How long after childbirth should I wait before doing CO2 laser treatment and fillers?

Thank you for your question. You’re asking essentially how long after giving birth and breastfeeding is it appropriate to do CO2 laser and fillers. You ask further about how pregnancy affects the skin, and what kind of impact there could be if you undergo a laser procedure and injectable filler.
I can share with you how I guide my patients who frequently ask the same questions in our practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Rejuvenating the skin and face are very big parts of what I do every day in our practice. All the tools of the trade such as lasers, injectable fillers, and neurotoxins are part of how I help my patients look their best every day.
To simplify the effects of pregnancy on the relative risk of CO2 laser, I would start by asking what you want to do that requires CO2 lasers. Generally we use the CO2 laser, or the Erbium laser for wrinkling and discolorations, with the secondary benefit of collagen induction.
So what are the potential risks related to pregnancy? One has to do with pigmentation. There’s a condition called melasma associated with pregnancy, often referred to as the mask of pregnancy with the effects of estrogen and hormonal changes on the skin. Pigmentation is a variable that’s important to consider before undergoing a procedure such as CO2 laser. Often for things we would maybe consider a CO2 laser for particular discolorations related to conditions like sun exposure or sun damage, we can use alternatives that are non-ablative such as the Q-Switch laser to try to minimize the effect of thermal energy on the skin.
The basic rule of thumb is to allow some time to transpire with laser treatment. I would say 6 months to go by to get a sense of what the skin looks like, and its stability before doing a laser type of procedure.
Injectable fillers that add volume such as anything in the hyaluronic acid family is pretty much safe to do at any time. Dealing with the changes of hormonal levels after delivering are still going to have an effect on facial volume. Unless someone has a very thin face or a particular area of concern, we can either choose to wait for filler treatment, or conservatively add volume as is appropriate.
Other options such as the use of a neurotoxin like Botox®, Dysport, Xeomin for this particular area is probably safe at any time. There’s no data on the relative risk for breastfeeding women, but since it’s a localized treatment, it is very unlikely there will be much in the serum that would be passed onto the baby. If you are used to getting Botox® with some consistently, or you like the effects of getting a Botox® brow lift, or Botox® lip lift or other Botox® treatments, you can consider getting that done a little sooner.
I think the doctor you work with in terms of injectables and lasers should have a sense of your history. Often with our patients we won’t see them for awhile, then they’ll tell me they just had a baby, but I have their photos before and I do comparisons. I look at any changes, and try to counsel them accordingly. Generally, allowing about 6 months to transpire is a pretty safe zone, after which you’re pretty close to your pre-pregnancy baseline, depending on weight gain and other variables that come with this type of life event.
The take home message of course is have a doctor who will watch you, and have a sense of what is appropriate. Ask yourself what specifically you want to achieve with the CO2 laser. If someone wants to have just a little fractional CO2 laser under their eyes to refresh any wrinkled skin, that should be pretty straightforward, and it’s not likely to get significantly hyperpigmented depending on your skin type. It goes back to specific strategies, outcome, and understanding what variables have an impact during this period of time. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Dear Sarak050,Thank you for your question. The hormones associated with pregnancy and breast feeding can impact the skin. Specifically, it can lead to issues with pigmentation. I would wait 3 to 6 months before proceeding with laser treatment. Regarding filler, we could probably do that at anytime.Please let us know if you have any other questions or concerns. Good luck!Sincerely,Dr. P Daniel Ward

I don't know of any specific timing, however, childbirth is a serious process that your body has gone through. I would rest up for a good 4-6 weeks and once your OB/GYN has cleared you for further procedures, then you should be all set. The healing from a CO2 laser can take up to a week, so be prepared for that and there is no healing from fillers. You will not be able to use any kind of botox/toxins if you are breast feeding so that is one contraindication for that procedure.