What is the best laser treatment with minimal downtime for solar elastosis? (Photo)

Thanks for sending the picture.  It appears that you have sun damage to the surface of the skin but also to the undersurface which has caused a loss of facial fat volume which is contributing to the wrinkles.  I would recommend a combination treatment involving a CO2 laser and sculptra which helps build up volume by growing collagen underneath and in the skin.  The fractional CO2 does have downtime of about 1 week but this can be helped with the use of PRP.  If done correctly, there is no hypopigmentation of the skin (whitening of the skin).  This helps a lot with the skin texture but does not help with the volume restoration.  To aid with the volume, Sculptra would be used. By restoring volume, it would help to lift the skin and stretch/tighten the skin.  Please consult with someone who has experience doing both.

I suggest a formal consultation. there are numerous lasers, peels, and skin care that can treat this condition you are describing.  You need to be evaluated for a formal treatment plan.  
I suggest a combination approach of :
1) skin care with products and PRP/microneedling

2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel, Viva, doctor fake diacomo urtisor Co2/Erbium
4) Sculptra injections a few times a year for collagen production
5) thermage/ultherapy for yearly skin tighteningBest, Dr. Emer.

The picture angle may make things worse than they are, but an honest answer is probably not your ideal one. Lots of offices would love to sell you 'no-downtime' skin tightening, but don't waste your money. Results are modest at best.Your skin type is really ideal for skin improvement, but it just takes time and tightening takes the biggest treatments of all to get real results. The safest and most natural looking resurfacing comes with erbium lasers (Sciton is best), especially if you want your doctor to be able to work down onto your neck. CO2 tends to give a white look and is not safe at aggressive levels off the face.One thing that may be able to help you with some lift without the downtime would be appropriate fillers. As we all lose volume in our face, there is less scaffolding under the skin and we see more 'puddling' at the bottom of the face. The answer is NOT to put more fillers in the bottom where you see the sagging, but rather where it used to be when you were younger. Take a look at pictures of yourself in your 20's, 30's and 40's. It may give you some helpful answers!

Thanks for the great question. As I'm sure you know, there are a spectrum of lasers all with variable downtimes. The general rule of thumb is that you get more improvement with lasers which have longer downtimes. For you, you'll see the best results with full field resurfacing with Erbium or CO2, but these lasers have 1-2 weeks of downtime. I also perform Halo laser which has a down time of a few days and can make a significant improvement in your skin, but not to the same degree as Erbium. I recommend seeing a surgeon in your area who is able to give you all of the best options which will meet your skin goals. Best,~Dr. Sieber

For this amount of laxity and elastosis, fully ablative laser is the best. Erbium or CO2- Dr Sue Kilmer or Dr Chis Zachary are masters in the art of fully ablative laser. Both located in CA. All the best, Dr Davin Lim. Brisbane. Australia.