Why Laser resurfacing can cause facial fat loss

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

The laser destroys the top layers, your body sends signals to rejuvenate the area.

While laser skin resurfacing can be an effective method for prompting a 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, actually recommend or use laser resurfacing for facial rejuvenation these days. Why? Because with laser resurfacing, regeneration of the skin is prompted by destruction and that destruction can also cause fat volume loss. Instead, I use facial fat transfers (aka, fat grafting).

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. To learn more, listen to the audio here or continue reading!

Lasers can trigger a process called apoptosis, aka cell death. Fat transfers do not destroy cells.

-Ricardo L Rodriguez, MD

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.

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

Something that is designed to tighten your skin can actually end up causing damage further below the skin and to the fat tissue that’s right under the skin . . . ultimately resulting in a loss of volume. Hear me speak about it.

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.

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 even months after the original injury. So patients who have had laser, or patients who have had radiofrequency, or patients who have had CoolSculpt, will continue to have subcutaneous fat tissue loss as a result of that.

How to correct facial fat loss after laser resurfacing?

An illustration of fat injection subcutaneous planes.

The best 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 from the laser.

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!

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

Want to learn more about your options?

Contact Us to schedule a complimentary in-office consultation or consider a virtual consultation for just $75 (which gets applied to your surgery when you book). Or just give us a call at 410-494-8100!
Note: Virtual consults can also be used to get second opinions.

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.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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82 thoughts on “Why Laser resurfacing can cause facial fat loss”

  • Sunny says:

    Thank you so much for this information. You are truly ahead of your time. I have intuitively felt this to be true and have observed so many women appearing gaunt not too long after radio frequency and some lasers. I myself have had issues with my neck after a few treatments. Most Practitioners are not aware of these facts as of yet. Fat transfer makes more sense. I am also concerned about the vaginal thermal lasers causing more strife in the long term. Lastly, would you have any information on red light therapy? I am in the LA area or I would run to your office. Again, much thanks.
    • Dr. Ricardo L. Rodriguez says:

      I have not seen many complaints about Red Light Therapy, perhaps because it is a low frequency mode. I don"t like Lasers and don"t use them as I think they can be unpredictable as far as results. Secondly, a perceived skin laxity is more often than not loss of subcutaneous volume, for which the solution is fat grafting, not tightening the skin.
  • Emma Clark says:

    Hi doctor, Thank you so much for this article. Could you possibly recommend a surgeon in London who specialises in fat transfer post-laser damage? I have had two previously unsuccessful procedures. Kind regards, Emma
    • Dr. Ricardo L. Rodriguez says:

      There is a great guy and very prominent fat grafting scientist in Marseilles, France named Guy Magalon MD. I recommend you Google him and visit him. Fat grafting is very technique dependent.
        • Dr. Ricardo L. Rodriguez says:

          You should inquire with breast reconstruction surgeons, as some of them use fat grafting
  • Lisa says:

    Dear dr Rodrigues I am based in london and had radio 6 frequency treatments in February this year. About 2 months ago I started to notice that I have fat loss in my face. I am distraught and although done research for plastic surgeons in london that are aware of this issue with RF I don’t seem to be able to find one that doses do you happen to know any Uk based plastic surgeons that I could contact or what else I can do as I’m terrified my face is going to continue to lose fat and want to address it befor it goes to far. Kind regards Lisa
    • Dr. Ricardo L. Rodriguez says:

      I don"t know what to tell you, as I am not familiar with the Plastic Surgeons in London or who is good at fat grafting there. There is a great guy and very prominent fat grafting scientist in Marseilles, France named Guy Magalon MD. I recommend you Google him and visit him.
  • Belinda Osmond says:

