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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research

Why Laser Resurfacing Can Cause Facial Fat Loss

skin layers epidermisLaser resurfacing is a procedure which is aimed at rejuvenating the face. It works by injuring the top layers of your skin, the epidermis, causing a signal which promotes regeneration of new skin at the top layer of the skin.

While laser skin resurfacing is an effective method for prompting fresher, more youthful facial glow, there are some risks that take place at various layers in the skin which can cause fat volume loss.

Because of this fact, I rarely, if ever, use laser resurfacing for facial rejuvenation. Instead I use fat grafting, aka fat transfer. Why? Because with laser, regeneration of the skin is prompted by destruction and that destruction can also cause fat volume loss. With fat grafting, regeneration of the skin is prompted by signals sent by adipose stem cells which reside in the fat that is injected into the subcutaneous layer. With fat grafting, instead of a loss of volume, there is an increase in volume. Volume is increased by direct injection of fat as well as the fact that the process does not destroy cells as laser can do.

Why do some people experience facial fat loss after laser resurfacing?

To answer this question, continue reading or listen to this audio:

Anytime you introduce an energy source into the body, whether it be radiofrequency, or laser, or even CoolSculpting – which is specifically designed to injure fat cells – the cells that are damaged release what’s called DAMPs (Damage Associated Molecular Pattern Molecules, aka Danger Associated Molecular Pattern Molecules) and those DAMPs signal other cells.

lasers can trigger a process called apoptosis, aka cell death

-Ricardo L Rodriguez, MD

If the signals are severe enough, or a particular kind,the DAMPS can trigger a process called apoptosis, which is programmed cell death, and that keeps on going for weeks or months after the original injury so that patients that have had laser, or patients that have had radiofrequency, or patients that have had CoolSculpt, will continue to have subcutaneous fat tissue loss as a result of that radiofrequency.

Something that is designed to tighten your skin, ends up causing damage further on below the skin and to the fat tissue that’s right under the skin.

skin-layers-fat-transfer-cannulaThe correction for this, of course, is fat grafting. Fat grafting works in two ways:

  1. It replenishes the fat that was lost.
  2. The stem cells and regenerative cells in the fat, restore the integrity of the tissue that was lost after the injury.

I now rarely, if ever, offer laser resurfacing as I feel that fat grafting does a much better job at facial rejuvenation. I have been talking about the benefits of facial fat grafting for years and I find that we are doing more and more facial fat grafting procedures as an alternative to facelifts.

Likewise, fat grafting is the perhaps the single best solution to fat loss that occurs following laser resurfacing. If you have had this happen, a fat transfer may be exactly what the doctor ordered!

By Dr. Ricardo L Rodriguez
Board Certified Plastic Surgeon
Baltimore, Maryland
Ricardo L Rodriguez on Google +

Dr. Rodriguez currently serves as President of the International Federation for Adipose Therapeutics and Science (IFATS), a non-profit, scientific organization devoted to studying the properties of adipose fat and related technology.

The illustrations above were created using the skin (layers, glands, vessels) illustration by Don Bliss via Wikimedia Commons.

Posted in Face Fat Stem Cells

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  • wrote
    December 27, 2016 at 11:23 am

    I hope everything turned out right from your carbon peel. By now it has been approximately 6 weeks and things should be stable.
    As I have said before, the solution to this laser damage to the subcutaneous layer of fat loss is to restore the fat.
    You may need fat grafting, but I would have to see pictures or have a virtual consultation with you .
    I will give your info to Kelly at kelly@cosmeticsurg.net
    Don’t despair, there is a solution!

  • wrote
    November 5, 2016 at 9:48 pm

    Hello, I have been doing some research online over the past couple of days, and you are the only doctor that I have run across that admits to the possibility of fat and volume loss from Laser treatments. Have you ever heard of Carbon Peels? If so, how likely is it that someone would experience fat loss with this. I had some damage with IPL in the past, and a lady just talked me into having a carbon peel done, and said it was simple like a chemical peel, but with a light laser. I am very concerned about the some of the ways that my skin is responding. I believe that I have lost even more volume in my face, and when I pinch the skin under my eyes, it sticks together. This has never happened. It has been three days since the procedure. I am hoping and praying each day that life jumps back into my skin. Please feel free to respond to my email thanks.

  • wrote
    October 16, 2016 at 1:39 pm


  • wrote
    September 12, 2016 at 9:32 pm

    Thank you for this information. After reading it I must agree that lasers aren’t the best way to go!

  • wrote
    October 31, 2016 at 9:29 pm


  • wrote
    August 29, 2016 at 10:16 pm

    Grafting is the perhaps the single best solution to fat loss

  • wrote
    October 16, 2016 at 2:01 pm

    I love Yoga!

  • wrote
    August 17, 2016 at 1:49 am

    Thank you for sharing the information about fat Loss. It is very beneficial for all who are little bit or more fat. Yoga is also beneficial for reducing fat.