Thank you for your question. You’re asking if Fotona laser treatment can lift and tighten the skin. I can certainly give you some guidance about this, without the benefit of a photo reference, and without a physical exam. I’m a Board Certified Cosmetic Surgeon and Fellowship-trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. I do own several lasers, including ones from Fotona, for treatment of skin tightening, skin resurfacing, hair removal, skin issues like age spots, dark circles, mole removal, and rosacea, and to assist in surgery. First of all, Fotona is not a particular laser in terms of different wavelengths. One Fotona laser we have can be used as Nd:YAG laser, and an Erbium laser, which can be used for skin tightening, wrinkle treatment, and skin resurfacing. A different laser from Fotona we have is a Q Switch laser, which is used for milder skin toning, and often used for pigment issues like age spots, and tattoo removal. Lasers are used for skin tightening to induce skin contraction, as well as induce a collagen response. This process works by using heat to make the skin tighten. Applying the right about of heat for a certain period of time makes the body react like it’s an injury, so it produces collagen for the area. Collagen is the protein in the skin that makes it strong, soft, and supple. Fractional lasers are usually used, where the beam is not constant, but pulses to reduce exposure and limit direct heat on the skin. The length of exposure, as well as temperature are crucial in getting the collagen response safely. With skin resurfacing, a fully ablative setting is used, where the beam is constant. A fully ablative laser removes the top layer of skin, so a fresh layer of skin grows in its place. Fully ablative settings or lasers are not used as often because they leave the skin raw temporarily, so they require a good amount of downtime. While skin tightening, toning, and resurfacing do have a lifting due to the collagen response, the body’s ability to generate collagen at a given time is limited, and the ability for a laser to lift safely is also limited. Generally, a laser cannot replace surgical lifting. Problems occur when a person wants the effects of a surgical lift without surgery, but using a laser, which increases amount of heat, and prolongs exposure. Fat beneath the skin that provides a youthful softness to the skin can get cooked, and shrink, so facial volume can be decreased, and the opposite effect happens making the person look older. A young face is not tight, but rather soft with ample facial volume. Surgical lifting is not just about lifting the skin, but about tightening the underlying muscle layer that makes surgical lifts last, and trimming stretched or excess skin, which lasers cannot do. Lasers are great at skin resurfacing and generating collagen to improve the quality and texture of the skin. However, they can be overused, and the effects of diminished fat and damaged skin from overexposure are challenging and costly to rehabilitate. Generally, lasers can be used for skin quality issues like wrinkles, age spots, and improving skin tone, but are not advised for lifting sagging skin and tissue as complications from overexposure can occur. This is especially important as many practitioners offering non-surgical laser lifting procedures are not even doctors, and even some doctors offering non-surgical lifting are not surgeons experienced or knowledgeable with deeper facial anatomy. I hope you found this information helpful. Thank you for your question.