Nonablative Fractional Laser and facial fat loss?

Question

I read online that in-office nonablative fractional lasers penetrate up to 650 microns, and that the epidermis of the face is, on average, about 180 microns thick. Is this true? Could a nonablative fractional laser penetrate into the dermis, causing damage to fat cells and facial fat loss?

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

Ryan Rebowe, MD · Answer

In general, this is not a concern. The amount of energy should not be enough to penetrate through the dermis and into the fat, otherwise you would receive a "full thickness" burn that would not heal. While there is some thin skin on the face, such as around the eyelids, generally speaking the energy is turned down in these areas to avoid full thickness burns. I am not aware of any cases involving fat loss following fractional laser application.

Randal Haworth, MD, FACS · Answer

The information you’ve read is generally accurate. Nonablative fractional lasers are designed to penetrate into the dermis, stimulating collagen production without ablating (removing) the outer layer of the skin. The average thickness of the epidermis on the face is indeed around 100-200 microns.

While these lasers penetrate into the dermis, they are typically considered safe when used by qualified professionals. The energy is controlled to target specific depths, primarily affecting the dermal layers. The risk of damage to fat cells and subsequent facial fat loss is generally low with nonablative fractional lasers.

Best of luck !

Nonablative Fractional Laser and facial fat loss?

Answers (3)

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