Could Deka CO2 help tighten my nasiolabial folds? (Photo)

Question

Could Deka CO2 help tighten my nasiolabial folds? I don’t really have textural concerns. Are there other benefits I could see from Deka CO2?

Nelson Lee Novick, MD · Answer

Before jumping into expensive gizmo treatments, you might wish to consider a rather simple, immediate and relatively inexpensive solution that also engenders little to no significant post-treatment downtime: the use of robust HA lifting filler for cheek augmentation. Why? Because the cheeks provides a major support and lift to the lower cheeks and when there is volume deficit, as appears to be the case here, in the cheeks, the cheeks become more flattened and the smile lines appear. Accordingly, the use of an appropriately robust HA lifting filler can both create a more feminine Ogee Curve and heart-shaped face at the same time secondarily smoothing the smile lines. Hope this helps and saves you money, time and disappointment going forward. Best of luck.

Carl Truesdale, MD · Answer

This is one of the most common misunderstandings about CO2 laser. Deka CO2 (and any ablative CO2) is excellent for what it actually does &mdash; resurfacing skin, smoothing fine wrinkles, improving tone and texture. But the nasolabial fold isn't primarily a skin problem. It's a soft tissue and structural issue.
What creates the fold:
The malar fat pad descends over the cheek with age, piling up just above the fold.
The deep medial cheek loses volume, creating an apparent depression.
Skin laxity adds to the depth but isn't the primary driver.
What CO2 does well in this area:
Improves fine wrinkling and crepiness on the fold itself.
Tightens skin modestly (5 to 10 percent reduction in laxity for ablative CO2).
Better tone, pigmentation, and quality.
What CO2 doesn't do:
Lift the descended cheek pad back up.
Restore the volume that's been lost.
Significantly reduce the depth of the fold.
For meaningful fold improvement, the toolkit is different:
Filler in the deep medial cheek or directly in the fold (HA, lasts 9 to 18 months).
Deep plane facelift if you have moderate-to-significant facial descent (most durable answer).
Fat grafting to cheek + fold for longer-lasting volume restoration.
CO2 makes sense as an adjunct to any of these &mdash; done at the same time as a facelift, it adds skin quality on top of the structural lift. As a standalone, it disappoints patients hoping for fold reduction.
Honest read: if your goal is genuinely softening the nasolabial fold, get a consultation that discusses volume and lifting first. CO2 can be the second layer once the structural plan is set.

Could Deka CO2 help tighten my nasiolabial folds? (Photo)

Answers (2)

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