Why I combine surgery with laser and skin treatments

The short answer: surgery fixes the structure of the face and body: loose skin, fat and muscle. Skin treatments such as CO₂ laser, IPL and radiofrequency microneedling improve the quality of the skin itself: texture, fine lines, redness, scars and stretch marks. Most people need some of both to get a result that looks complete. Surgeons usually offer surgery and skin clinics offer treatments. I bring them together, and plan both from the first consultation.

I’m often asked why a plastic surgeon would be interested in lasers and skin treatments. The honest answer is that I got tired of seeing good surgical results let down by the skin. A beautifully lifted face can still have fine lines around the mouth. Perfectly balanced eyelids can still sit in crepey, sun-damaged skin. The surgery did its job; nobody had planned for the rest.

“Surgery changes the shape. Skin treatments change the surface. Patients see both, so I plan both.”

Mr Siva Kumar, Consultant Plastic Surgeon

Structure and skin are two different problems

As we age, two separate things happen. The structure loosens: skin stretches, fat moves or disappears, and the muscles and supporting tissues slacken. At the same time, the skin itself changes: it gets thinner, loses collagen, collects sun damage, and develops fine lines, pigment and redness.

Surgery is very good at the first problem. A facelift lifts the jowls and neck, eyelid surgery removes hooding, and a tummy tuck removes loose skin. But surgery does very little for the second. Lifting skin does not change its texture.

Skin treatments are the opposite. Fractional CO₂ laser resurfaces the skin and stimulates new collagen. IPL treats redness and brown marks. Radiofrequency microneedling firms and smooths skin and improves stretch marks. None of them can lift a jowl or remove a fold of loose skin.

Why surgery and skin treatments are usually kept apart

In the UK, surgeons mostly offer surgery, and aesthetic clinics mostly offer non-surgical treatments. Patients end up with two separate plans from two separate places, often with nobody looking at the whole picture. Treatments get done in the wrong order, or one undoes the benefit of the other, or something important is missed altogether.

I wanted to close that gap. I am one of the few surgeons in the UK who combine eyelid and facial surgery with CO₂ laser resurfacing and carry out both myself. IPL and radiofrequency microneedling are carried out by me or by a specialist nurse working with me, as part of a plan I set.

What a reconstructive surgeon brings to cosmetic work

My NHS work is in reconstructive surgery and skin cancer at Queen Victoria Hospital in East Grinstead, where I lead the skin cancer multidisciplinary team for Kent and the local Sussex area. Much of that work is on the head and neck: rebuilding noses, eyelids, lips and ears after cancer, where there is very little spare tissue and every millimetre matters.

That training shapes how I approach cosmetic surgery. It teaches you to plan scars carefully, to handle tissue gently, to think about how an area works as well as how it looks, and to manage healing when things are not straightforward. It also teaches you to think about the skin, because after skin cancer surgery the scar and the skin around it are what the patient sees every day. You can read more about this on my facial reconstruction page.

How I plan a combined treatment

1. I listen first. What bothers you when you look in the mirror? What would make the biggest difference to you?
2. I examine both layers. The structure underneath, and the skin on top: its thickness, sun damage, pigment, redness and scarring.
3. I explain what each treatment can and cannot do. Sometimes surgery alone is enough. Sometimes a skin treatment alone is enough. Often it is both.
4. I plan the order. Some treatments are done during the same operation, such as CO₂ laser to the eyelids or around the mouth during eyelid surgery or a facelift. Others work better weeks or months later, once healing has settled. It depends on your skin, your recovery and what fits around your life.
5. You get a written plan and quote for the whole thing, so there are no surprises.

The combinations I use most

• Eyelid surgery with CO₂ laser for hooded eyelids with crepey skin.
• Facelift or neck lift with CO₂ laser around the mouth and on the cheeks.
• Tummy tuck with radiofrequency microneedling or CO₂ laser for stretch marks that remain.
• Scar correction with laser or IPL to improve texture and colour after surgery.
• Skin cancer surgery with scar refinement once the wound has healed.

There are example plans with timings on my surgery and skin page.

“Combining is not about doing more. It’s about doing the right things, in the right order, so the result looks finished.”

Mr Siva Kumar, Consultant Plastic Surgeon

When I don’t combine

Combining is not right for everyone, and I will tell you if it isn’t right for you. I am cautious when:

• you smoke or vape and are not ready to stop, because healing and laser recovery both suffer
• you have darker skin, where laser carries a higher risk of colour change and needs careful assessment and gentler settings
• you have recently taken isotretinoin (Roaccutane), or you are pregnant
• you get frequent cold sores, which need antiviral cover before any laser near the mouth
• one treatment alone would give you what you want

Questions I’m often asked

Can laser be done at the same time as surgery?

Sometimes, yes. CO₂ laser to the eyelids or around the mouth is often done during eyelid surgery or a facelift, under the same anaesthetic. Other combinations work better staged. Every plan is individual.

Who carries out the treatments?

I perform the surgery and the CO₂ laser myself. IPL and radiofrequency microneedling are carried out by me or by a specialist nurse working with me.

Is it safe to combine surgery and laser?

When the plan is right for your skin, yes. Each treatment still has its own risks, which I explain in detail. Doing laser during an operation can mean one recovery rather than two.

Does combining treatments cost more?

Each treatment is priced separately, and you receive a written quote for the whole plan before you decide. Combining treatments in one session can save a separate visit.

Why see a surgeon for skin treatments?

A surgeon can tell you honestly whether a skin treatment, surgery or both will give the result you want, rather than offering only what they do. Government proposals published in October 2026 would also restrict higher-risk laser treatments to qualified healthcare professionals.

Next steps

If you are thinking about surgery, skin treatment or both, you are welcome to book a consultation. You can also read more about me.