Thank you for your question!
You’re asking a question that you are planning to get a deep profractional laser treatment
full face and you’re asking will it affect the fat transfer that you had with your facelift.
Well, I can give you some understanding of the interaction of the lasers and the skin
relative to what you had in terms of grafting but it may be difficult to be as specific
as you like.
To give you a little background, I’m a board certified cosmetic surgeon and a fellowship
trained oculofacial plastic and reconstructive surgeon.
I’ve been practicing in Manhattan and Long Island for over 20 years and I’ve had a
lot of experience with lasers since using the original CO2 lasers back in the mid-90s
then switching to erbium laser, ablative erbium laser for many years and then coming back
to fractional CO2 laser.
And what I think is a challenge for a non-physician and someone who’s not even familiar with
the brand names of these lasers is that the term fractional is getting confusing.
There are a couple of concepts to understand to differentiate erbium and CO2 laser.
To begin with, the erbium laser is a laser that generates and causes ablation but doesn’t
generate as much heat to the deeper area of the skin which causes tightening of the back
bone of the skin called the dermis.
Now, the profractional laser is an erbium laser.
So that’s one factor that might be to your advantage in terms of affecting potentially
what’s going under the skin.
Hopefully, your doctor was able to explain that to you because a lot of times people
think that they’re getting a fractional CO2 laser and fractional CO2 laser penetrates
deeper and deeper doesn’t always mean better but it just means that there’s more thermal
energy delivery to the deeper layers of the skin that can cause some skin tightening.
So you also have to understand what’s desired outcome.
When I did full faced erbium laser, I would say that the skin appeared a little bit tighter
but it was more about resurfacing and getting a smoother quality skin.
Now, if you think about fat grafting, you know fat is grafted below the skin and if
the fat has already healed, then it’s not likely that it will have a direct effect on
the fat under the skin.
With that being understood and it depends on the timeline since you’ve had your face
lifting and fat grafting procedure, a lot of times when fat grafting is done, it’s
not done in exactly the same areas as the flap of the facelift but rather in areas which
haven’t been undermined because you need a very good stable blood supply.
So chances are, it’s not going to be an issue at all.
People who’ve had a facelift whether it’s at the time of the facelift procedure or even
after, it’s always important to communicate that with the doctor or if it’s a different
doctor performing the resurfacing procedure to understand the timeline since the procedure
because it is a trauma.
Laser is a trauma to the skin and I always explain to patients that there’s a certain
amount of limit on whether it’s heat energy or resurfacing or abrasion or whatever it
is that the skin can tolerate.
In our practice, we advocate very strongly regenerative technology such as the use of
platelet-rich plasma and Acellular matrix to help rejuvenate skin without being too
aggressive ablation.
This is from so much experience that I have in what happens to skin long term after aggressive
laser treatment.
That’s no way am I contradicting to what your doctor is recommending but in terms of
the integrity of the fat that was placed under the skin, it’s not likely to be a problem.
Sometimes when there’s skin inflammation, that can be a problem.
If there’s an infection, that can be a problem but as long as you and your doctor have a
good sense of communication about what to expect and if you’re basically using an
erbium laser to resurface the skin, what you should see is an improvement in fine lines,
you should see an improvement in discoloration but you should also not have a prolonged amount
of redness from a lot of thermal energy being delivered into the skin.
So I would advise again clarify this with your doctor, the individual who’s going
to do the procedure.
And if you are trusting this doctor to take off all the top layers of skin on your face
then I think you should probably have enough trust in the quality in their knowledge that
they convey to you about the safety to the fat grafting that you had under your skin.
So I hope that was helpful, I wish you the best of luck and thank you for your question!