Fillers before or after fractional laser?

Question

I have an appointment for fillers a few days after my SkinLaundry laser appointment. The lasers used are Yag and fractional. I am reading that fillers should be done two weeks prior or after, but I don’t have that kind of room in my schedule. Should I cancel my lasers?

Shanthala Shivananjappa, MD · Answer

This is an excellent and thoughtful question—thank you for asking! It’s a critical topic because combining laser treatments and dermal fillers requires careful consideration to achieve optimal results while minimizing risks.

Here’s an important framework to guide you:
	1.	Understanding Laser and Skin Healing Risks:
Fractional lasers, like those used for resurfacing, temporarily disrupt the skin’s protective barrier. During the post-laser healing phase, the skin may be more susceptible to swelling, sensitivity, and even infection. Introducing fillers too soon after a laser treatment may increase the risk of complications.
	2.	The Role of Timing for Fillers:
Ideally, dermal fillers should be placed at least two to four weeks prior to a laser procedure. This allows the fillers to fully settle and ensures the laser treatment doesn’t interfere with the filler placement. Conversely, if fillers are planned after the laser, it’s crucial to ensure the skin has fully healed, which depends on the type of laser used, its intensity, and your individual healing process. Performing fillers on skin that is still swollen or peeling from a laser treatment is not advisable.
	3.	Combining Treatments Safely:
In my practice, I frequently combine Non ablative & ablative lasers  such as  UltraClear Laser-Coring with dermal fillers & Biostimulators on the same day, using precise protocols that ensure safety and optimal outcomes. However, this requires advanced expertise and a deep understanding of laser technology, facial anatomy, and the healing process. When done correctly, this approach can deliver seamless and transformative results.
Since you’re planning to see different providers for your laser and filler treatments, it’s especially important to consult both professionals beforehand. Discuss:
	•	The type of fractional laser being used and its post-treatment care recommendations.
	•	The specific timing of your filler appointment and its potential interaction with the laser’s healing phase.
	•	How each provider plans to manage any complications should they arise.

Ultimately, coordination and communication between your providers are key to ensuring a safe and successful treatment plan. While time constraints can be challenging, prioritizing proper planning will allow you to enjoy the best possible outcomes from both treatments.

Thank you for asking such an insightful question! Wishing you all the best on your journey to radiant, rejuvenated skin.

Warm regards,
Dr. Shanthala

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Raffi Der Sarkissian, MD, FACS · Answer

The general recommendations is lasers first followed by fillers. The reason is two fold. First, if lasers effectively minimize lines and wrinkles, you may require less fillers. Secondly, many if the fillers generate thermal energy which could theoretically break down some of the filler material and lead to premature need for additional filler. Hope this helps.

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