50, fit female, aging arms & considering laser resurfacing, would this help with sagging skin? (Photo)

Question

I"m a 50 year old fit woman who eats very healthfully. I take collagen, drink plenty of water, lift weights, am on HRT, etc. I'm not happy with the elasticity of the skin on my body. My arms are aging the fastest bc I used to marathon train in the summer and they have just had a ton of sun exposure over the years. I've had radiesse in my arms as well as Morpheus 8 treatment. What is stronger? I'm considering Laser Resurfacing, would this help with sagging skin? what kind? TY

Anna Chacon, MD, FAAD · Answer

It's great to hear that you are proactive about your health and fitness! Addressing skin elasticity and sagging, especially in areas like the arms, can be challenging but there are several treatment options that could help.

Understanding Laser Resurfacing
Laser resurfacing is a procedure that uses concentrated beams of light to remove damaged skin layers and stimulate the growth of new skin cells and collagen. It's primarily effective in improving skin texture, reducing fine lines, and treating pigmentation issues. However, its impact on significantly sagging skin might be limited, as it doesn't address deeper structural issues.

Types of Laser Resurfacing:
1. **Ablative Lasers:** These include CO2 (carbon dioxide) and Erbium lasers. They remove layers of skin and can be quite effective for deeper wrinkles and scars. CO2 lasers are more aggressive and have a longer recovery time, while Erbium lasers are less invasive but still effective.
2. **Non-Ablative Lasers:** These include Fraxel and Nd:YAG lasers. They work by heating up the underlying skin tissue without removing the top layer, which promotes collagen production with minimal downtime.

Considering Your Concerns:
Given your history of sun exposure and the treatments you've already undergone (Radiesse and Morpheus 8), laser resurfacing could potentially help improve the overall texture and appearance of your skin but might not fully address sagging.

Alternatives to Consider for Sagging Skin:
1. **Radiofrequency (RF) Treatments:** These treatments, like Thermage or RF microneedling (which includes Morpheus 8 that you've tried), can help tighten the skin by stimulating collagen production.
2. **Ultrasound Therapy:** Ultherapy uses focused ultrasound energy to heat deeper layers of the skin, which can stimulate collagen production and result in skin tightening.
3. **Injectables:** While Radiesse is a dermal filler that can help with volume loss, other options like Sculptra can stimulate collagen production over time.
4. **Surgical Options:** For significant sagging, a surgical procedure like a brachioplasty (arm lift) might be the most effective option. This would involve removing excess skin and tightening the remaining skin and tissues.

Recommendations:
1. **Consult a Dermatologist or Plastic Surgeon:** They can evaluate your skin and recommend the most appropriate treatment based on your specific needs and goals.
2. **Combination Therapy:** Sometimes, combining treatments can yield better results. For instance, you might benefit from a combination of laser resurfacing to improve skin texture and RF or ultrasound therapy to address sagging.
3. **Sun Protection:** Given your history of sun exposure, continue to be diligent about sun protection. Use broad-spectrum sunscreen daily and consider wearing protective clothing during outdoor activities.

Laser resurfacing can improve the texture and appearance of your skin, but it might not be the most effective treatment for significant sagging. A consultation with a qualified professional can help you determine the best approach, which might include combining different treatments for optimal results.

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

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