CO2 laser resurfacing

Over the years, skin ageing is not just a loss of volume: the architecture of the dermis changes. Through natural ageing and sun damage (photoageing), collagen fibres become scarcer, elastin weakens and the skin shows lines around the mouth, fine lines around the eyes, uneven pigmentation and a loss of radiance.

The CO2 laser, fractional or ablative depending on the indication, is a reference technique for skin resurfacing. It allows controlled ablation and stimulates dermal remodelling to improve texture, soften wrinkles and tighten the tissues. How strong the result is, and the recovery, depend on the skin and the settings chosen.

The protocol, step by step.

1. Step 1

   Skin assessment and preparation (D-30)

   Analysis of skin type and elasticity. A depigmenting and antioxidant topical preparation may be prescribed depending on the skin, to limit pigment reactions and prepare for treatment.

2. Step 2

   The session (45 to 60 minutes)

   Disinfection, local nerve blocks and topical anaesthesia depending on the areas, then laser treatment sector by sector under pulsed cold air.

3. Step 3

   Weeping and repair (D1 to D5)

   Application of the prescribed occlusive healing balms. The initial swelling gradually settles and fine protective crusts form.

4. Step 4

   Reveal and consolidation (D6 to M6)

   The crusts fall off on their own, often around days 6 to 8, sometimes up to day 10 depending on intensity. The skin stays pink; dermal remodelling continues for 3 to 6 months.

Dr Afshin Yousefpour’s surgical vision

Using a high-energy CO2 laser requires knowledge of skin thickness, the underlying muscle dynamics and the face’s micro-circulation. Dr Afshin Yousefpour, a maxillofacial surgeon, approaches resurfacing as personalised tissue sculpting rather than a standard treatment.

• Calibrated area by area: energy, micro-pulse density and depth adapted to the thin eyelids, the mobile lips, the cheeks and the jawline.

• Pain management: local nerve blocks and topical anaesthesia according to the protocol, to improve comfort without guaranteeing a complete absence of sensation.

• An even result: gradual transitions towards the neck and jawline to limit lines of demarcation and an overly tight look.

A dual action, on the epidermis and the dermis

The infrared energy of the CO2 laser is absorbed by the water in the tissues. It combines a surface action with a deeper thermal effect. In fractional mode, untreated zones are kept between the pulses to support repair.

• Surface ablation: controlled vaporisation of the damaged layers of the epidermis, to soften sun spots and irregularities, smooth the surface and improve the look of pores. Suspicious lesions must be assessed before any aesthetic treatment.

• Deep thermal effect: zones of dermal coagulation and fibre contraction, followed by stimulation of collagen production over several months.

Main indications at the practice

• Pronounced lines and creases: lines around the mouth (“sun creases” or smoker’s lines), crow’s feet, forehead and frown lines.

• Crepey eyelids and moderate laxity: improving the skin of the upper and lower eyelids depending on the indication; the laser does not replace surgery for significant excess skin.

• Complex scars: atrophic acne scars, including ice-pick or saucer-shaped scars, surgical scars and the after-effects of facial trauma.

• Laxity and loss of density: improving the tissues of the lower face, neck and décolleté, with settings adapted to these areas.

How does the CO2 laser differ from a deep peel or other lasers?

The CO2 laser allows the settings and treatment depth to be adjusted. In fractional mode, the islands of skin kept between the micro-beams support re-epithelialisation and can shorten recovery compared with full ablation. The choice between laser, peel and other techniques depends on the indication, skin type and individual risks.

Is the procedure painful?

Depending on the areas treated, the session uses local nerve blocks and topical anaesthesia. These measures aim to limit pain; feelings of heat or discomfort remain possible, particularly after treatment. The anaesthetic protocol is explained at consultation.

How long is the social downtime?

The document generally allows 5 to 7 days for a standard fractional treatment, and 8 to 12 days for a targeted or deep ablative treatment, with regular rich skincare. Times vary with the intensity and individual healing; residual redness may last longer.

Mineral make-up or a medical concealer can be considered from the eighth day, only if the epidermis has fully healed and with the doctor’s agreement.

What results can I expect and how long do they last?

An improvement in complexion and texture can appear after peeling. Skin remodelling and softening of wrinkles develop mainly between the second and sixth month. The benefits can last several years, but are not the same for every patient and do not stop natural ageing.

Why does maxillofacial expertise matter?

Skin thickness and the underlying structures differ greatly between the eyelids, cheeks and other areas. Dr Yousefpour’s anatomical knowledge allows the intensity of treatment to be adjusted and delicate areas to be taken into account, without removing the risks inherent to the laser.

Usual recovery after treatment

• Redness and heat: a burning feeling and redness for the first 24 to 48 hours.

• Swelling: reactive swelling, especially of the eyelids and cheeks, often most marked between day 1 and day 3.

• Weeping and crusts: temporary oozing, then brownish micro-crusts from day 3, falling off on their own within 7 to 10 days according to the protocol.

• Residual redness: a pink tint that may last four weeks to three months depending on intensity, which can be covered once healed with approved make-up.

