I’ve Had a Facelift - So Why Does My Skin Still Look Aged? How CO₂ Laser Resurfacing Can Help
A facelift can create a significant improvement in facial ageing. It can lift and reposition tissues, improve jowling and restore definition to the lower face and neck.
But there is something we hear surprisingly often from women who visit us following facelift surgery:
“My face has been lifted, but my skin still looks old.”
This can be frustrating, particularly after investing in facial surgery. However, it doesn’t necessarily mean that the facelift hasn’t worked.
The reason is relatively simple: a facelift and a skin resurfacing treatment are treating two very different aspects of facial ageing.
At The Derma Clinic Kent, we regularly see patients following facelift surgery who are happy with the improvement in their facial contours but are still concerned about the quality, texture and appearance of their skin.
This is where treatments such as CO₂ laser resurfacing after a facelift may have a role.
What Does a Facelift Actually Treat?
Modern facelift surgery is primarily designed to address structural ageing.
Depending on the surgical technique, a facelift may improve:
● Facial and lower-face laxity
● Jowling
● Loss of jawline definition
● Sagging tissues
● Neck laxity
● Changes in facial contours caused by ageing
The results can be transformative.
However, lifting and repositioning tissue does not necessarily change the condition of the skin covering it.
Years of UV exposure, collagen loss and intrinsic ageing are still present within that skin.
This means that after surgery, some patients become more aware of their skin quality, particularly once the underlying laxity has been corrected.
Why Can Skin Still Look Aged After a Facelift?
Facial ageing happens at several different levels.
We experience changes to bone, fat, muscle and supporting tissues — but the skin itself also changes.
Over time, we produce less collagen and elastin. Repeated UV exposure contributes to pigmentation and photodamage, while the skin can become thinner, less resilient and more irregular in texture.
A facelift can reposition the deeper tissues, but it doesn’t necessarily address:
● Fine lines and wrinkles
● Crepey skin
● Uneven texture
● Sun damage
● Areas of pigmentation
● Roughness
● Enlarged-looking pores
● Loss of skin firmness
● General deterioration in skin quality
A useful way to think about it is this:
A facelift can reposition the structure of the face. CO₂ laser resurfacing is designed to work on the skin itself.
For some patients, addressing both elements can produce a more complete approach to facial rejuvenation.
What Is CO₂ Laser Resurfacing?
CO₂ laser is an ablative skin resurfacing treatment using a 10,600 nm carbon dioxide laser.
The treatment creates controlled thermal injury within the skin, initiating a wound-healing response and stimulating tissue remodelling and new collagen formation.
Depending on the device, settings and treatment technique, CO₂ laser can be used at different intensities and depths.
It may be considered for concerns including:
● Fine lines and wrinkles
● Sun-damaged skin
● Uneven skin texture
● Areas of pigmentation
● Crepey skin
● Certain types of scarring
● Loss of skin smoothness
● Overall skin rejuvenation
It is important to understand that CO₂ resurfacing is not simply a facial or a superficial “glow” treatment.
It is a medical laser procedure that intentionally creates a controlled injury to the skin, meaning appropriate patient selection, treatment planning and aftercare are extremely important.
Can You Have CO₂ Laser After a Facelift?
Potentially, yes.
CO₂ laser resurfacing can be considered following facelift surgery in appropriately selected patients, but timing needs to be individualised.
The skin and surgical tissues must have healed appropriately, and consideration needs to be given to the type of surgery performed, scar healing, blood supply, medical history and the proposed intensity of laser treatment.
There is also published evidence supporting fractional CO₂ laser for the treatment of surgical scars. Studies have reported improvements in characteristics such as scar texture, thickness and overall appearance, although the evidence relates to a range of surgical scars rather than specifically proving that every facelift patient should undergo laser treatment. (PubMed)
Interestingly, research into surgical scars suggests that fractional CO₂ laser can sometimes be used relatively early in the healing process. However, this should not be interpreted as a universal timeframe for full-face resurfacing following facelift surgery. Treating a surgical scar and performing extensive facial resurfacing are not the same clinical scenario. (PubMed)
For this reason, we would never recommend choosing an arbitrary number of weeks after surgery and assuming treatment is automatically safe.
Where appropriate, communication with your plastic surgeon may also form part of the decision-making process.