    I under went co2 laser surgery 2 and a half years ago, it has had a catastrophic effect on my skin, and face, my face deflated shortly after the procedure, and have been left with damaged sebbaceous glands, my skin cannot retain any moisture and have developed acne since the procedure and nothing seems to heal since the treatment I have permanent burning, itching sensation, I believe it has damaged my blood vessels as any change in temperature , causes sever flushing and my skin has literally bled on occaasion, I now have scaling on the whole of the area that was treated, everything causes it irritation and it hurts trying to move my face, the scaling also spread to my lips shortly after the procedure, and I have exfolitive chelitis now also. I dont know if it would be wise to have any further treatment, but wondered if a fat transfer would improve the condition of my skin. Have you ever come across anyone who has had this terrible reaction, if so would be glad for any advice, or could you put me intouch with anyone who could help me. I had previously sensative but healthy skin before this procedure. All the doctors I have visited are in denial that the laser can do this sort of damage.
    • Dr. Ricardo L. Rodriguez says:

      The reason I wrote this article in the first place is because in the late 90"s I had a few patients OF MY OWN who developed exactly these problems after laser "rejuvenation". Needless to say I quit doing lasers then. 2-3 years later I started learning about fat grafts and about the regenerative power of the stem cells residing in the fat grafts. The fat grafts have to be processed in very specific ways to retain the viability and activation of those stem cells. There are scientific societies (IFATS is one of them) that focus on this and there is plenty of clinical and research work being done in this area. Fat transfer will definitely improve your situation, but it has to be done by somebody who can process the cells correctly. Check out the many other blogposts I have on fat grafting. Laser CAN and DOES do this type of damage and fat grafting properly performed can help you.
  • Mark says:

    Hello doctor , I am from France I underwent a radio frequency procedure to treat acne scars 3 months ago and since my face has lost weight and I have a worsening of my acne scars what is the treatment for this? I"m only 26 years old thank you doctor , iam really worried.
    • Dr. Ricardo L. Rodriguez says:

      I would recommend to you that you visit Dr. Guy Magalon in Marseilles. He is an authority in Fat Grafting and PRP. He will be able to help you.
  • Melanie says:

    Hi Dr, does a laser like erbium 1540 also potentially cause facial fat loss due to DAMPs. Im 31.. had this treatment done. Now I"m afraid.
    • Dr. Ricardo L. Rodriguez says:

      Don"t be afraid unless you really start noticing fat loss. Most women I have seen with fat loss are near menopausal age. You are not even close to menopause age. Enjoy the Day!
  • Rima says:

    Hi. I had 5 rounds of invasive lasers and lost the fat in my face. It has been a year since my last laser. I recently did fat grafting which helped with my under eye and cheeks. It has been 2 months now since my surgery. I’m fearful the laser is still attacking my face and my fat grafting will go away. I’m also realizing the laser has affected my nose and that’s something that was not addressed with the fat grafting. What can be done for a nose? Also, what can be done for eyebrows? I’m 34 years old. Do you think my fat loss has stopped?
    • Dr. Ricardo L. Rodriguez says:

      Hard to say, but another possibility is that the fat grafting may be reabsorbing. The viability of fat grafts is heavily dependent on the methods used to harvest and process the fat. You should do more fat grafting from somebody who really takes care about graft harvest pressures, graft size, injection cannula, etc. We can also graft the nose. Anyways, contact leeza@cosmeticsurg.net if interested in a virtual consult
  • Vio says:

    Hi Dr, I have a question. Iam looking into fat grafting now, due to my fat lost, from laser. I spoke with a surgeon and said to wait till the fat lost has stopped, is this correct or can I do fat transfer now?
    • Dr. Ricardo L. Rodriguez says:

      The fat graft has stem cells in it that helps reverse the process of fat loss. Therefore i see no problem and in fact recommend doing the fat grafts whenever convenient for you. Fat grafting is highly technique dependent and you should really concentrate on finding a surgeon that does the right technique. This includes 1) Low suction pressure 2) Harvest with a small cannula to get fragments 1-1.5 millimiter in diameter or less 3) proper fat processing- I centrifuge at low speeds and for short time 4) Injection with a small cannula that is pretreated on the inside to minimize shear damage to cells. Small fragments also have much better chance of survival once injected into the tissues. Please look in my website, I have previous blogspots where I speak about fat processing. Let us know if you need more info.
  • Vio says:

