What is a Hooded eyelid?

Hooded eyelid is a term that is used to describe the typical appearance seen in older people where large amount of excess eyelid skin forms a ‘hooded’ appearance over the eyelids impacting their vision and facial appearance.


Why do hooded eyelids occur?

There are many age-related changes in the eyelid skin, eyebrow, fat, muscle and bone that cause the appearance of hooded eyelids. In some cases, hooded eyelids occur due to a single cause but frequently there are more than one cause for the hooded eyelid.


What are the common causes of hooded eyelids? 

All causes are due to the age-related changes in the skin and muscle of the eyelid, skin, muscle and underlying fat of the eyebrow and the underlying bone of the eye socket.


Patients with hooded eyelids may experience these symptoms 

  • Headaches, particularly tension headaches in the forehead area especially at the end of the day. 
  • Neck pain due to straining
  • A feeling of eyelid heaviness at the end of the day despite the routine use of glasses.
  • Smudging of eyeshadow due to overhang of excess skin
  • Negative social comments such as "you look tired", ‘you look stressed” ‘you look sleepy”.

What does the clinical examination of patients with hooded eyelids reveal?

  • Eyebrow elevation, high arched eyebrows or uneven eyebrows in an attempt to compensate for restricted visual fields
  • Overhanging excess skin on the upper eyelids touching the eyelashes or hooding making the eyelids weak or droopy looking 
  • A hollow look in the eye socket, due to loss of fat.
  • Tired and sleep look due to droopy or weak eyelids
  • Fat bulges in the upper eyelid and loose excess and crepey skin.
  • Reduced eyeshadow space.
  • Uneven or asymmetric eyes
  • Uneven of asymmetric eyelid crease

Patients with hooded eyelids - practical concerns 

  • Vision is bad despite wearing reading glasses.
  • Difficulty reading in dim light situations such as early morning or late in the evening.
  • Difficulty driving at night 
  • Restaurant menus are hard to read often requiring a bright source of light like a torch on your smart phone.
  • Occasionally run into objects because you did not see them coming.
  • When you wake up in the middle of the night, you struggle to see as everything is pitch black.

What is the best surgery for hooded eyelids?

It depends on the severity of the hooded eyelids and the symptoms that the patient experiencing such as restriction of vision and symptoms of headaches. There are three common surgical procedures for hooded eyelids and are used depending on the severity of the hooded eyelid condition

  • Removal of excess upper eyelid skin
  • Removal of excess upper eyelid skin and correction of droopy eyelid (eyelid ptosis)
  • Combined removal of upper eyelid skin + correction of droopy eyelid + eyebrow lift


Is hooded eyelid surgery classified as functional or is it cosmetic surgery?

Hooded eyelid surgery is primarily functional. The cosmetic benefits are secondary.


Benefits of hooded eyelid surgery 

Hooded eyelid surgery by removing the excess eyelid skin, tightening the droopy eyelid and stabilising and lifting the droopy eyebrow improves the visual field and symptoms such as headaches, and heaviness of the eyes. The improvement in vision improves the quality of life, productivity and appearance following surgery. 


Find out if you are the ideal candidate for hooded eyelid surgery.

You are an ideal candidate for hooded eyelid surgery if you have 

  • Over hanging excess upper eyelid skin or eyelid hooding
  • The hooding or excess skin restricts your visual field or causes heaviness in the eyelids
  • Droopy or weak eyelids that make you look tired or sleepy
  • A droopy eyebrow that accentuates the appearance and adds weight to the upper eyelids


What happens during the consultation?

The in-clinic eyelid surgery consultation usually lasts about 45 – 60 minutes and will help you determine whether eyelid surgery will address your concerns and more importantly, whether you trust me as your Surgeon.

Following a detailed medical history, evaluation of the structure, function and aesthetics of your eyelids and eyebrows and clinical photography we can decide if the cause of the hooded eyelids is eyelid skin, droopy eyelids, droopy and heavy eyebrow or a combination of all three.

