Will a Laser-Lift Result in Facial Wasting Like Thermage Treatments?

Question

I've read about Thermage's final outcome being loss of sub-cutaneous facial fat resulting in a much older appearance.

Vincent N. Zubowicz, MD · Answer

High tech is appealing to surgeons and patients. However, much of the new technology we see in aesthetic surgery doesn't work and may do harm. If you want a facelift, seek out an experienced and talented surgeon. If he instills confidence, let him do his job and you will be delighted.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  The laser-lift is certainly an area in evolution.  Applying energy to the dermis - with some form of energy - can certainly cause some skin contraction, but it can also cause injury and scar formation.  Loss of fat can also occur with higher tissue temperatures.The jury is still out on which laser and which settings are the best.  Be careful.

Larry S. Nichter, MD, MS, FACS · Answer

Although not written about I have heard on a fat transfer panel that Thermage can cause loss of transferred fat even years later. I have not seen scientific literature that your native fat will disappear.Thermage is not a laser. It is designed to cause skin contraction (to a small extent) and not to replace a facelift. Many of my patients have been disappointed in Thermage and we do not offer this technology.

Otto Joseph Placik, MD · Answer

There are a few individuals who claim benefits from the use of Thermage but it appears that a good number of patients are dissatisfied with treatments, In some instances it has even resulted in fat atrophy or necrosis.

Harold J. Kaplan, MD · Answer

The term "Laser Lift" does not ring a bell for us as this is not a term that is commonly used in the industry. If you are talking about Titan, then we would recommend that you skip it as the results have been similar to Thermage. 
If you are speaking about some other laser procedure then there are options for helping with skin tone and texture including the following that will not result in "facial wasting":

CO2 Resurfacing
CO2 Fractional Resurfacing
Erbium Resurfacing
Erbium Fractional Resurfacing

Stephen Prendiville, MD · Answer

Thermage is technique for radiofrequency deep tissue heating, and achieves a completely different result than any laser.  The results from Thermage have not been as impressive as originally hoped. The term "laser lift" may refer to skin resurfacing, which can be achieved via CO2 or Erbium laser, delivered in Fractionated or standard delivery modes.  It could also refer to laser assisted lipolysis which would refer to fat removal and skin tightening.  It could also refer to a marketing "gimmick" : there is no established proof that use of a laser to make incisions and/or other aspects of a Facelift have any benefit over currently available techniques.  Lastly, it could refer to use of fractionated laser resurfacing with a Facelift.
A general rule of thumb in cosmetic surgery is beware of catchy brand names that describe procedures.

Raffy Karamanoukian, MD, FACS · Answer

Laser assisted facelifts are part of the evolution of facelifts from a purely surgical procedure, to one that incorporates laser, chemical peel, and facial volume enhancement procedures. Laser treatments can improve tightening of the skin and also help in the dissection of the dermal layer. In all, laser assisted facelifts will not or should not cause facial fat wasting.

Ross A. Clevens, MD, FACS · Answer

The laser assisted 'weekend' necklift represents the evolution of sophisticated facial plastic surgery techniques.These techniques are uniquely combined to achieve improvement in the contour of the chin and neck with minimal incisions and rapid recovery. Cervicofacial liposculpture is first employed to contour the unfavorable fatty changes seen in the face and neck as time passes by, such as the 'Turkey neck' and 'double chin'.Careful attention is then turned to tightening the neck muscles and eliminating neck bands.
Finally, the laser is used to 'resurface' the underside of the neck skin, thereby 'shrinkwrapping' the skin of the neck restoring a youthful contour. This innovative procedure may be performed at the same time as other rejuvenative procedures such as eyelid surgery, midface lifting, endoscopic browlifting and cosmetic laser skin resurfacing.

Michael Kulick, MD, DDS · Answer

Regarding using a laser for actually cutting, while there is not universal agreement, I have been using a laser to divide tissue while doing my Vertical Facelift and have excellent results, fewer complications and the results are lasting.  This does require a surgical procedure. The laser seals blood vessels as it divide tissue.  
In contrast, patients that do not want a "surgical" procedure have turned to non-invasive technologies (many out there) that try and tighten the skin. These treatments have not provided consistent improvement in terms of the skin tightening that surgical treatments afford patients.  
The other use of lasers to tightening the skin refer to when a doctor burns the skin using a laser. It is different than the laser I use for surgical cutting. If a patient has a lot of loose skin, this may not be a good option.

Toby Mayer, MD · Answer

These names of procedures, for various marketing purposes, confuse the issues involved. Yes, a laser causes the vaporization of some fat. It sounds Hi-tech when we use the term Laser. There are many other issues you should be aware of before having any of these done. See an experienced plastic surgeon who will guide you through the various procedures possible and help you pick the one that is right for you. He will be motivated by what is best for you and not best for him.

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