight after her procedure?  Weight loss can cause some loss of facial volume.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Laser resurfacing and facial volume loss

Laser resurfacing should have no effect on facial volume.  You may just be noticing it more.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Can Laser Resurfacing Reduce Facial Volume?

Hi Kathi.  Reduction of facial volume would be the opposite effect of what would normally happen with laser resurfacing.  The body generates new collagen in response to the injury that is induced when laser resurfacing is performed.  Your friend should not see a reduction, but an increase in tissue volume and you should as well.

You may also want to consider Sculptra injections or other dermal fillers for facial volume loss.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 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.