Possible risks and complications

Every medical procedure carries risks, even when technical and anatomical precautions are taken.

• Pigment changes: post-inflammatory hyperpigmentation, more common on darker skin or after UV exposure, often temporary but sometimes persistent; hypopigmentation that can be permanent, rare in fractional mode.

• Skin infections: reactivation of herpes or bacterial infection. An antiviral or preventive antibiotics may be prescribed after medical assessment.

• Healing problems: atrophic, hypertrophic or keloid scars. Picking the crusts, scratching and infection can increase this risk.

• Prolonged redness: redness beyond 3 to 6 months that may need further treatment.

Contraindications and precautions to report

Report your full medical history and treatments so the doctor can confirm the indication and timing. Some situations require postponement or specific precautions.

• Pregnancy or breastfeeding.

• Recent use of isotretinoin: the document mentions the last 6 to 12 months. The interval that applies depends on the type of laser and your situation and must be assessed individually. Do not stop any treatment without medical advice.

• A history of keloid scars or poor healing.

• An active skin infection on the area to be treated.

• A recent tan or sun exposure, or exposure planned within the next three months.

Care and commitments after treatment

• Follow the local care, barrier healing balms and treatments prescribed by Dr Yousefpour.

• Never pick, scratch or rub the crusts: they must fall off on their own.

• Avoid all direct sun exposure for at least three months. Apply mineral SPF 50+ sun protection as soon as the skin allows, according to the practice’s protocol; reapply every two hours when exposed and add physical protection.

Information and informed consent for CO2 laser

The practice’s document sets out the principle of resurfacing, how the treatment is performed, the expected benefits, the limits, normal recovery and the risks. Before deciding, you must be able to report your full history and treatments, ask your questions and have enough time to reflect.

Consent is obtained at the practice after the discussion with Dr Afshin Yousefpour. This page presents the medical information and is neither a signature nor consent given online.

The art of medical and surgical synergy for the face

Facial ageing combines deterioration of the skin, loss of deep volume and sometimes excess skin or eye bags. The CO2 laser works on texture; hyaluronic acid or fat grafting can restore volume; eyelid surgery treats some excess skin and fat herniation.

These treatments can be arranged in an overall protocol or, for some indications, in the same operation. Their combination is personalised and does not guarantee the same result for every patient.

Full eye-area protocol: eyelid surgery and peri-orbital laser

For heavy eyelids, bags and crepey skin, surgery treats the excess skin and removes or repositions the fat. A transconjunctival approach (from inside the eyelid) can avoid an external skin incision when suitable.

Fractional laser can complement the surgery for the texture of the lower eyelid and the fine lateral lines. A combined treatment can be performed under local anaesthesia with sedation depending on the indication. Swelling and bruising around the eyes may be more marked for 7 to 10 days; watery or dry eyes may require the prescribed eye care.

Bio-regenerative protocol: CO2 laser and PRP

Platelet-rich plasma (PRP) comes from a blood sample taken from the patient, centrifuged at the practice and then applied under sterile conditions after the laser. Its autologous growth factors are used with the aim of supporting skin repair, particularly for acne scars or sun-damaged skin.

The document mentions a 30 to 40 % reduction in downtime. This figure is not an individual guarantee: benefits and timing vary with the protocol and the available evidence. Being autologous does not rule out the risks of sampling, preparation or application.

Restructuring and texture protocol: laser and fillers

For a hollow face with fine lines, targeted injections of hyaluronic acid or tissue stimulators such as calcium hydroxylapatite can complement laser smoothing. The choice of product and its specific risks are discussed separately.

The document generally plans two stages 3 to 4 weeks apart. Structural restoration of the cheekbones or chin can come before the laser; a fluid gel for superficial lines can be offered 4 to 6 weeks afterwards, once the skin has healed enough. The schedule is confirmed by the doctor.

Can eyelid surgery and laser be combined in the same procedure?

Yes, for some indications chosen by Dr Yousefpour, to treat both the excess skin or bags and the texture of the skin around the eyes. Recovery from both can take place in the same rest period, often 7 to 10 days in the document, without ruling out a longer recovery.

What is the benefit of combining PRP with CO2 laser?

Applying PRP after the laser aims to support repair, reduce inflammation and promote remodelling. The effect on healing and collagen production is not guaranteed and depends on the protocol and individual response.

Should injections be done before or after the laser?

The order depends on the clinical analysis: structural volume can be restored about 3 to 4 weeks before, while superficial injections can be considered 4 to 6 weeks after healing. Respect the personalised interval given by Dr Yousefpour.

Information and consent for combined protocols

An addendum to the consent sets out the additional procedures chosen: eyelid surgery, PRP, injections or another procedure. It describes their benefit, their sequence, the alternatives and the risks of each technique.

The after-effects can add up: greater or longer swelling after eyelid surgery, temporary asymmetry as the swelling settles, bruising and swelling at the injection points. The risks specific to each procedure still apply, and the intervals between sessions must be respected.

Any eye care, the instructions and the specific risks are explained before the decision. Consent to the combined protocol is obtained at the practice after your questions and time to reflect; no choice of procedure or signature is recorded on this page.