
If you’re starting to see wrinkles or even lines appearing on your face, you no doubt wonder what you can do about it. No one wants to look older than their years or older than they feel. Many have heard about lasers and wonder if laser resurfacing will really smooth out their lines and wrinkles. They may also wonder if microneedling, a less-invasive treatment, could work for them. And some wonder if they’ll need a facelift soon. After performing these procedures for years, let me give you the benefit of my experience.
Editor’s Note: Dr. Brian Machida is a double board-certified facial plastic surgeon with an unusually high level of experience. In his career he has performed more than 4,000 facelifts, beside other cosmetic surgical and non-surgical procedures. He taught facial plastic surgery for years at the University of Southern California’s Keck School of Medicine. He now practices at STC Plastic Surgery in Ontario, Inland Empire, California.
Keys to reducing lines and wrinkles
Young skin is naturally smooth and elastic. Healthy skin enjoys good circulation. It has plenty of key proteins like collagen and elastin. Every lasting treatment that effectively targets wrinkles on your face will increase your collagen and elastin levels. That is true of laser resurfacing, Renuvion, and microneedling.
Collagen forms a matrix on which healthy skin is built. Elastin keeps your skin firm and elastic. Unfortunately, everyone’s levels of collagen and elastin start to decline after their 20s. You can maximize your natural production of these vital proteins by providing your skin with what it needs for good health – important nutrients and circulation. You can learn more in “Can Food Fight Wrinkles and Premature Aging?”

It’s also important to avoid accelerating the facial aging process. It happens quickly enough on its own. Behaviors that are common today actually make you look older faster. You can forestall premature aging by avoiding smoking and vaping, as well as anything more than light to moderate drinking – see “Facelift Before and After – How Long Do Facelifts Last?” It might not be easy when you’re with your friends, but any sacrifice will be worth it when you look in the mirror.
Unfortunately, even those with the healthiest lifestyles eventually get facial lines and wrinkles. What’s your best method for treating them?
Will microneedling work for your wrinkles?
If you start seeing wrinkles in your 30s, your best treatment option is probably microneedling. This minimally invasive procedure can improve fine lines and wrinkles, some acne scarring, and stretch marks. Because it avoids the skin discoloration sometimes seen with other methods, microneedling is the treatment of choice for people with darker complexions.
Microneedling works best on healthy skin, so you’ll want to follow the recommendations outlined above. This treatment causes tiny injuries to your skin. This, in turn, increases your collagen and elastin production. If fact, research reveals that medical grade microneedling can increase levels of these vital proteins up to 400%.
If your lines and wrinkles are a bit more advanced, radio frequency (RF) microneedling could help. Using a specialized device, your physician will puncture your facial skin with microneedles and then introduce radio waves through the needle tips. This makes the controlled injury to your facial skin a bit more extensive. It can increase collagen and elastin production even more.
If you’re no longer in your 30s, you’ll probably need a more aggressive treatment. Fractional CO2 laser is often the answer.
Fractional CO2 laser effectively treats lines and wrinkles
Fractional CO2 laser is often the answer when lines and wrinkles are more advanced than you’d typically see in your 30s. A patient satisfaction survey published in the Journal of the American Medical Association found that after 3 months, all participants felt that laser resurfacing had improved their appearance. CO2 lasers vaporize the wrinkled top layer of your skin. Fractional CO2 lasers affect fractions of your skin, producing less discomfort. Eliminating the wrinkled top layer brings fresh, smooth skin to the surface. The laser’s heat also stimulates collagen and elastin production.
You should heal in about a week. For the fastest and best recovery, you’ll need to follow your physician’s instructions to the letter. It’s important to keep your face clean and moisturized. You’ll need to stay out of direct sunlight for a time. It’s important to wear sunscreen anytime you go outside. That’s a good strategy to avoid sun damage in any event.
Fractional CO2 laser works well for moderate lines and wrinkles. But what if your lines and wrinkles are deeper? Or, what if you’re in your 50s or older?
Laser first, then facelift?
By the time people reach their 50s, or experience more advanced facial aging, many know they’re going to need a facelift. The question is: When? Many patients ask, “Can I have laser resurfacing first and then have a facelift only if I need it?” That sounds logical.
The problem is: Advanced facial aging is frequently a sign that your wrinkles are more than just skin-deep. Often, facial muscles are also starting to sag. There’s no laser on earth that can fix that problem.
It’s important to note that in the laser satisfaction survey published in JAMA, after 30 months patient satisfaction had started to decline. Why? It could be that poor diet, smoking, overdrinking (for skin), or neglecting skincare was making patients’ wrinkles return. Another reason could be sagging facial muscles.

The only answer to sagging muscles is a facelift. A good facelift will lift sagging jowls and eliminate marionette lines that run from the corners of your mouth to your jawline. A better facelift will also lift your midface and cheeks.
Often, the best way to eliminate deep lines and wrinkles is a facelift followed by laser resurfacing. The best facelift for this is the Deep Plane facelift. The more widely used SMAS facelift tightens the connective tissue network above the facial muscles, particularly affecting the lower face and neck. The Deep Plane facelift effectively lifts sagging cheeks as well, greatly improving nasolabial folds.
Laser resurfacing after a Deep Plane facelift is ideal. It’s safer than laser after a SMAS facelift, since lasers can harm tissues that were lifted away from the SMAS. A Deep Plane facelift never lifts skin off the SMAS, so there’s much less risk of damaging any tissues with laser treatment. Your skin can be refreshed nearly ear-to-ear. Highly effective Renuvion resurfacing is also safe with a Deep Plane facelift.
Which professional you choose to treat your wrinkles makes a difference
The first thing everyone sees is your face. Make sure you treat it right. You wouldn’t cut corners in choosing a brain surgeon or a heart surgeon. Why cut corners with something as important to your success and well-being as your face? A board-certified facial plastic surgeon, plastic surgeon, or cosmetic dermatologist is in the best position to effectively eliminate lines and wrinkles. They have the knowledge and experience to know which modality is best for you, considering the state of your skin, your facial structure, and your level of facial aging.
You’ll want to choose someone who has plenty of experience treating wrinkles and facial lines in people like you. If you’re in Inland Empire, California, you can find me at STC Plastic Surgery in Ontario.
