Carboxytherapy before and after: the benefits of carbon dioxide injections for facial and body skin

The subcutaneous administration of carbon dioxide, also known as carboxytherapy, is one of the most effective and widely appreciated non-surgical aesthetic treatments for cellulite and skin laxity of the face.

Carboxytherapy is now one of the most discussed treatments in aesthetic medicine. First of all, because it aims to go beyond a simple improvement in aesthetic appearance, and to demonstrate how the skin can change when it is stimulated to “function better.” Unlike many non-surgical aesthetic treatments, which act superficially or offer immediate but temporary results, carboxytherapy follows a different logic, one that is closer to human physiology. It does not “correct” from the outside, but works from within, activating natural mechanisms that progressively improve tissue quality.

The treatment uses medical carbon dioxide (CO₂), administered in small quantities into the subcutaneous tissue through controlled microinjections. This is a substance that our body knows well: it is continuously produced by cells and eliminated through breathing. It is precisely this biological familiarity that makes it safe and, above all, effective as a stimulus. What makes carboxytherapy particularly interesting is not so much the substance itself, but the response it triggers. When CO₂ is introduced into the tissues, the body reacts by increasing blood circulation and improving oxygenation in the treated area. It is as if a system that can become less efficient over time is “reawakened.”

The result is a more metabolically active environment, where skin cells function better, receive more oxygen, and are more efficient in maintaining tone, elasticity, and firmness. It is from this gradual but real process that the visible changes in carboxytherapy before and after emerge: brighter, more even, and progressively healthier skin, both on the face and body.

Facial and body biorevitalization: why does CO₂ improve skin quality?

To truly understand the effectiveness of carboxytherapy, it is essential to analyze in greater depth what happens in the tissues when CO₂ is introduced subcutaneously. This is not merely a local action, but the activation of a complex physiological response involving the vascular system, cellular metabolism, and the structure of connective tissue.

When carbon dioxide is injected, it creates a temporary increase in tissue pressure and a variation in local pH. This altered microenvironment is immediately detected by cellular receptors and vascular regulatory systems, which trigger an adaptive response. The body is programmed to maintain a constant balance between oxygen and carbon dioxide, and any variation is rapidly compensated.

The resulting vasodilation is not simply an increase in blood flow, but also an improvement in capillary perfusion — that is, the ability of blood to reach all cells within the tissue uniformly. This is particularly important in areas where microcirculation is compromised, such as regions affected by cellulite or aging skin.

The Bohr effect plays a key role in this process. In the presence of increased CO₂ and slight tissue acidification, hemoglobin changes its conformation, reducing its affinity for oxygen. This facilitates oxygen release precisely where it is most needed. In other words, not only does more blood reach the tissues, but the blood becomes more “efficient” at nourishing them. This increased oxygen availability directly impacts cellular metabolism. Skin cells increase energy (ATP) production, enhance protein synthesis processes, and become more active in tissue regeneration.

Fibroblasts, in particular, respond to this stimulus by increasing the production of type I and III collagen and elastin. At the same time, the extracellular matrix is reorganized, becoming denser and better structured. This process improves not only the appearance of the skin but also its mechanical function, making it more resilient and less prone to sagging.

Carboxytherapy before and after: what really happens over time?

When discussing carboxytherapy, it is important to understand that the visible improvement in skin appearance is the final manifestation of a series of biological processes that develop over time. In the early stages of treatment, the improvement is primarily functional. Increased microcirculation leads to better tissue oxygenation, with visible effects on skin brightness and complexion. This initial result is often perceived as an immediate sign of effectiveness, but it represents only the first level of response.

With repeated sessions, deeper mechanisms related to tissue regeneration are activated. The dermis, which forms the structural framework of the skin, begins to change its architecture. Collagen fibers become more organized, the extracellular matrix is enriched, and the skin’s ability to retain water improves. This process is slower because it follows the biological timing of collagen turnover, which can take weeks or months. However, it is precisely this gradual progression that makes the results more natural and long-lasting.

On the body, the improvement translates into overall rejuvenation, firmer skin, and reduced irregularities, particularly for concerns such as cellulite, fluid retention, and lipedema (a chronic, progressive condition of adipose tissue causing abnormal subcutaneous fat accumulation), especially in its early stages. On the face, one observes a more even skin texture and reduced loss of elasticity.

Carboxytherapy for cellulite: why is it so effective?

Carboxytherapy is considered one of the most effective treatments in aesthetic medicine for addressing particularly troublesome — and often painful — conditions such as cellulite, lipedema, and more generally, microcirculatory disorders affecting subcutaneous tissue. For instance, cellulite develops when microcirculation loses efficiency. Slowed blood and lymphatic flow lead to fluid accumulation in interstitial spaces, causing edema. This environment promotes tissue hypoxia (oxygen deficiency), which in turn alters the metabolism of adipocytes and fibroblasts. Over time, connective tissue changes: fibers become more rigid and disorganized, forming fibrotic septa that trap adipose tissue, resulting in the characteristic uneven skin surface.

Carboxytherapy acts on multiple levels. Its primary effect is the improvement of microcirculation: the introduction of CO₂ induces vasodilation in capillaries and arteries, significantly increasing blood flow in the treated area. The increase in tissue oxygenation is particularly relevant in areas affected by cellulite, where chronic hypoxia is often present. Restoring adequate oxygen levels allows cells to function under more physiological conditions, promoting more efficient metabolism in both adipocytes and fibroblasts. This helps reduce degenerative processes in compromised tissue.

