Lasers vs. Facelifts

Navigating through the world of anti-aging measures can be tricky, especially if you’re not sure what problem each tool best addresses. As we age, three major changes take place: a loss of volume, sagging skin and textural changes of the skin. “There are more options available today than ever before, which can be overwhelming. In the past, the only choice patients had was surgery. But today there are also lasers, fillers and neurotoxins. For some, a mix-and-match approach that incorporates a variety of rejuvenating options is necessary to achieve the results they desire,” says Largo, FL, oculoplastic surgeon Jasmine Mohadjer, MD.

Choose a laser if you have mature skin that's sun-damaged with little or no laxity: The more mature the skin is, the less elastin and collagen it contains, hence the formation of deep lines and wrinkles. “Lasers, which can be used on skin as early as your 30s, help to improve the texture and tone of skin, including mild wrinkles and lines, that have resulted from exposure to the sun, age, stress and lifestyle choices,” says Beverly Hills, CA, facial plastic surgeon Davis Nguyen, MD. New York plastic surgeon Z. Paul Lorenc, MD, adds, “I always explain that a laser can only help with lines and wrinkles so much.”

How a laser really works: Either nonablative (meaning they don’t damage the outer layer of skin) or ablative (these create controlled damage to the outer layer of skin), fractionated lasers help reverse signs of sun damage, textural issues and fine lines by creating miniscule holes in skin via a beam of fractionated energy. The body recognizes the injury (it’s done in a safe and controlled way) and, in an effort to repair the damage, creates new collagen. As a result, new collagen leads to smoother skin over the next few months. Ablative CO2 fractional lasers (the strongest option) require the most downtime and have the potential for scarring and pigment change, but provide the most dramatic effect.

What it can do: Correct textural changes, discoloration, fine lines and minimal wrinkles

What it can't do: Remove skin laxity or dramatically tighten skin

Choose a facelift if you are experiencing lines, wrinkles, and loose skin, especially around the jawline and on the neck: Fillers and lasers can do wonders, but if they leave your skin looking doughy or waxy or aren’t providing the results you want, then they likely aren’t the right choice—or, they may need to be done in conjunction with surgery. For skin that’s experiencing extreme laxity, surgery is the only option (it can be combined with fillers and/or lasers to get a dramatic result). “We start to see initial sagging when the face begins to lose volume, but as the aging process progresses, the ligaments stretch out and skin starts to become really loose. The only thing that will fix it at this point is surgery,” says New York facial plastic surgeon Konstantin Vasyukevich, MD. If there is volume deficiency, micro-fat grafts can be added at the time of the facelift.

What it can do: Remove loose skin, reposition fat, muscle and tissue, and correct sagging

What it can't do: Address volume loss or the tone or texture of skin; lines and some wrinkles may still persist

Insider tip: The signs of aging are inevitable, but taking care of your skin and feeding it with the right "nutrients" may help delay the effects you see. Atlanta dermatologist William L. Dobes, MD, says that aging and wrinkling of the skin can be prevented with a regular use of a good sunscreen and a prescription-strength retinoid. "Early intervention really is best."  

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