Can Laser Be Done on the Upper Eyelids for Tightening Crepey Skin?

Doctor Answers 3

Laser Skin Tightening for Eyelids

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Laser skin tightening is a common procedure for lower eyelids with mild to moderate skin excess.  The standard for upper lid skin is surgery to excise the extra skin.  It must be kept in mind that lasers are good for mild and sometimes moderate wrinkles but have have minimal effect on coarse wrinkles or loose/hanging skin.  In these cases, surgery is usually the best option.

Laser eyelid surgery - blepharoplasty

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Lasers can be used to remove the outer layers of skin or as a cutting tool instead of a scalpel. I assume from your post you are referring to removal of the outer layers or resurfacing thinking that this is less aggressive than actual surgery.

When CO2 non-fractional lasers appeared on the scene in the mid-1990s doctors everywhere were buying or renting them to treat every imagineable part of the aging face. Since the products were pushed to market by the manufacturers without the traditional trial period to find the best candidates and indications for use it took 2 or 3 years for us to find out that the skin shrinking and smoothing abilities were limited. Since the laser is akin to a type of burn it does give you some shrinkage but to get the required shrinkage in the case of much extra skin the risk of scarring was high. With respect to skin smoothing we eventually found out that the lasers worked well on lines of skin aging (non-motion lines) but not well or only temporarily on lines due to facial muscle movement (motion lines). The manufacturers did not tell us that in the beginning because they just wanted to sell machines to any doctor, surgeon or non-surgeon, that they could find. For the upper and lower eyelids we found that within margins of safety the results were more limited and less permanent than classical blepharoplasty surgery. In my opinion that did not change with the later introduction of Erbium and then fractional lasers. The fractional lasers eventually gave the same result you just traded off recovery time after treatment with more treatments.

There is a large misunderstanding by the general public as to what laser is & can do medically. Part of the problem has been unscrupulous physicians & laser manufacturers convincing the public via advertising & newsmagazine shows (also advertising) that laser is a godsend. Lasers are not some magical star trek device.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Laser lid surgery

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Laser skin tightening is frequently performed for lower eyelid tightening, but is not the standard for upper lids.  Upper blepharoplasty (skin excision, or skin + fat excision) is usually preferred for what you describe.  While blepharoplasty is a surgery, and thus, more invasive than laser treatment, downtime is minimal and scarring is generally insignificant. 

Jason Hess, MD
San Diego Plastic Surgeon

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.