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Laser skin rejuvenation (Er:YAG and Nd:YAG) in Istanbul
For fine lines, mild laxity and uneven texture without surgery. This page explains the four laser steps, how many sessions are usual, what recovery feels like and what the evidence shows.
- Treatment time Varies with the areas treated
- Hospital stay None: you go home the same day
- Time in Istanbul Short stay per session; a course needs repeat visits
- Back to work Usually the same day; redness can last 1–2 days
What is laser skin rejuvenation?
Laser skin rejuvenation here is a non-surgical protocol combining two lasers, Er:YAG (2940 nm) and Nd:YAG (1064 nm), in four steps in one session: first from inside the mouth, then on the skin. The heat aims to tighten collagen and prompt new collagen, softening fine lines and improving texture and mild laxity. It is not a CO2 laser and does not lift like surgery. Most people need no anaesthesia and resume daily life the same day, sometimes with redness for 1–2 days. Op. Dr. Bilgehan İlker usually plans 4–6 sessions.
What it can do
- Soften fine lines, especially around the mouth
- Help soften the folds running from nose to mouth
- Improve skin texture and tone gradually
- Help mild laxity look firmer
What it cannot do
- Lift sagging skin the way a facelift does
- Remove eye bags; eyelid surgery treats those
- Reduce facial fat: no independent study supports this
- Fill deep hollows or replace lost volume
Is it right for you?
Suitability depends on your skin type, concern and medical history, and is confirmed at an in-person examination.
Usually a good fit if
- Fine lines, particularly around the mouth
- Mild laxity rather than marked sagging
- Uneven texture or tone
- Wanting a non-surgical option with little downtime
Better to wait or consider alternatives if
- Marked sagging or deep wrinkles, where surgery may serve you better
- Active acne, a skin infection, sunburn or a fresh tan
- Pregnancy or light-sensitising medicines: discuss these first
- Expecting the result of a surgical lift
Techniques
Four steps run in a fixed order, each heating a different layer. The protocol is known commercially as Fotona 4D.
Step 1: Er:YAG inside the mouth
Non-ablative Er:YAG warms the lining of the cheeks and lips to tighten collagen around the mouth.
Best for
Lines around the mouth
Step 2: Short-pulse Nd:YAG
Heats deeper in the skin without breaking the surface, prompting new collagen.
Best for
Overall skin quality
Step 3: Deep Nd:YAG
Long pulses heat the skin deeply, aiming for gradual firming.
Best for
Mild laxity
Step 4: Light Er:YAG peel
A light, controlled peel of the outermost layer.
Best for
Fine lines and texture
Op. Dr. Bilgehan İlker
Specialist in plastic, reconstructive and aesthetic surgery
- Specialist training: Dokuz Eylül University
- Medical degree: Trakya University
- Health tourism authorization: ST-2657
- Dr. İlker speaks English and Turkish.
How Dr. İlker approaches laser skin rejuvenation
Op. Dr. Bilgehan İlker is a specialist in plastic, reconstructive and aesthetic surgery, trained at Dokuz Eylül University. She counts this laser among the non-surgical treatments she uses most and treats the face and neck as a whole.
Because the final step is a light peel, she prefers autumn and winter for a course; daily sunscreen matters in any season.
- Matched to the stage of ageing Laser suits skin quality and early laxity; marked sagging needs other options, including surgery.
- Combined when it helps For wrinkles she often adds anti-wrinkle injections and RF microneedling.
- A planned course Usually 4–6 sessions, 2–3 weeks apart, reviewed as your skin responds.
The treatment, step by step
Each session follows the same order.
-
Consultation
Skin type, sun exposure, cold-sore history and medicines are reviewed, and the areas to treat are agreed.
-
Preparation
Your skin is cleansed and your eyes are protected.
-
Inside the mouth
The first step brings building warmth and brief hot pricks, usually without anaesthesia.
-
On the skin
Two Nd:YAG steps heat the deeper layers, then a light Er:YAG peel finishes the surface.
-
Finishing
Moisturiser and sunscreen go on and you return to your day.
Your days in Istanbul
Each session needs a short stay; a course of 4–6 sessions means repeat visits.
-
Examination
Before your first session
Arrive in time for an in-person examination; suitability is confirmed then.
-
Session, then your day
Treatment day
No hospital stay. Keep your skin out of the sun.
-
Next dates
Before you fly home
Redness after an intensive session can last 1–2 days. Agree your next date before leaving.
Recovery, day by day
This is the typical pattern; yours may differ.
- During the session
Warmth
Building warmth and brief hot pricks.
- Hours 0–24
Pink and warm
Skin looks pink and feels warm. Keep it out of the sun.
- Days 2–3
Settling
Redness fades.
- Weeks 1–2
Daily sunscreen
Protect your skin every day; the next session is due at 2–3 weeks.
- Month 1
Course continues
Changes build gradually with each session.
- Months 1–3
Fuller effect
Tightening, which can be noticed within weeks, builds over about 1–3 months as collagen remodels.
- Month 6 and beyond
Maintenance
One small study found benefit 6 months after the last session; maintenance is planned case by case.
Contact us straight away if you notice
- Blisters, or skin that looks burnt
- Pain that increases instead of settling
- Discharge, crusting or fever
- Redness beyond a few days, or new dark or light patches
- A cold-sore outbreak near the treated area
In an emergency, call your local emergency number.
Aftercare at home
- Use sunscreen every morning, even when cloudy
- Moisturise as advised
- Avoid sunbathing and tanning during the course
- Let any flaking come away on its own
- Report blisters, crusting or lasting redness promptly
Risks and how they are reduced
Studies of this protocol are small and reported no serious side effects; these are the general risks of laser skin treatment.
