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

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.

For significant improvement, hooded eyelids require surgery if there is enough skin. For nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin. I recommend getting a formal evaluation with an experienced cosmetic dermatologist. Best, Dr. Emer.

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. 

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.

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