Q:I have noticed that my eyelids are showing signs of increasing laxity. What can I do to tighten the skin of my eyelids without having eyelid surgery?

A: During the past four years, there have been dramatic and revolutionary advances in laser technology. By applying these new technologies to the eyelids, it has become possible to rejuvenate and tighten the eyelid skin in nearly all patients without surgery.

Patients who only have mild eyelid laxity are best treated with the eyelid Thermage procedure. Eyelid Thermage is a procedure that tightens the eyelid skin and deceases eyelid hooding and wrinkling. Only one treatment is needed and there is no downtime. Patients who have had eyelid Thermage report that their eyelid sagging is improved and both the upper and lower eyelids are tighter. The eyes look brighter and appear more open.

Eyelid Fraxel is intended for patients who have developed moderate laxity and crepiness of the skin of the upper and lower eyelids. The procedure tightens the skin more than Thermage, reduces skin crepiness, softens lines and wrinkles, and produces an overall skin rejuvenation effect. There are two ways of performing eyelid Fraxel.

The first method, known as traditional Fraxel laser resurfacing, is done as a series of four or five treatments given at monthly intervals. These treatments have no downtime. Alternatively, patients may consider the Eyelid Fraxel Repair procedure. Eyelid Fraxel Repair has the advantage of completing the eyelid rejuvenation in a single treatment. Patients who undergo Eyelid Fraxel Repair should be prepared for four to five days of healing following the procedure.

Eyelid Thermage, traditional eyelid Fraxel, and eyelid Fraxel Repair all work by stimulating new collagen production. This new collagen is living tissue, and for this reason, the improvement in the eyelids following these treatments should persist for years.

Regardless of which technology is used to treat the eyelids, the rejuvenation may be further enhanced with Botox and dermal fillers. By combining Thermage or either of the two Fraxel lasers with Botox and dermal fillers, our patients achieve very natural eyelid tightening and rejuvenation without undergoing surgery. We welcome all patients to our office who wish to rejuvenate the skin of their eyelids without surgery.