Almost no improvement in fine lines after laser resurfacing after 4.5 months

Question

I had fractionated ablative erbium combined with non ablative erbium 4.5 months ago for sun damage, sagging skin and fine lines. After four months the improvement is almost non existent. I'm 33 yo and I was told the settings were very high. Healing process was corresponding with high settings too. I don't believe it will improve from now on. All fine lines in the mouth and eye area are still there. I thought that fine lines would be erased since they're not deep. Any explanation? Thank you.

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

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Jeffrey Ridha, MD · Answer

At 4.5 months,  you should be close to your final result. With a combination treatment, there should be significant improvement in lines and wrinkles. I would recommend returning to see your board-certified plastic surgeon or dermatologist to assess your results, and determine whether a repeat treatment, or additional modality is necessary.  Best wishes.

Philip K. Robb Jr., MD, FACS · Answer

I'm sorry that you're not happy with your results. Often times these fractionated/combined therapies take multiple rounds of treatment to see significant benefits.

In my practice, I use ablative lasers more because the results are more substantial. The recovery can be more protracted but none can argue with the results.

I would recommend returning to the plastic surgeon who performed these to make sure everything was performed as discussed. Communication is key and you have to be realistic with the expectations of the treatment.

Hope this helps and God Bless!

Dr. Robb

Diane I. Duncan, MD, FACS · Answer

In order to achieve full correction of fine lines and wrinkles, in my experience, full ablative erbium laser is needed. While the temporary deformity can be more severe with fractional laser the healing time is similar. if you are looking for a really dramatic change, and have skin type 1-3, I'd recommend you take a deep breath and consider ablative rather than fractional erbium resurfacing.
Full ablative erbium differs from fractional in that the entire surface of the skin is treated as opposed to a small fraction of the surface area. While the power you were treated with may have been high, if the percentage of surface area treated was low, it is unlikely that you will see much difference.

Almost no improvement in fine lines after laser resurfacing after 4.5 months

Answers (8)

Answer: Fractionated laser

Answer: Fractionated laser

Answer: Full ablative erbium needed

Answer: Full ablative erbium needed

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Everything you need to know about Laser Resurfacing

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Almost no improvement in fine lines after laser resurfacing after 4.5 months

Answers (8)

Answer: Fractionated laser

Answer: Fractionated laser

Answer: Full ablative erbium needed

Answer: Full ablative erbium needed

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Recommended reading

Everything you need to know about Laser Resurfacing

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