Fractional CO2 laser skin resurfacing is a safe and effective procedure which helps to smooth and tighten the skin of the upper and lower eyelids. The laser energy is absorbed by the collagen fibers in the deep layers of the skin's dermis, causing the collagen to remodel and contract which improves the texture and tone of the lid tissues. In addition,the outer layers of skin will peel following the procedure, which helps to eliminate brown spots and superficial fine lines and scars. In general it's a good idea to use the laser to resurface the whole face, not just the eyelids, so that all of the skin will be evenly matched and refreshed. The fractional CO2 laser is gentler than the older, aggressive ablative CO2 lasers, so with the newer technology we can customize the treatment for many different skin types. It is often helpful to repeat the treatment (total 1 to 3 treatments, each at least 2 months apart) to get optimal results. The procedure is done in the office after a topical anesthetic is applied to the facial skin. Discomfort is minimal, and recovery takes less than a week (the skin peels within 4 to 6 days, then looks great!). It is very important to protect the face from sun damage after treatment, as the new skin is much more sensitive.
I personally use the DEKA DOT therapy fractional CO2 laser in my office, and both my patients and I have been thrilled with the results. I have had experience with Thermage, and I have been underwhelmed by the results. I therefore would not recommend Thermage (or Fraxel, for that matter) if you want to see substantial improvement. Also bear in mind that ultimately, for severe upper lid skin excess, a surgical blepharoplasty is the best way to rectify the situation. The surgical option, however, is not typically indicated for an individual in their early thirties.