This is followed by a discussion of all risks and benefits followed by ample time for questions. After the consultation you will be given information that describes the hooded eyelid surgery procedure, risk and complications of eyelid surgery and the costs of eyelid surgery. I will refer you for the Visual Field testing by the optometrist. 

It is standard practice that we schedule a second consultation which provides you another opportunity to clarify the doubts and ask questions and be reassured of your safety.


Hooded Eyelid - Middle Age



Is surgery for hooded eyelid covered by Medicare or private health fund?

Hooded eyelid surgery may be partly covered by Medicare and private health fund if it affects your vision as proven by a visual field test done by an Optometrist, your surgery may be eligible for cover. 


After your consultation, I will assess you and refer you for the Visual Field testing by the optometrist. 


How long does the operation take?

Droopy eyelid surgery is performed in a licensed facility and usually takes between 1.5 to 2.5 hours, but this can vary from patient to patient depending on procedure performed to correct hooded eyelids.

  • If the only procedure is to remove excess upper eyelid skin approx. 1.5 hrs
  • Correct droopy upper eyelid / upper eyelid ptosis – add 30 – 40 mins
  • Brow lift (direct, temporal or endoscopic brow lift) – add 30 -40 mins

What happens after the operation?

Immediately after the operation you will spend some time in the recovery ward where you will be closely monitored till you are fully awake. There will be no bandages on the eye, and you will be able to open and close your eyes. You will need regular lubricating eye drops, eye ointment to the suture line and ice packs over your eyes. 


It is desirable to stay overnight for regular monitoring because during the first 12 hours after eyelid surgery, there is a risk of bleeding, pain, nausea and vomiting due to the anaesthetic and general drowsiness due to a slow recovery from the anaesthetic leading to an increased risk of bleeding. In addition, the blurred vision following surgery can make the patient anxious.  Staying in hospital where you will be monitored, and your eyelids looked after 


What results can I expect after surgery for hooded eyelid?

Hooded eyelid surgery will get rid of loose and excess eyelid skin, tighten and lift droopy eyelids and lift your eyebrows to give you a fresh look. Hooded eyelid surgery improves the visual field and symptoms such as headaches, and heaviness of the eyes.


Most changes are noticeable soon after the operation, we recommend waiting for a good 6-12 weeks for all the temporary changes including swelling to resolve to experience the final result. 


Risks of hooded eyelid surgery

Most eyelid surgery procedures are complex operations requiring technical expertise and aesthetic finesse. That’s why it’s so important to choose a top eyelid surgery expert Plastic Surgeon, who has had extensive training and experience in eyelid surgery.

If your doctor gets your eyelid surgery wrong and botches your blepharoplasty, you could end up with some unwanted complications and appearance concerns – some of which won’t be able to be repaired easily. 

Complications of eyelid surgery include: 

  • constantly flowing tear ducts or watery eyes
  • dry eyes
  • very uneven eyelid appearances
  • being unable to fully close your eyes or blink
  • unacceptable scars
  • reoperation
  • other surgery complications (you’ll be given a full list in your consultation)

Tips to reduce risks of hooded eyelid surgery

Fit and healthy patients who choose a fully qualified Specialist Surgeon for droopy eyelid surgery, instead of a doctor who is not a Surgeon can reduce some surgery risks by:

  • Making sure their plastic surgeon is very experienced in eyelid procedures
  • Carefully following instructions before and after surgery
  • Not trying to do too much too soon
  • Avoiding driving, and not wearing contacts or eye makeup, until your Surgeon has cleared you to do so after surgery

A botched operation can leave you with some serious eye lid problems it’s just not worth it and will cost you more in the long run. 

“All eyelid surgery requires intensive planning around varying facial features, eye area anatomy and precision surgical techniques. That is why it’s so important to choose a fully qualified Specialist Plastic Surgeon, one who has extensive experience and expertise in eyelid surgery procedures.”


All surgery carries risk.   A second opinion from an appropriately qualified health practitioner is recommended before proceeding

Book a consultation

or call: 02 9387 2110


Royal Australasian College of Surgeons


Plastic Surgery Research University of Louisville


Royal College of Surgeons of Edinburgh


PACES Plastic Surgery Atlanta USA