A device and methods for treating tissue via laser energy to induce tissue reduction and/or necrosis are described herein. Laser energy may be applied to a tissue region via an optical fiber advanced through a lumen of at least one needle. Fluid may also be infused or injected into the tissue region through at least one needle. Tissue reduction and/or necrosis of a target tissue region in turn reduces the appearance of droopy, baggy and/or wrinkled skin.