Thermage or Laser Resurfacing for Winkles and Lines?

For fine line and wrinkles around the mouth do you recommend Thermage or Laser resurfacing?

Doctor Answers 5

Laser resurfacing, Botox, and possible fillers remove lip lines and wrinkles

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Thermage is used to tighten skin, especially on the neck-it achieves about 20% of what a facelift achieves.

For wrinkles around the mouth, lip lines and lip wrinkles you need laser resurfacing. The newer fractional ablative laser resurfacing with the 2940 Erbium is safer and very effective. New combined non-ablative 1540 and ablative 2940 Erbium fractional is very effective (see reference below.)

Even with excellent laser resurfacing, mouth lines lip lines and wrinkles can come back.

For nearly complete correction of lip lines you will need Botox and fiuller injections like Juvederm, restylane, or perlane for best results.

Lines around the mouth

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Unfortunately, no treatment eradicates all lines around the mouth as the skin creases when the muscles move during speaking and eating. Laser resurfacing helps more than Thermage for this. A small amount of Botox might be given prior to the treatment to minimize the muscle movement so that the new laser resurfaced skin heals on a smoother “bed” but all the movement can’t be eliminated with the Botox, otherwise there would be problems with the lips not functioning correctly. Fillers do help significantly when they are used to replace volume loss in the nearby regions should this have occurred. The normal youthful volume supports the skin of the lower face and if the volume decrease over the years, more lines form from lack of support. Rather than filling individual lines, this volume replacement in addition to the Botox and laser resurfacing can help diminish perioral lines (around the lips)…but lines will always to some extent, once you heal and smile and purse your lips.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

CO2 laser resurfacing would be the choice

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Thermage primarily helps to tighten the skin. It doesnt help any wrinkles or lines.

For the wrinkles around the mouth Fraxel CO2 laser resurfacing is the choice in our office.

We also ocassionaly will use the Erbium laser but the results with the CO2 Fraxel Repair has been superior in our hands.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

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Erbium laser resurfacing for fine lines and wrinkles.

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Laser and Thermage are completely different in how they work, and in the results you get.  In New York, we use erbium laser resurfacing to "erase" many fine lines and wrinkles.

Thermage is effective in tightening skin, along the jawline, for example.  It does not help with fine lines.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Laser Resurfacing

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The gold standard for wrinkles and fine lines has been laser resurfacing and continues to be. Thermage works below the skin's surface or below the wrinkles to heat the collagen and tighten the skin. I would also suggest that it is not an either or and that you may benefit from both treatments as they tend to address different aspects of the skin.

Charles Perry, MD
Sacramento Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.