What is the best way to deal with these perioral lines? Would Fractional laser work better than Contour TRL? (photo)

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

While it is difficult to make a recommendation from photos alone, I would say a series of fractional laser treatments might give you a comparable result depending on the device used and the skill and experience of your provider. I would seek a consultation with a board-certified dermatologist and laser expert who offer an extended range of laser procedures. The wider selection allows your provider to customize your treatment with the precision necessary to ensure an optimal outcome. You can also consider combining your laser treatments with other procedures like injectables or RF microneedling to enhance your results further.

Deep resurfacing might be a good option for you, but a series of fractional treatments might also produce a positive result. As long as you are working with a doctor who is both board certified and experienced in treating perioral lines, you should have confidence in knowing the treatment chosen for you will meet your needs and goals best. 

Fraxel or Co2 are best for resurfacing. I always combine lasers with microneedling/prp, Sculptra, peels and rf treatments for more robust outcomes for facial rejuvenation. We space treatments every 4-6 weeks, but will depend on healing. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

You have pretty deep lines as well as loss of volume all around your mouth area.  The deeper ablative C02 laser treatments are really still the gold standard for these deep lines.  I don't think a short series of shallower treatments would be as good as one CO2 fractional laser treatment.  There is a 7-10 day recovery.  Also , you could use a little volume to support the skin, and give you a more youthful look, and for that I would recommend your own fat or a hyaluronic acid filler.  
Good luck!

Thank you for the photo. I understand your concern since there are many options out there and patients are confused about their options. Fractional non ablative lasers are good for fine lines and patients have to complete three sessions usually 4-6 weeks apart. They will give you very similar results as the ablative lasers. If downtime is a concern I always advice fractional series. If the patient can take about 5 days post op, ablative lasers is a good way to go with very nice improvement. 
The final result always depends on how deep the wrinkles are and the capacity of you body to produce collagen. Sometimes I combine laser treatments with low amount of fillers and PRP. Dr. LM. 

Fractional CO2 laser alone can give you the best results.  In this particular case, the type of laser used is important.  Lumenis ultrapulse CO2 lasers operating in deep FX mode  are the best lasers for  this, and can achieve excellent results in just one treatment. However, the end result is always dependent on the skill and expertise of the surgeon performing the procedure. The cost for this should be no more than $500.        jlr 

See Dr Sue Kilmer in CA, laser dermatologist, or Dr Chis Zachary. The use of fully ablative CO2 or erbium laser is preferred, followed by volume correction. Your other option is fully ablative FRACTIONAL laser, not non- ablative given your clinical presentation. All the best, Dr Davin S. Lim