What treatment is best for perioral "smokers lines" and acne scars around mouth? FX Fraxel/lower face lift? Best for me? (Photo)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue.The result is clearly visible lines, folds and wrinkles. Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. The most common side effects of Fraxel laser treatment are swelling and skin redness, which should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited.

I suggest speaking to a dermatologist who specializes in scarring and lasers.  You need a combination approach to get the best results for these conditions.  Best, Dr. Emer.

Typically these lines are some of the most difficult to treat.  I can't tell from the photos if you need a lower face lift.  An in office consultation is the only way to assess this situation.  However, a combination of fillers, Fraxel, and topical skin care are generally needed in these areas.  Please consult a board certified dermatologist for the best cosmetic results. 

For smoker's lines I recommend a combination approach.  Most patients need all 3 of the following, while others may need only 1-2 for optimal results.Neuromodulator (Botox, Dysport) to relax the muscles that purse the lips - done before laser to help prevent re-etching of lines in newly resurfaced skin.Laser resurfacting (Full-field Erbium or fractionated CO2)Filler (e.g. Restylane Silk, Belotero)For acne scarring it is important to consider the type of scars - rolling, boxcar, pitted.  A combination approach is often indicated and may include:Subcision to release fibrous bands that tether the scarsLaser or radiofrequency device (e.g. fractionated CO2, Infini RF, non-ablative fractionated 1540)Filler (e.g. Restylane)You will need to consult with your physician to see what your unique needs may be.  Best of luck!