Can CO₂ Laser Improve Facelift Scars?
This is another question we are frequently asked.
Fractional CO₂ laser has been studied for the treatment of postoperative scars, and research supports its ability to improve certain characteristics of surgical scarring. A 2022 systematic review and meta-analysis found improvements in overall surgical scar scores, while more recent controlled research has also reported improved scar appearance and patient satisfaction. (PubMed)
However, facelift scars require careful assessment.
Scar colour, thickness, maturity, position and healing all need to be considered before deciding whether CO₂ laser — or another treatment entirely — is appropriate.
Why Skin Quality Matters After Facial Surgery
We often talk about facial rejuvenation as though ageing is one single problem.
It isn’t.
Someone may have excellent facial structure but significant photodamage. Another person may have beautiful skin but considerable tissue laxity.
This is why the best treatment depends on what is actually creating the aged appearance.
If laxity is the primary concern, no amount of superficial skin treatment is going to reproduce what appropriately performed surgery can achieve.
Equally, if the facial tissues have been successfully repositioned but the skin remains heavily sun damaged, crepey or texturally irregular, lifting the tissues further isn’t necessarily going to solve the problem.
For the right patient, improving the quality of the skin after surgical rejuvenation can therefore be the next stage of their journey.
“My Facelift Looks Good, but I Want My Skin to Match”
This perhaps describes our post-facelift patients better than anything else.
Many aren’t looking for more surgery or a dramatic change.
Their facial shape has improved. Their jawline may look better. They may feel significantly more confident about their profile.
They simply want the surface of their skin to look healthier and more rejuvenated too.
This is where a consultation focused specifically on skin quality becomes valuable.
Rather than automatically recommending CO₂ laser, we assess what is actually contributing to the concern.
For one patient, resurfacing may be appropriate. For another, pigmentation may be the predominant issue. Someone else may benefit from a completely different treatment approach.
The aim should always be to treat the problem, rather than simply choose the most powerful treatment available.
What Is Recovery Like After CO₂ Laser?
Downtime varies significantly depending on the intensity and type of CO₂ resurfacing performed.
After ablative treatment, patients should expect a period of visible healing. This can include redness, swelling, sensitivity, peeling or crusting as the skin recovers.
Redness can persist beyond the initial healing phase.
Strict aftercare and sun protection are particularly important following resurfacing, and patients need to understand the recovery process before proceeding.
This is one reason we believe CO₂ laser should be approached as a planned medical procedure rather than a casual beauty treatment.
Is Everyone Suitable for CO₂ Laser?
No.
CO₂ laser is a powerful treatment and is not appropriate for every skin type, medical history or skin concern.
Assessment may include factors such as:
● Fitzpatrick skin type
● Tendency towards abnormal scarring
● Previous surgery
● Current wound and scar healing
● Pigmentation risk
● Medical history
● Current medication
● History of cold sores
● Active skin conditions or infection
● Recent sun exposure
● Expectations and ability to follow aftercare
Particular consideration is required in patients at greater risk of post-inflammatory pigment alteration.
This is why a detailed consultation should always come before treatment.
CO₂ Laser After Facelift Surgery: The Bottom Line
A facelift and CO₂ laser resurfacing aren’t competing treatments.
They treat different components of facial ageing.
A facelift primarily addresses structural changes and tissue laxity.
CO₂ laser resurfacing primarily addresses the skin itself - its texture, photodamage, fine lines and overall quality.
For some women, their facelift has achieved exactly what it was intended to achieve, but they are left feeling that their skin hasn’t caught up with their new facial contours.
In appropriately selected and fully assessed patients, skin resurfacing may therefore be considered as part of the next stage of facial rejuvenation.
CO₂ Laser Resurfacing in Canterbury, Kent
At The Derma Clinic Kent in Canterbury, we regularly assess patients who have previously undergone facial surgery and would now like to explore options for improving their skin quality.
Our approach is not to assume that everyone needs CO₂ laser.
Instead, we assess the skin, discuss your previous procedures and concerns, and determine whether resurfacing is appropriate - and, importantly, whether it is the right time to consider treatment.
If you have had a facelift and are happy with the lift but still feel concerned about sun damage, fine lines, crepey texture or the overall quality of your skin, a consultation can help establish what options may be suitable for you.