In terms of results, carbon dioxide laser resurfacing remains the gold standard. Ward and Baker1 have presented an excellent and needed retrospective review of the long-term results of carbon dioxide laser resurfacing in 47 patients. Using a scale described by Lemperle et al2 in 2001, they reported a mean improvement of 45% in the facial rhytid score. They also reported decreased efficacy in treating perioral rhytids and, in agreement with other authors,3,4 ascribed the decrease in efficacy to muscular activity in the perioral region. This phenomenon is also seen during treatment of lateral canthal rhytids, which have a substantial muscular component.
Carniol PJ. Is There Still a Role for Carbon Dioxide Laser Resurfacing? Arch Facial Plast Surg. 2008;10(4):244–245. doi:https://doi.org/10.1001/archfaci.10.4.244
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