Can sagging eyelids be tightened by laser surgery?

Yes, but the results vary, depending on the kind of laser used.

One approach, discovered in a small study of 31 patients, is to use a "nonablative," or nondamaging, laser. Doctors found that patients who were getting a full-face treatment emerged with somewhat tighter upper and lower eyelids, although that was not the purpose of the treatment.

The procedure seemed to stimulate new collagen formation, which in turn tightens up eyelid skin, although in many cases only slightly, reported Dr. Roy G. Geronemus of the Laser & Skin Surgery Center of New York. He led the study and owns stock in the laser company (formerly called Reliant, now Solta Medical Inc.). The procedure, not covered by insurance, costs "a few hundred dollars," he said.

A follow-up study used a more aggressive, or "ablative," laser procedure that Geronemus said penetrates deeper into the skin and does injure tissue. It produced more dramatic eyelid-tightening results - closer to those of blepharoplasty, or surgical removal of excess eyelid tissue.

Dr. Daihung Do, director of dermatologic surgery at Beth Israel Deaconess Medical Center, said that for patients who don't want surgery, the nonablative laser option may offer modest benefit. The more aggressive ablative laser method may be more promising, he said, but study results are not yet published.

Bottom line? Stayed tuned. There still haven't been enough patients undergoing these treatments to tell for sure how effective they are.

Judy Foreman

E-mail health questions to foreman@globe.com.