In short. The fractional laser, microneedling and peel categories for the static crease, what a course involves, and why they come second to the rung that reaches the muscle.
Key points
- Resurfacing the surface of a crease that is still being folded hundreds of times a day loses most of its result, because the folding continues to recreate the groove while the skin is trying to remodel.
- It is the order in which the two rungs support each other rather than working against each other.
Once a crease is visible with the face completely at rest, part of it lives in the skin rather than in the movement. The rungs that work on that part are the resurfacing ones: the fractional laser categories, microneedling, and chemical peels of medium depth.
The categories
Non-ablative fractional laser treatment creates columns of controlled injury while leaving the surface largely intact, which is the gentler end of the group and usually needs more than one session. Ablative fractional laser treatment removes the surface layer as well, which is a stronger effect with a longer recovery. Microneedling creates the injury mechanically, with or without radiofrequency energy delivered through the needles. Medium-depth chemical peels remove a controlled layer of the surface. All four work on the same principle: a controlled injury, followed by the skin’s repair, with new collagen laid down in the area.
A course rather than a single session
These treatments are given as a series, and the honest version of a plan is a range rather than a number: commonly a few sessions at intervals of some weeks, with a plan that may differ according to the skin and how it responds. Recovery differs by category, from a few days of redness to a week or more of visible healing. The result is judged weeks after the last session rather than on the following morning.
Why it comes second to the muscle rung
Resurfacing the surface of a crease that is still being folded hundreds of times a day loses most of its result, because the folding continues to recreate the groove while the skin is trying to remodel. It is the order in which the two rungs support each other rather than working against each other.
Who the plan has to be built around
Skin type matters more than anything else here. Skin that tans easily and rarely burns carries a higher risk of pigment change after injury, and that risk is discussed before rather than after. Active infection or inflammation in the area, recent treatment with a medicine that affects healing, a tendency to form raised scars, and pregnancy are all reasons to wait or to choose differently. Pigment change and scarring are uncommon, and they are the reason these treatments belong with someone who performs them regularly.
Three cautions
- Pigment change after resurfacing is a real risk, particularly in skin that tans easily, and it is discussed before treatment.
- Redness and sensitivity that continue for weeks are reasons to be reviewed rather than to add another session.
- Resurfacing arranged alongside a relaxing injection without a plan for the order halves its own result.
How much of a crease is etched is established in how frown lines are assessed. What happens to the etched part when the muscle rung is used is described in why these lines etch so deeply, and the decision to treat at all is set out in the honest ceiling.
Frequently asked questions
Why is resurfacing not the first thing to do about the line?
Because the crease is still being folded hundreds of times a day by the muscles beneath it. Resurfacing works by producing a controlled injury and letting the skin repair itself, and that repair is undermined while the folding continues to recreate the groove. The muscle rung stops the folding; the surface rungs then work on what is left.
How many sessions does a course involve?
It depends on the category and the skin. The gentler end of the group is usually given as a series of sessions some weeks apart, and the stronger end may need fewer. Any number you are quoted is an estimate for planning rather than a schedule, and your own plan may differ once the skin has been examined and its response to the first session is known.
Is darker skin a problem for these treatments?
It changes the plan rather than ruling it out. Skin that tans easily and rarely burns carries a higher risk of pigment change after any controlled injury, and that risk is discussed before treatment rather than managed afterwards. The category, the depth and the intervals are all chosen with it in mind, and sometimes the answer is a gentler option or none at all.
Risks & Limitations
- Relaxing the corrugator and the procerus also lifts the medial brow, and in a brow that already sits high that lift can become the complaint rather than the result.
- A drooping eyelid, double vision, or difficulty swallowing, speaking or breathing after an injection needs emergency care rather than a wait-and-see approach.
- Resurfacing carries a risk of pigment change and, rarely, of scarring, and its result is judged weeks after the last session rather than on the following morning.
- No rung removes a crease that is established in the skin. A line that is visible at rest usually softens, and any statement that promises more should be treated with suspicion.
When to Seek Care
- Difficulty breathing, chest pain, or difficulty swallowing or speaking after an injection needs emergency care immediately.
- A drooping eyelid, double vision, or an eye that will not close fully after treatment.
- Weakness or numbness on one side of the face, or a brow that has dropped on one side.
- A crease that has appeared or deepened over weeks rather than years, or any change in vision on one side.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.