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

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.

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.  

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. 

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.  

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.  

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).

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.
 

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

 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

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