    Hi Dr. Ricardo, I have a question regsrding the fat volume lost. Will it keep on going till all the fat is gone ? Or will it stop? It’s been a yeAr since I had my laser procedure and I have had lots of fat lost, and Iam scared it’s going to be on going.
    • Dr. Ricardo L. Rodriguez says:

      I do not know how long it takes, I think it has a lot to do with age and hormonal changes. But I do know fat grafting halts the process because the new grafted cells regenerate the damaged tissue. Well performed Fat grafting is a real answer for those who have had fat tissue loss due to aging, laser, trauma, etc.
  • Taylor says:

    Hi Dr, I am 21 years old and recently got a profractional laser procedure done for my acne scars. I have been reading your blog and am getting very paranoid about the possibility of facial volume or fat loss happening to me. I believe I have thicker skin that looks plump and healthy and do not want this to change. I was wondering what is the possibility of this happening considering my age, and considering the type of laser, which I believe profractional is not as invasive as Co2. Is the volume and fat loss a rare occurance and mostly because of a certain age range/agressiveness of the procedure and skills whoever is performing the procedure? The place I got mine has high reviews and takes many precautions. Also, how many patients did you experience this when you did laser and what were their attributes, ie age, skin type, etc. and if that matters. Thank you for your time.
    • Dr. Ricardo L. Rodriguez says:

      I think it has to do with age, and being close to menopause. I have seen it with both CO2 and Fraxel. But if you are 21 you are young and you have good regenerating cells. Should you start experiencing fat loss, let us know and we can help you, but if you have not started experiencing it yet I would bet you are safe.
  • Viola says:

    Hi Iam 39 years old and I had laser resurfacing in November 2018. I am having lots of fat lost/volume lost it’s been already over 4 months now, Iam so worried it’s going to continue. Can the fat lost continue more then 4 months.??? I have so much anxiety over this.
    • Dr. Ricardo L. Rodriguez says:

      My apologies for the late response. Our web site was redesigned and these comments somehow were not on the answer queue. It has been 9 months since you wrote this. How are you doing now? I hope everything has stabilized. I do know that a properly performed fat grafting (careful harvesting, small particle size, etc.) definitely will help. Let us know if we can help you.
  • Kay Alexander says:

    I have loss of volume in my face and in my nose. It made the scars show up on my nose. Will the volume come back in my face and nose own it's time without treatment? Kay Alexander Lubbock tx
    • Dr. Ricardo L. Rodriguez says:

      Kay: My apologies for the delay. Our website was redesigned recently and questions to the blog were not readily apparent for review. I do not think your facial fat will come back on it"s own, but if it does let me know as it will be a good think to know and something I can write up on the blog to offer hope to others who may have the same problem. If you still have the same problem, a properly performed fat graft will help. Fat grafting is very technique dependent and you should be careful of choosing the right surgeon. Important things are delicate harvest, small particle size and meticulous injection technique.
  • Jared says:

    Hi. You mentioned chemical peels would not cause fat loss, as "chemical peels act directly on contact, so their effect does not go beyond the peel layer". What do you think of Microneedling (can this cause fat loss)? Many thanks.
    • Dr. Ricardo L. Rodriguez says:

      Jared: Chemical peels have their dangers too. If they goo too deep, they can cause skin depigmentation or even worse, hypertrophic scarring. As for micro needling, it does not destroy tissue, rather it separates, or disrupts tissue. It "tricks" the regenerative cells to initiate a healing phase without an inflammatory phase. I do not use micro needling, but I think it is a good technique.
  • Rosalyn Drage says:

    I feel I need to share my story to someone who understands. I have extreme volume loss, a misshapen face and more wrinkles do to ablative co2 laser on my face neck and chest. For 2 months my face inflated then deflated and I thought this was a natural process as my face was building new collagen. Then my face continued to deflate and I had my skin literally hanging off my chin. I panicked and got on line to find anything that would plump up my face. I ended up ordering collagen jel/creams which were delivered overnight. They actually worked. Also I use vitamin c and hydronic acid. But it’s very interesting if I do not use them my face goes back to being deflated. So I know my face isn’t building new collagen. I will eventually need to find something more permanent and maybe fat graft are the answer. Absolutely no doctor post volume and fat loss as a compilation. Laser can be so damaging.
    • Dr. Ricardo L. Rodriguez says:

      Rosalyn: I definitely understand and you may find fat grafting to be the permanent solution you need, but I would need to see photos or have a virtual consultation to advise you. If you would like to discuss your specific situation with us, please email Kelly, our patient coordinator (kelly@cosmeticsurg.net). Don"t give up, help is available!
  • Michelle martine says:

    Hello - About 30 years ago when I was 30 I had an acid peel. This was very effective to remove layers of sun damage. I don’t think this is even used now. Three years ago I had a co2 and thermage laxer supposedly to firm my skin. It did not really work. My skin does look nice but it is sagging. I had a halo laser and a Pico laser since then and I felt the halo did not do a whole lot for me - I actually felt more result from the lighter Pico laser. I do realise I am 61 but I am wondering if these lasers may have effected the fat in my skin and what can I do now living in Australia. Thank you regards Michelle ?
    • Dr. Ricardo L. Rodriguez says:

      Michelle: Apologies for the delay in reply. My website was being redesigned and these comments were unavailable for a while. It seems you have indeed had subcutaneous fat loss from Laser. Laser manufacturers and practitioners deny it but all you have to do is look at the responses to may post to see that this is a true phenomenon and not just chance. You can have a properly performed fat graft that will aid you and restore the lost fat volume. Seek someone who has specialized expertise in fat grafting- i.e. someone who devotes a large part of his practice to it. Successful fat grafting is very technique dependent.
  • Kay Alexander says:

    Have scars on face, large pores, volume loss, and tethered skin in alarm crease of nose. Had microlaser peel 20 microns 2/2017, dermapen treatments 2.0 12/2017, 2/2018, and 4/2018. Would you know which may have caused the damage or did all contribute. It seems to continue damage, when will it stop? Appreciate your help. Thanks Kay A. 806-22
    • Dr. Ricardo L. Rodriguez says:

      Kay: Our apologies, we had a web redesign and the blog comments have been unavailable until now. Are you still having this problem? As you have read in the blog, this does have a solution- fat grafting. But the procedure has to be done very carefully to be successful. A fat graft will not survive if done improperly. Anyways, let us know, even if you had the problem solved. We want to keep track of this problem as we think it is underreported.
  • Kay Alrxander says:

    I had a microlaser peel 20 Micron in Feb 2017 and 3 dermapen 2.0 Dec 2017, Feb 2, 2018 and last one on April 13, 2018. I had healing problems, and July 2018 and started getting some scars and volume lose. I had revision rhinoplasty 2004, and my nose shows a lot volume lose with scar on areas of my nose and tethering in the alarm crease where internal graft was placed. Do you think it was the laser or dermapen that did damage or both? I can"t anyone to help , and would appreciate your help. Thank you Kay A Lubbock Texas 806-224-8673
  • Hope Unterschuetz says:

    Pertaining to DAMP, when the cell dies does the whole cell get removed by the body or just the cell contents?
    • Dr. Ricardo L Rodriguez says:

      The cell is completely processed by inflammatory and scavenger cells so the entire cell (broken up into smaller units) is eaten up by other cells.
  • ScienceBecomesHer says:

    This is such great information. I rarely see practitioners reporting facial fat loss as a side effect of laser treatments. It raises the question of informed consent, as patients need to be aware of all possible side effects, no matter how rare! Studies suggest that a lot of people have unrealistic expectations with lasers and radio frequency treatments as they are often marketed as 'non-surgical facelifts'. This is misleading and leads to patient dissatisfaction. I have had the laser genesis treatment to improve mild acne. While it did improve my mild acne, I now have more noticeable expression lines on my forehead. I thought that it was a coincidence until I read your article. I have read many accounts of people losing facial fat volume after radiofrequency treatments, which doesn't seem surprising considering the same treatment is marketed for fat loss on the body. It inspired me to look into the research behind radiofrequency treatments which I have tried to summarise here: https://sciencebecomesher.com/facial-fat-loss-after-radiofrequency/ Thank you for your informative article and bringing this issue to public attention.
  • Victoria says:

    Hi. I'm 30 and just had co2 fractional laser resurfacing. I'm currently on day 4 and am reading about how the laser makes you lose facial fat and am starting to get really worried. I have nice plump skin and don't want to lose fat. I asked the PA who did it and he said I won't lose any. I read it usually takes a year before you notice the fat loss. Is there anything I can do in the meantime so that I don't lose any just as a safety precaution? Thanks
    • Dr. Ricardo L Rodriguez says:

      Sorry to get to you so late, but how is it going with your facial volume? You are young, so I think you will be OK, but let me know!
  • Sarah says:

    I am devastated by what two laser genesis treatments did to my face. They told me all these great things would happen but what happened is that I lost all my facial volume. It is only been 2 months and I am terrified to see what will continue to happen now. The volume loss was dramatic and began to show up within 2 to 3 weeks. Now when I make Expressions there is so little flesh underneath the skin to support it. All my skin piles up and makes deep lines across my forehead and across my upper cheek bones where I used to have fat pad. I had the most beautiful lines in my face and now it is just all flat and I don't look like myself at all. It even made my nose look bigger and relation to my face and my jaw is sharper and angular. I am devastated because I am not a candidate for the permanent fillers due to medications I am on and I cannot afford fat transfer. I'm not sure what to do, I am just miserable every time I look in the mirror or take a photograph. I was doing pretty well for 50 years old and was often mistaken for being 30, but that won't happen anymore. I look just like my 70 year old mother now as far as facial volume goes. I didn't do this procedure because I am vain. I have put off doing anything to my face for a very long time, but its long history of medical issues and medications and the son had done some damage and this was what was recommended. I went to the Laser Clinic because they still have $400 of my money and they try to lie to me over and over and say the lasers couldn't do this to you, but I know it did. I can still feel a strange tightness under my forehead and when I touch my face I don't feel any of the flesh that used to be there, I just feel skin and bone. I looked into getting temporary fillers but they said it would be a waste of money because I would keep having to do it over and over, and I'm afraid of the risks of hitting an artery and affecting my vision permanently. The last thing I want to do is add one mistake on top of another. I was trying to keep my appearance up because my fiance is 10 years younger than me, and I don't like being mistaken for his mother, since he also looks younger than he is, but I guess I'll have to get used to that now. This has been very depressing.
    • Dr. Ricardo L Rodriguez says:

      Sorry to get to you this late after your surgery, I do not use this blog as a patient contact form. But definitely I can help you with fat grafts, and I have done it for several patients already. Ironically the first few were my own patients from when I used to do laser. I have stopped doing Laser completely. Fat does regenerate and rejuvenate the tissues. It will thicken the sink and restore subcutaneous volume. Call us, we can help you. Contact leeza@cosmeticsurg.net
  • bradd says:

    Hi i stumbled upon this via google from researching treatments to restore volume loss in my mid 30s. are there any lasers or light sources in your knowledge that dont cause this effect of fat atrophy ? or that can even cause fat cells to grow ? can prp and microneedling effect fat cells to grow ? is there anything that can be used with or staggered in treatment with fat stem cell transfer to help the body make its own new fat cells ? thank you for your time.
    • Dr. Ricardo L Rodriguez says:

      Stem cell production is age dependent. So is potency of the Stem Cells. Any energy source directed at the subcutaneous tissues has the potential of causing "apoptosis" (Programmed cell death) of the subcutaneous tissues. I have seen it mostly in premenopausal women, but also in some women in their thirties. The best answer is the old plastic surgery saying: Replace like with like. In the case of fat the best replacement is fat, with the added attraction that it has stem cells in it to help stimulate rejuvenation of the tissues.
  • Hil says:

    I had 1 session of Fractional RF October last year, and 2 dermapen (no heat) treatments earlier this year and noticed 2 months ago that a wrinkle had sprung up overnight on the right side of my forehead. I'm only 29, always wear sunscreen & before this had many people ask what I use because my skin was great/had no fine lines. If I run my fingers over the area it does appear to be mild volume loss. You seem to be one of only two doctors I've found that admit these devices cause volume loss, thank you for writing about it. Currently, it seems that only one area on my forehead was affected; in your opinion should I expect it to get worse or for other areas to start losing volume? How long after the treatment can apoptosis go for? Thank you for your help
    • Dr. Ricardo L Rodriguez says:

      Hil: Difficult to predict what will happen. I think volume loss is more common at the perimenopausal age group. Your volume loss is probably done by now. But in the future, for skin rejuvenation think more fat grafting than laser. Fat grafts have stem cells in them that actually rejuvenate the skin.
  • Emily says:

    Hi Dr. Rodriguez, Thank you so much for this information. Up until reading all the information on fat loss caused by lasers, I had been considering IPL or VBeam but now I am not. However I have broken capillaries on my face and was wondering if there was anything you could recommend? Thank you in advance.
    • Dr. Ricardo L Rodriguez says:

      If you have broken capillaries, there are lasers specifically tuned to the wavelength that affects blood vessels. Consult with a laser specialist that does not do a lot of cosmetic procedures. Cosmetic laser dermatologists tend to push a lot of skin tightening procedures. Don't go for a modality that treats a large patch of skin, go for something that is very targeted at the blood vessels.
  • Juliana Micklos says:

    I had some broken blood vessels and the spa recommended an IPL. The technician told me she was turning up the volume for treatment but wouldn't go deep. I ended up with burns, and now have scars, fine lines, orange peel and fat loss. I noticed over months my skin kept looking worse. I read your post about DAMPS, so I decided to post. My first and only experience with a laser, broad wave band...what can be done to improve the texture? Thank You?
    • Dr. Ricardo L Rodriguez says:

      Juliana: I would recommend fat grafting as the stem cells in the fat graft help resolve scar and regenerate healthy tissue. Be careful as to who you choose for fat grafting. Technique is crucial to success. The important factors are low suction pressure, use of small cannulas both for harvest (3mm) and injection (2mm), and processing of fragments to get 1mm diameter fragments. Injection has to be done in very small droplets. It is time consuming. If you want more info contact us at contact@cosmeticsurg.net Thanks!
  • Valerie Austin says:

    Can chemical peels also lead to fat loss? I trust your input on lasers and I value your response on chemical peels. Thank you.
    • Dr. Ricardo L Rodriguez says:

      Valerie: Chemical peels act directly on contact, so their effect does not go beyond the peel layer. Laser and ultrasound, being energy sources have their maximum effect at a designated point, but there is an area of decreasing effect radiating outward. It is these areas of decreasing effect that cause problems, because they are damaged tissue that remains and must be dealt with. The damage is caused by the response of the body to the damaged tissue.
  • Maria says:

    Hello, Last year I had a cuople of sesions of laser fraxel repair and restore with a machine called Lynton Award Winning Fractional Laser machine ( that what they said). I experienced fat loss on my cheeks and on my temples a couple of months later, everybody told me what happened to me , they think I have loss weight and Im afraid it was because of the laser. They told me that this is imposible but I don't believe it, because many years ago my dentist applied a laser ( I don't know what kind of laser was that ) on one of my cheek to lower the inflamation he caused to break my tooth and I lost fat on that cheek!. I feeling very depressed, I had panic attack thinking that this might be getting worse. I looking for a solution. I live in the Uk.
    • Dr. Ricardo L Rodriguez says:

      Maria: Yes the fat loss is related to the Fraxel. I have seen it in my own practice and it is why I stopped using Laser. The solution is Fat grafting. Check out our other blog posts on fat grafting to see why it is very important to check that the surgeon processes and injects the fat correctly. Your solution exists, and it is correctly performed fat grafting. Contact Kelly at kelly@cosmeticsurg.net for more info.
    • Vio says:

      Hi Iam having the same issue. How has it been for you has youre fat lost stopped ? Mine is on going it’s been a year for me? Iam so depressed Iam afraid it’s never going to stop.
    • Vi says:

      Hi Maria I wanted to know how you are doing. ? I have the same problem but it’s been a year now and I still see fat volume lost , has you’re stopped?
      • Dr. Ricardo L. Rodriguez says:

        Maria and Vi: Please let me know how you are doing. I think this subject is under appreciated and Laser companies as well as practicing physicians have an interest in not having this subject discussed publicly.
        • Vi says:

          Hi this Vi. I am not doing good. Mine is still on going. It has not stopped. I am thinking of getting fat transfer, but afraid of choosing the wrong surgent. I live in LA. Do you recommend anybody? I just have been depressed over this.
          • Dr. Ricardo L. Rodriguez says:

            Check out Dr. Steve Cohen in San Diego, or Brian Kinney in LA
  • Hope says:

    I had co2 laser done under my eyes. Everywhere the laser hit it left a deep permanent mark. However, the worst thing to come out of the procedure was the significant fat/volume loss all over my face. I even think it did something to my nose, but from what I have read the nose doesn't have fat. My question is how are the companies who make these lasers allowed to keep marketing and selling them as if they don't kill fat? I live in Oklahoma and none of the plastic surgeons will admit it causes fat loss. I knew I wasn't crazy. I'm not understanding why the FDA hasn't stepped in. I wasn't even warned that fat loss was a possibility.It's hard to get help when there is no documentation or drs in the area to be experts on the subject.I am now considering fat grafting,I am going to contact your office to see how things work with out of state people. Thanks for your article!
    • Dr. Ricardo L Rodriguez says:

      Hope: I don't think many surgeons are aware of this and it doesn't happen on every patient. But it happened to me twice in the early 2000's and it was a shock to me when it happened. Since then I got rid of my Laser practice. Fat grafts are very effective in restoring the tissue defects and rejuvenating the skin. I do both clinical and lab research on this and can assure you the effects of fat grafting on the tissues are real and well documented. We have many patients from out of town, so I encourage you to visit. Contact kelly@cosmeticsurg.net and we can set up a virtual consultation with Skype or FaceTime. Looking forward to a consultation!
  • Catherine says:

    Wouldn't the type of laser or radiofrequency device differ in their affect on fat, related to the fluence of the laser or the type of penetration? Ulttherapy skin tightening, for example, I would expect to have some impact on the subcutaneous fat. But why would something that doesn't penetrate past the dermis - like clear + brilliant, lasergenesis, even light based like IPL affect the fat cells? Is the mechanism you're suggesting that if any layer of the skin creates DAMPS that it triggers DAMP cascades in other layers nearby that weren't directly affected by the laser? I'm interested in getting IPL and have been considering clear+Brilliant or lasergenesis but wanted to clarify first so as to not worry about fat loss. If that is the case I'd prefer to avoid! Also I'm a biochemist and this is really interesting. Thanks for sharing.
    • Dr. Ricardo L Rodriguez says:

      Catherine: The more superficial a laser is, the less damage- but also the less effect on the skin. IPL's are a little different because they target specific pigment types. But my general point is that most energy based therapies work by injuring the tissue in one way or another then creating an inflammatory response followed by a regeneration response. The new "collagen" formed is not the elastin type but predominantly the collagen associated with scar tissue. The ultimate aim of all these therapies is to make the skin BE younger so it will appear younger. That is why I love fat grafting. The act of liposuctioning activates the stem cells in fat tissue, and if you process the fragments carefully, when they get injected into solar damaged or aged tissue the stem cells trigger a regenerating response that actually replenishes and rejuvenates the tissue. Many studies have been done to show increase in dermal thickness and restoration of elastin fibers, both characteristics of younger skin.
  • Kathryn says:

