There are two modalities that I would consider for large scale facial resurfacing and treatment for these fine lines. One is the class of chemical peels. If we are talking about more permanent solutions, we turn to the category of high concentration trichloroacetic acid and even stronger Phenol peels. We don't offer these at the office, because results can be inconsistent and unrelaible, but both of these peels can also be very effective. These peels are strong enough to penetrate deep into the reticular dermis, and cause some really nice resurfacing. They allow for the lay down of new collagen fibers and elastin.
The second finalizing wrinkle option are lasers. These yield a more consistent, even, reliable result. The ablative category of lasers include lasers with a high frequency . These lasers tend to be more destructive and extend deeper down into the dermis. As a general rule of thumb, the higher frequency in nanometers of that laser, the deeper it will penetrate. For example, a CO2 laser carries a 10,600 frequency and non-ablative lasers usually carry a frequency under 1,000 nanometers.
In the ablative laser category, I personally am most successful with the CO2 laser. I like returning to this laser for permanent corrections of fine lines. We can turn up or dial back power for adjustable results and healing time. Short answer: In our practice, we consistently use CO2 lasers for long term reduction of fine lines and wrinkles.