How long must I wait before having CO2 after filler on acne scars? (Photo)

Question

How long after I have filler done to raise my acne scars do I need to wait to have co2 laser done.

Edward P. Miranda, MD, FACS · Answer

Thank you for your question. Ideally you should have CO2 sessions prior to filler for acne scars. Since the filler was done first, we would recommend waiting 4 weeks to begin a CO2 treatment.

Stephen H. Fink, DO, FAOCO · Answer

Typically, since most fillers have a shorter duration than the results of a CO2 laser treatment, I usually recommend laser first followed by filler to touch up remaining areas.  If you already had the filler, then it depends on the type of filler and where it was placed. Assuming it was placed superficially in the skin, I expect the heat from the laser may hasten the absorption certain fillers. That would not necessarily be a contraindication. However, I also expect when areas  that have filler are combined with longer result treatments,  there may still be  changes over time consistent with the diminishing of filler effect.

Jason Emer, MD · Answer

We often perform lasers and fillers on the same day. These types of scars need a combination of lasers, microneedling/prp, TCA cross, Cosmelan, punch excision and fillers. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

P. Daniel Ward, MD · Answer

There is some theoretical concerns that the treatment of the skin with a laser might make the filler go away more quickly. I usually wait six weeks after the filler before proceeding with laser treatment.

Arbella Sarkis, MD · Answer

Hello kevTHo, 
Good question.
Depends upon the filler and work performed. If a filler procedure was performed for something like wrinkles, which is and can be a very shallow application of fillers you would likely benefit from waiting until most of the filler effect went away. 
In other words, fillers placed shallow are more likely to be adversely impacted or be noticeable in newly tightened skin. Fillers placed deeper are less likely to be directly impacted. 
However, though a deep filler is unlikely to be impacted after a couple weeks of placement, remember that your skin will tighten. Therefore, its important to assess where it may end up as the skin moves and how it may look. Will you have a bump or ridge where not intended? 
Most of the time it will be OK, but I have seen some end results not be as desired. There are too many factors to list. A good practitioner should be able to help make that judgement call. 
In the ideal world, I prefer to tighten skin first, then ad the accents. This is not a requisite, only a preference.
I hope the above helps. I hope and wish you achieve everything you hoped for.
Warmly,
Arbella Sarkis, MD

Lisa Jenks, MD · Answer

There is some debate on this issue.  Some physicians feel that doing a laser (such as CO2) over filler causes the filler to dissolve more quickly.  Others (myself included) feel that, after about four weeks, it is fine to do laser over fillers as long as the area where the filler is does not get any heavy rubbing or massage while the skin is hot.

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