Does laser resurfacing hurt? Are you under anesthesia? Which is best for tightening?

In my opinion, the co2 laser is good for removing wrinkles. People who have wrinkles from a significant amount of sun damage do very well with the co2 laser. The Laser is painful as it ablates the skin. That means it vaporizes the tissue. Some physicians perform this procedure with intravenous sedation. Others use nerve blocks and oral and intramuscular sedation. I believe that there are other devices that work as well or better for skin tightening. These are radio frequency devices. Some are bipolar and some are mono polar. Lately we have had good results with microneedle radio frequency of the skin (infini) for tightening.Tightening of the midface is difficult with any device. Fillers are often used in this location. I hope this helps. Good luck.

Ice pick scars DO NOT improve with laser resurfacing, they require lasers with TCA cross or surgery to improve them.  Yes resurfacing hurts but can be painless (see my videos) with the proper numbing, oral medications, cool air/ice packs, and nerve blocks.  Best, Dr. Emer.

Over the years, the experience gained with laser resurfacing has provided me with a comfortable technique.  Certainly under general anesthesia there would be no discomfort during the procedure, however I prefer a local anesthesia technique which when done expertly provides a comfortable patient experience.  Mild oral sedatives combined with local tumescent anesthesia and field block can do the trick.  The experience of the laser surgeon is important.Fractionated CO2 laser is excellent for acne scars, but expectations need to be tapered.  Some over 45 years of aged patients can also benefit from facelift in addition to the laser to further smooth out the deformities.