    I have suffered fat loss from just one fraxel treatment. I am shocked!. Is microcurrent, as in a microcurrent facial damaging as well? And if I may ask what machines use radiofrequency?
    • Dr. Ricardo L Rodriguez says:

      Kathryn: At this point the solution to your problem is not more machines, but restoring what you lost. What you lost is fat, therefore you would benefit most from fat grafting to the face. In addition to the restoration of volume the stem cells in the fat graft will regenerate the tissue and make your skin younger and more healthy. Be very careful about who does the fat grafting, they should use very specific methods to process and purify the fat.
  • Toni says:

    I did profractional laser with 25 microns. I didn't experience fat loss, maybe bcs it's not deep. It's good to know that laser can cause fat loss so we don't go for deep treatment. Thanks.
    • Dr. Ricardo L Rodriguez says:

      Toni: Not everybody loses subcutaneous fat with CO2 laser. But when it does, it's a big headache.
  • Amber says:

    Thank you for your sharing of information! I believe that volume loss has started since getting fraxel laser 1 week age. Is there a way to stop the apotosis process to prevent further loss? Please advise. I am willing to try anything to stop it.
    • Dr. Ricardo L Rodriguez says:

      Amber: Sorry for getting back at you so late. This blog is more for giving out information than as a social network so I check it out only once in a while. At this point, your best option might be fat grafting. The stem cells in the fat graft will not only replenish lost tissue but also rejuvenate existing tissue.
  • Robert says:

    Hello, I have come across this because I had a very strange experience after laser hair removal on my face. I'm 39 and I just wanted to stop shaving and to get rid of the 5 o'clock shadow. I went to a board-certified dermatologist to have this done. I only had 2 sessions and 2 and half weeks after my 2nd session, I noticed a wrinkle or laugh line. I had absolutely no wrinkles or laugh lines before this. None. I noticed this immediately. It seems to have gotten marginally better since the day I noticed it but it's still not anywhere near where it was before. Like I said, I had nothing. I'm starting to believe that this was because of some sort of volume loss (which I guess is the same as fat loss). I went to the doctor yesterday and showed him. He said that he didn't think it was because of the laser. It is. There is no doubt about it. I've never had this before and now it's there, all of a sudden. It was 100% because of that. Anyway, he said that he has seen fat loss because of laser hair removal before but those cases were when the settings were extremely high and were accompanied by burns on the skin. I did not burn in any way but I must admit that the first session, in particular, was very, very painful. Again, I didn't get any burns or anything but I did experience folliculitis for a couple of weeks. The second session was also somewhat painful but nothing like the first. I think that this may have caused this wrinkle that I'm seeing. Maybe it resulted in some fat loss or something. So, I have a couple of questions, if you don't mind: 1. Could this be just temporary fat loss and can my body replenish it in time? Could it be that the actual cells weren't damaged and it was temporary fat/volume loss? I've read that laser hair removal is a relatively minor procedure. It's so hard for me to fathom that it could cause permanent damage such as this. 2. If I ever were to do a fat transfer, would that solve my problem? Is this a temporary fix that will eventually wear off or will my body just accept it and pick up where it left off before the laser hair removal? I'm sorry for the length of this post but would like to thank you in advance for your time.
    • Dr. Ricardo L Rodriguez says:

      Robert: The first thing to do after any treatment is to wait for at least 2-3 months to see what the ultimate results are going to be. We have seen a lot of cases of fat loss after Laser, and for that reason I got rid of my own Laser service. Fat grafting does have stem cells in it which would help rejuvenate the skin and thicken the dermis. As to you in particular, If you want a more specific answer I would need to know more. You can contact Kelly at kelly@cosmeticsurg.net if you are interested in a virtual consultation. Thanks for looking us up!
  • Virginia L Nahass says:

    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.
    • Dr. Ricardo L Rodriguez says:

      Virginia: 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!
  • Nancy Harrigan says:

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