Risk is reduced by assessing your skin and history first, protecting your eyes, setting the laser for your skin, planning for cold sores and strict sun protection.
| Risk | How often |
|---|---|
Redness and warmthExpected; can last 1–2 days after an intensive session. | Common |
Pigment changeDarkening, or rarely lightening, of treated skin; more likely in darker skin. | Varies |
Cold sore flareHeat around the mouth can reactivate cold sores; preventive medicine may be advised. | Varies |
Infection or acne flareListed risks of laser skin treatment; report discharge, crusting or fever. | Varies |
ScarringRare; prompt care of blisters or infection lowers the risk. | Rare |
Results and how long they last
Tightening can be noticed within weeks and builds over about 1–3 months as collagen remodels, adding up across the course.
Independent studies are small (13 to 36 people) with short follow-up. Results vary from person to person.
How long it lasts: There is no strong data on how long results last; your skin keeps ageing, so maintenance is discussed individually.
With any surgical or interventional procedure, results vary from person to person. We recommend a detailed consultation with your doctor before any procedure.
Before and after
Before and after photos are shared only with patients’ written consent. You can ask to see examples during your consultation.
Before and afterQuestions to ask at your consultation
Take these to any surgeon you see — including us.
- Which laser will be used, and who operates it?
- What is your specialist training?
- How many sessions do I need, and how far apart?
- Is my skin type at higher risk of pigment change?
- What does each session include, and what costs extra?
- Whom do I contact after I fly home?
- Would another treatment, or surgery, suit my concern better?
What shapes your plan and quote
Prices are not published. After assessment you receive a personal written plan stating what is included.
- The number of sessions in your course
- The areas treated: face, neck or décolletage
- Whether other treatments are combined
- How many visits to Istanbul you need
We do not publish prices: every plan is personal and is written for you after your assessment.
Frequently asked questions
How many sessions will I need?
Most people have a course. Op. Dr. Bilgehan İlker usually plans 4–6 sessions, 2–3 weeks apart. Published studies used 2–6 sessions, 2–4 weeks apart. Your number depends on your skin and goals.
When will I see results?
Tightening can be noticed within weeks, and the effect builds over about 1–3 months as new collagen forms. Because each session adds to the last, the clearest change usually appears after the course. Photos taken beforehand help you judge progress fairly.
Does it hurt?
Most people describe warmth that builds during each pass, with brief hot pricks, rather than pain. Anaesthesia is usually not needed. How it feels varies from person to person, so tell Dr. İlker straight away if any step feels too hot.
Is there any downtime?
Most people resume daily life the same day. After a more intensive session your face can stay red for 1–2 days. Dr. İlker describes a day or two of partly interrupted social life.
Is it a CO2 laser? Is it ablative?
No, it uses Er:YAG and Nd:YAG lasers. Only the final step removes tissue, as a light peel of the outermost layer; the other steps heat without breaking the surface. Full erbium resurfacing is a deeper treatment that takes about a week to heal.
Laser or focused ultrasound (HIFU)?
They use different energy at different depths. This protocol heats several skin layers with laser light; focused ultrasound sends energy into deeper tissue to tighten it. Which suits you depends on whether skin quality or laxity is your main concern, decided at examination.
How long do the results last?
Long-term data are limited. In a small study of the step done from inside the mouth, improvement in the folds from nose to mouth was still present 6 months after the last session. Your skin keeps ageing, so maintenance is discussed with Dr. İlker.
Does it melt fat or shrink eye bags?
It should not be expected to. The deep heating step warms the deeper skin, but we found no independent study showing facial fat reduction or smaller eye bags. If puffy lower lids are your main concern, eyelid surgery is the treatment designed for them.
Is it suitable for darker skin?
Possibly, after careful assessment. Lasers carry a higher risk of pigment change in darker skin, although a small study of combined Er:YAG and Nd:YAG around the mouth in medium to olive skin (types III–IV) reported no serious side effects. Your skin type and history decide the plan.
How long should I stay in Istanbul?
One session needs a short stay: there is no hospital stay and daily life usually resumes the same day. Plan time for the examination before your first session. A course of 4–6 sessions, 2–3 weeks apart, means repeat visits, so agree dates before booking flights.
Medical informationThe information on this page is general information only. It is not medical advice and does not replace a diagnosis or treatment. Every surgical and interventional procedure carries risks, which will be explained to you in detail during your consultation. Whether this procedure suits you can only be decided after an in-person examination and assessment. We encourage you to also seek independent advice from your own doctor before deciding.
Sources
- American Society of Plastic Surgeons (ASPS): Laser skin resurfacing
- PubMed: Intraoral Er:YAG laser for nasolabial folds (2018)
- PubMed: Intraoral Er:YAG split-face pilot study (2020)
- PubMed: Er:YAG and Nd:YAG for perioral rejuvenation (2025)
- PMC: Four-step Er:YAG and Nd:YAG facial rejuvenation, histology study (2021)
- PubMed: 3D imaging of skin tightening after Er:YAG and Nd:YAG laser (2026)
A conversation, at your pace.
Would you like to know whether laser suits your skin?
Send your questions, with photos if you wish, and Op. Dr. Bilgehan İlker will say whether an examination makes sense. We also suggest talking to your own doctor before deciding.
- Nef 22 Ataköy, D Blok, Kat 1, Daire 36, Çobançeşme E-5 Yanyol Cad. No:22, Bakırköy / İstanbul
- Monday to Saturday, 10:00–18:00
- +90 542 280 27 51
- Dr. İlker speaks English and Turkish.
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