News & Politics

The Truth About Lasers

Laser treatments such as Thermage and Fraxel are touted as “lunchtime lifts” that take off years. Do lasers live up to the hype?

Laser treatments are the third piece in the new holy trinity of staying young, after Botox and fillers.

Lasers are especially popular among thirty‑ and fortysomethings: A quick blast from a laser can jolt the collagen layer under the skin into firming up jowls or cheeks just beginning to slacken.

Thermage, Genesis, Fraxel Re:pair, Titan—the names of the different laser systems are full of hope, especially when you hear them on Oprah or a makeover show. But what people say in answer to the “Worth it?” questions at, a tell‑us‑what‑it‑was‑like site affiliated with the American Society for Aesthetic Plastic Surgery, is a reality check. Laser treatments get some of the lowest satisfaction scores of any procedure.

It isn’t that laser treatments don’t work. It’s that they don’t work the way hype leads people to expect.

“I had Thermage treatments about nine years ago, just before my college reunion,” a 55‑year‑old Bethesda woman told me. “It was expensive and it hurt like hell, even with the topical anesthetic. I did get some results out of it, but they didn’t show up for several months. The results lasted maybe 18 months. Now you can’t tell I had anything done.”

Says Arlington plastic surgeon Talal Munasifi: “Regardless of what you see on television, there is no such thing as a ‘lunch-hour facelift’ or a ‘weekend facelift.’ ” Still, Munasifi is excited about the possibilities lasers offer for those who don’t need or don’t want a facelift: “With all the new tools, we can offer so much more than before.”

If you’re looking for light firming—getting rid of tiny wrinkles and having the rest look better—you may be pleased by a laser treatment. Doctors say lasers do up to a third as much as a facelift.

“They definitely push back the clock,” says C. Coleman Brown, a plastic surgeon in Chevy Chase. “You can get three or four years out of it, maybe a little less, maybe more.” Brown says that the effects don’t last forever; you have to come back for tune‑ups.

If you are hoping every line and sag will go away for good or that one laser treatment or a package of three or four will be a “lunchtime facelift,” you’ll probably be disappointed. Perhaps angry as well: A package of treatments can cost $2,000 to $5,000 and a single treatment $600 to $1,500, depending on what it is for and whether the location is a doctor’s office, hospital, or surgical center.

If you’re seeking a specific treatment, say hair removal or skin rejuvenation, which laser is best? Is Thermage better than Titan for firming? No medical studies have settled these questions.

Doctors spend $100,000 to $150,000 to buy a laser system that can perform multiple tasks. “You can’t possibly buy them all,” one doctor says. So the physician who purchases the system that includes Thermage will laud that, and the doctor who uses Titan will be equally convinced of its virtues. For the consumer to ask which laser is best is like asking which scalpel is best: It depends on the hands that hold it. Spend more time finding the right doctor.

While I was researching this article, Karen Lawson, an internist in Arlington, used a Cutera LimeLight laser on my hands. I felt short bursts of heat that were at first startling, then somewhat pleasant. During the next three weeks, freckles and spots accumulated during years of gardening without gloves turned red. A day or two later, a tiny blister formed under each freckle. They didn’t hurt, and I had to look hard to see them. Then all the spots literally dried up and fell off.

I had lily‑white hands—until I pulled weeds sans gloves and sunscreen a month later. Even with that, after six months, my hands still look more like those of a Victorian lady than her yard help.

This article first appeared in the February 2009 issue of The Washingtonian. For more articles from that issue, click here.