Thermage or Laser Resurfacing for Winkles and Lines?

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

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.

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.

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.

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.