60, good skin & getting a facelift/neck lift with skin tightening resurfacing under eyes, which laser? (Photos)

Question

I am adding a picture and wondering about which laser I should use to tighten under my eyes (erbium or fractional CO2) or just Tca Peel. I have seen 3 doctors about performing a lower facelift and need to make a selection however each suggests a different skin treatment for under my eyes. one want s to just do a strong TCA peel and another wants to use an aggressive erbium laser. the last one wants to use his fractional CO2 laser. I am 60 and have "good skin" for my age but also want to make the most of the fact im being sedated. would love to know pros and cons and which would be best.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

John L. Burns Jr., MD · Answer

I think you'd have similar results with either of these options.  I'd opt for the surgeon you feel most comfortable with.  All things being equal the CO2 option might give the most tightening but the difference would be very subtle.

Nelson Lee Novick, MD · Answer

If you literally go in asking for something, like expensive, aggressive surgical face/necklifts or gizmo "bells and whistles" laser/RF treatments, you are very likely to get what you ask for. At least from the photos provided, you are normal weight, have a desirable oval face shape, have not much in the way of deep wrinkles, jowls or overall crinkly skin. An appropriate low viscosity, cohesive HA filler, properly injected would likely give you the improvement you seek in the under-eye areas.  A more robust HA filler can be used to augment chin projection in profile (which can also secondarily straighten and define the jawline), and which can be directly further contoured with an additional robust HA filler (which would secondarily improve the upper neck region). And finally, HA filler can be used to accent the vermilion border of the lips, as well as to diminish the incipient marionette folds visible in the profile photo . In experienced hands, all of the aforementioned can be performed in under about 3/4 of an hour, with little to no significant downtime and immediate, on-the-spot results. So, I repeat, think very carefully before approaching any venue with suggestions drawn from Drs. Google, instagram or TikTok bc you are likely to just get what you ask for. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Hooe this helps and best of luck.

60, good skin & getting a facelift/neck lift with skin tightening resurfacing under eyes, which laser? (Photos)

Answers (3)

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60, good skin & getting a facelift/neck lift with skin tightening resurfacing under eyes, which laser? (Photos)

Answers (3)

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.