At the same time, vasodilation and increased blood flow facilitate the drainage of excess fluids. Greater pressure and mobility of fluids within tissues help reduce interstitial edema, improving the stagnant component typical of cellulite and alleviating the sensation of swelling and heaviness. In the medium to long term, effects extend to the structural component of the tissue. Continuous stimulation of fibroblasts, favored by a more oxygenated and metabolically active environment, leads to a reorganization of connective tissue. Fibers become more elastic, less rigid, and better aligned, with a progressive reduction in fibrotic components. These changes result in a visible improvement in the skin’s surface: it appears smoother, firmer, and less uneven, with a reduction in the characteristic “orange peel” appearance—an outcome that is not only aesthetic but also physiological.

Facial carboxytherapy: before and after improvements in microcirculation and skin quality

Facial carboxytherapy stands out for its ability to target a frequently underestimated aspect of skin aging: the reduced efficiency of exchanges between blood and tissues. Over time, not only does collagen production decrease, but the ability of capillaries to adapt to the skin’s metabolic needs also diminishes. This results in a condition where cells, although present and active, function in a less favorable environment, with reduced oxygen availability and impaired waste elimination.

The controlled introduction of CO₂ creates stimulation that goes beyond temporarily improving blood flow; it induces a sort of “vascular training.” Blood vessels become more responsive to stimuli and improve their ability to adapt to changes in metabolic demand. This is particularly important in the face, where microcirculation must respond quickly to variations related to temperature, stress, and muscle activity.

Another significant effect concerns fluid dynamics at the interstitial level. In conditions of slowed microcirculation, an imbalance often develops between capillary filtration and reabsorption, leading to stagnation. Carboxytherapy helps restore this balance, improving fluid mobility and reducing the “congested” component that makes the skin appear dull and less defined. In the periocular area, where microcirculation is particularly delicate, the treatment can reduce venous and lymphatic stasis, improving the appearance of dark circles and puffiness, especially when they have a vascular component.

At the dermal level, beyond fibroblast stimulation, there is also a progressive optimization of the extracellular environment. This is not only about producing more collagen but also about improving the quality of the matrix in which cells are embedded. A more organized matrix facilitates metabolic exchange, improves nutrient distribution, and makes the tissue overall more efficient.

These combined effects lead to a “before and after” transformation that is not artificially constructed but progressively visible. The skin becomes more responsive, more even, and more stable over time. This normalization of skin function allows for subtle and natural rejuvenation that does not alter facial expressions—since there is no modification of volume, as occurs with other non-surgical procedures such as fillers, but instead restores a healthier, more refined appearance.

Carboxytherapy costs and useful information

The cost of carboxytherapy depends on the condition being treated and, consequently, on the type and duration of the treatment plan. It is also influenced by the initial condition and the desired results: each patient presents different characteristics in terms of skin quality, circulation, and biological response. For this reason, the overall cost cannot be standardized. However, it is important to consider that carboxytherapy works on real biological mechanisms, making it an investment aimed at progressive and long-lasting results.

From a clinical perspective, carboxytherapy is considered safe when performed by qualified medical professionals using certified devices. The CO₂ used is sterile medical-grade carbon dioxide, a substance already present in the body and naturally eliminated through respiration. This contributes to its high tolerability and low systemic risk. During the session, the most common sensation is a mild pressure or tension in the treated area, related to tissue expansion and vascular response. This is temporary and typically subsides quickly after the treatment.

Any side effects are generally mild and transient, and may include minor bruising, redness, or temporary local sensitivity — all related to the microinjections and the physiological response of the capillaries. These effects usually resolve spontaneously within a short time without the need for specific intervention.

The benefits of carboxytherapy at Acquaforte Thalasso & Spa

Treatments focused on skin quality, such as facial and body carboxytherapy, are now part of an approach to aesthetic medicine that is increasingly oriented toward tissue regeneration rather than transformation. The goal is not to alter facial features or intervene invasively, but to improve the biological function of the skin, restoring optimal conditions in terms of oxygenation, hydration, and cellular renewal.

Within this holistic and preventive vision lies the work carried out at the Acquaforte Thalasso & Spa at Forte Village Resort, often described as “the most beautiful resort in the world,” located just steps from some of the island’s most stunning beaches and less than an hour’s drive from Cagliari. Here, aesthetic medicine is interpreted as a journey aimed at gradually and naturally improving the skin’s appearance, enhancing overall balance, freshness, and radiance without altering individual features.

Alongside carboxytherapy, the clinic offers other non-surgical and minimally invasive treatments, such as biorevitalization, which uses microinjections of non-crosslinked hyaluronic acid, vitamins, and bioactive substances to act directly on the dermis, improving deep hydration and supporting cellular metabolism. The result is a progressive improvement in skin quality, particularly evident in tissues stressed by environmental factors such as sun exposure, wind, or salt. Medical chemical peels, such as PRX-T33, should also be considered. These promote controlled exfoliation of the epidermis and stimulate cellular turnover, improving skin texture and complexion uniformity. In some protocols, these additional advanced aesthetic treatments may be combined to act synergistically on multiple levels of the skin. The principle underlying this approach is personalization: each treatment plan is tailored to the actual condition of the skin and developed gradually to achieve natural, stable, and physiologically consistent results.

For more information about facial carboxytherapy and other treatments offered by the spa, or to book a stay at Forte Village Resort, call +39 070 9218818 or email holiday@fortevillage.com.

Would you like to enjoy a dream vacation while discovering the most effective treatments for facial and body skin? Book your stay at Forte Village Resort in Sardinia