Best Laser Tightening for the Skin Around the Eyes?

I am 31 years old and am starting to show some very minor hooding/excess skin on my upper eyelids (and a bit of excess skin on the lowers).

I don't think I'm quite ready for invasive surgery, and am wondering if there are any effective laser tightening procedures that can safely be done around the eye area (barring Thermage, since it doesn't really seem to work). Thanks!

Doctor Answers 14

Fraxel re:pair Among the Best Lasers to Tighten Eye Lid Skin

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

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Ultherapy Best for Facial Skin Tightening

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.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Hooding of the upper eyelids

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. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

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Tightening skin around eyes

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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews


I think if your specialist is capable, CO2 still provides the best outcomes. If you have minor hooding, laser can delay the process of skin excision (bleph) for a few years. My technique of laser involves erbium with coag (sciton), then fractional CO2 laser at the highest setting (80Mj) CORE system, for 5 passes. 

Downtime is 8 -9 days, redness around the area will persist for 4 weeks. I always blend the surrounding crows feet area, or de-markation arrises. 


Dr Davin Lim 
Brisbane and Gold Coast

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

New combined fractional laser skin resurfacing best option for eyelid skin rejuvenation

The new combined fractional laser skin resurfacing provides excellent results with less risk than CO2 based lasers.

The new procedure utilizes a combination of two different erbium laser wavelengths. The treatment consists of the non-ablative fractional Lux1440 Erbium laser followed by the Lux2940 fractional Erbium ablative laser (see reference below.)

Results with this technique are the best I have seen in 15 years of doing laser resurfacing.

The benefit over CO2 based lasers, fractional and flat beam, is that the Erbium recovery is 5-7 days compared to 2 weeks with the CO2 at effective depths.

In addition, the Erbium does not change skin color as does the CO2 based devices.

See before and after photos of laser resurfacing with new fractional ablative 2940.

Fractional CO2 Laser (ActiveFX/DeepFX) for non-surgical eyelid rejuvenation

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.

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Fractional CO2 laser (DOT therapy) for eyelid rejuvination

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.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon
3.0 out of 5 stars 3 reviews

The right lasers can help

If your skin is hanging out on your eyelashes, go for the blepharoplasty. But if there is a bit extra only, I think a good mix of noninvasive treatments can be very effective. First - Botox injected in the lateral brow will lift it, taking skin from the upper lid. Second - a fractionated CO2 laser with eye protection is great for crepey skin. Finally - the Alma Accent, usually about 4 to 5 treatments performed over forehead AND upper lid, works to tighten the loose skin. These treatments performed early in eye aging and maintained (Botox every 6 months, Accent every year) can delay blepharoplasty for years.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 13 reviews

Minimally invasive procedures are useful around the eyes

Many minimally invasive lasers have been used, especially for lower eyelids. Currently, we have been very pleased with Fraxel as both safe and effective with early eyelid skin changes. Many highly trained oculoplastic surgeons are very skilled at treating the eylid area with lasers

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.