Best Laser Tightening for the Skin Around the Eyes?

Hi Te,
For a 31 year old woman with "some very minor hooding/excess skin on my upper eyelids (and a bit of excess skin on the lowers)", and who does not wish to undergo a surgical procedure, fractionated CO2 laser will correct the minimal skin excess.
Fraxel re:pair is the fractionated CO2 laser that has accomplished this for patients in my practice.
Fraxel re:store is a not a fractionated CO2 laser and will not do the job. Those physicians here who have stated that "Fraxel won't work" must be referring to the re:store.
It is very important to choose your treating physician carefully.
Good luck and be well.
Dr. P

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

No. None of them will get rid of the hooding that you are describing. Only an upper eyelid Blepharoplasty and/or a Brow lift will help.
Regards

You really can't shrink skin, no matter what the method. The co2 laser will allow very modest tightening but it is agressive and patients need to be properly selected. If there is a true excess, only surgical removal will work. You are right about thermage, it doesn't work. Neither does fraxel therapy or Pearl (which I use for modest sun damage.
Examine the patients at the galleries. Look at blepharoplasty and co2 laser. You might see someone with problems similar to your own.

There’s a new combined fractional laser treatment that’s perfect for hooding and eyelid rejuvenation. This consists of the combination of a non-ablative fractional erbium laser with a fractional erbium ablative laser. It gives you a natural rejuvenated look with a recovery time of 5 days; there’s also a CO2 laser that works just as good as the erbium laser. It only takes a little bit longer of recovery time. Another way to treat the saggy skin from the upper eyelid is to have Botox injections to raise the eyebrow and improve the saggy skin. You can combine these treatments, but all will depend on the quantity of extra skin you will have in this area; this consultation is recommended to explore all the options.

Thank you for your question. I would suggest Ultherapy for facial skin tightening. Ultherapy deposits focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will actually begin to lift and tone over time. Collagen is a natural protein that gives skin its youthfulness by keeping it firmed, toned and elastic. Plus, the treatment is completely non-invasive and does not require downtime. I have seen excellent results with the treatment.

Depending on the amount of skin of your upper and lower eyelids you will have 2 options.
1. If the amount of skin is mild to modest you can have a non-surgical eyelid rejuvenation with ActiveFX/DeepFX. in my hands I have had very good results with this technique specially when used in young patients. The skin tightening ability of ActiveFX in the eyelid area is very effective for premature aging. This will improve the wrinkles and sun spot/damage skin as well. the recovery time is about 4-5 days. One treatment should be sufficient as compared to other laser procedures that require 2-4 treatments.
2. If the amount of skin is moderate to severe then you might consider eyelid surgery for the improvement of the condition.
the best word of advice is to visit your local Facial Plastic Surgeon. He would be the best physician to recommend the most adequate approach to improve your condition.
Good luck.

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.

If you have early hooding of the upper lid, you may just need a blepharoplasty. You may be able to avoid this with some Botox to elevate the tail of the later eyebrow.