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Microwave and Fractional Microablative CO2 Laser for Postpartum Abdominal Laxity

Aesthetic AuthoritySmart Skin Care: Aesthetic Authority Vol. 2: No. 2
Volume 2
Issue 2
Pages: 26

Combining microwave and microablative CO2 laser treatment is both safe and effective for treating postpartum abdominal laxity.

Microwave and microablative CO2 laser treatment is effective for postpartum abdominal laxity, according to findings of a 2020 study published in the Journal of Cosmetic Dermatology.

Laxity can occur post pregnancy due to loss of muscle tone and abdominal elasticity, wrote study coauthors Paolo Bonan, MD, and Alice Verdelli, MD, of the Laser Cutaneous Cosmetic & Plastic Surgery Unit at Villa Donatello Clinic in Florence, Italy.1 The study’s goal was to assess the efficacy of combined microwave and fractional microablative CO2 laser treatment to improve these postpartum effects.

The investigators examined 15 women who were 18 years or older (median age, 38) and who were at least 12 months postdelivery. The patients received microwave treatments (ONDA Coolwaves; Deka)2 to the abdomen once a month for 3 months followed by fractional microablative CO2 laser (SmartXide2; Deka)3 1 month later, for a total of 4 months of treatment.

Coolwaves, a patented microwave technology, reduces localized adiposities in the abdomen and other areas, according to Deka. It dissolves fat, tightens and contours the skin, and firms tissue. The technology is to be used in place of radiofrequency for tightening and skin toning, according to the company.

SmartXide2 uses a CO2 fractional microablative system to cause a rapid tightening of the skin; it reduces blemishes and softens irregularities and scarring. The laser stimulates collagen production, making the skin look younger and plumper. This collagen production in turn helps prolong the treatment effects and gives more even results.4

Patients were instructed to maintain the same eating and exercise habits prior to the treatments throughout the study. The investigators also did a follow-up of patients’ eating habits and weight. They used a patient satisfaction index, abdominal laxity score and measurements, and digital and 3D photography to assess the treatment’s effectiveness.

The investigators reported the overall mean circumference as 3.6 cm plus/minus 1.2 cm. Both physicians and patients reported great improvement in tightening and skin laxity, and striae distensae were also reduced. The investigators noted umbilicus repositioning following the treatment and reported that the procedure was well tolerated, with no adverse effects.

“This initial study confirms that the combined ONDA Coolwaves and SmartXide2 (microablative CO2 laser) treatment are safe and effective for the treatment of postpartum skin laxity and striae distensae,” the study authors wrote. “Thus, combined treatment could be a promising option for those patients who refuse surgical procedures in the rapidly growing demand for noninvasive aesthetic treatment.”

Jessica A. Shepherd, MD, MBA, an aesthetic gynecologist and CEO and founder of Sanctum Med + Wellness, spoke with Aesthetic Authority® as an independent commentator on the study. She says postpartum abdominal skin laxity is caused by a combination of genetics, hormonal changes, and weight gain. She adds that an increase in relaxin decreases adhesiveness between collagen fibers, and that formation of ground substance creates striae in areas causing stretch marks and loose skin. Shepherd notes that even with weight loss through diet and exercise, factors such as genetics and number of pregnancies also affect abdominal skin laxity.

“Alternative therapies for skin tightening that do not require significant downtime or surgical intervention are important options to present to women,” Shepherd says.

Regarding the study, she notes that using this particular type of laser treatment not only tightened the skin but also improved the appearance of its texture. “The upgraded technology of the Coolwaves brings up the energy to 3 times the efficiency and selectively targets subdermal fat,” she explains.

Shepherd emphasizes that although the study had a small population, the findings highlight the sustainable changes in the reduction of circumference and appearance of skin, which is appealing for women seeking marked changes in this area.

“Convenient and time-saving options for women in the postpartum phase are important, and with the variety of complex physiological changes in the skin during pregnancy, [we need] to have solutions,” she says. “This combined technology…seems promising and may create another innovative option that is safe and decreases the need for surgical intervention.”


1. Bonan P, Verdelli A. Combined microwaves and fractional microablative CO2 laser treatment for postpartum abdominal laxity. J Cosmet Dermatol. 2021;20(1):124-131. doi:10.1111/jocd.13510

2. SmartXide2 laser. Deka. Accessed June 9, 2021. https://www.dekalaser.com/en-GB/product.aspx?item=samrt1

3. ONDA Coolwaves. Deka. Accessed June 9, 2021. https://www.thecoolwaves.com

4. Smartxide CO2 Laser. Ciao Bella Medical Spa & Vein Clinic. Accessed June 9, 2021. https://www.ciaobellaplasticsurgery.com/smartxide-co-2-laser/

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