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.

 

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

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 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 recommended surgery for hooded eyelids?

The type of Blepharoplasty surgery performed 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 - also known as eyelid ptosis. 
     

 

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

Hooded eyelid surgery is primarily functional. 

 

Benefits of hooded eyelid blepharoplasty surgery 

Bby 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. Patients can expect improvement in vision and improvement in performing the activities of daily living.

 

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 
  • A droopy eyebrow that  adds weight to the upper eyelids
 
 
Copy of LEARN MORE 
 
 
 

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 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. 
 
 
 

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. 

 

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.

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 recommended 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. Hooded blepharoplasty (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 blepharoplasty 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. It’s so important to choose a fully qualified Specialist Plastic Surgeon, one who has extensive experience and expertise in blepharoplasty eyelid surgery procedures.”
 

 

 

OUR PROCESS 

You will generally see Dr Somia 3 times before your surgery.   If you prefer one of these consultations can be held via telehealth.    Two consultations are required by law before a date for surgery is scheduled.   This is to allow you plenty of time to ask questions and feel comfortable about the procedure.   Your third consultation will assist us to prepare you for your surgery (ie paperwork, pre-operative testing). 

 

PROCEDURE DETAILS 

The surgery takes approximately  1.5 hours to 2.5 hours depending on the procedure recommended and requires an overnight stay in hospital.   Our fees include specialist plastic surgeon, specialist anaesthetist, fully accredited hospital theatre, accommodation and 6 months aftercare.    A formal estimate will be provided after you have discussed your goals and what is possible to achieve them with Dr Somia.  

 

RECOVERY 

Each patient recovers at a different rate and anothers recovery should not be compared with yours.

Generally, initial recovery from swelling and bruising is approximately 3-4 weeks.   A return to normal activities can usually be expected after 6 weeks.   Full results can be expected 3-6 months after.  

You can return to work when you feel well and if your employer has lighter duties for you and will allow you to take time to rest and move around.    Most patients take 2-3 weeks off work if they work in an office context.   Patients working outdoors or in a physical capacity may need to take up to 6 weeks off work whilst they recover.   Talk to us about your specific occupation and surgery.   

You can drive when the anaesthetic has worn off, your vision is clear, and you are pain free getting in and out of the care and whilst performing an emergency stop.   You should check your vehicle insurance policy for their requirements in this situation.  

 

RISKS 

All surgery carries risks. When travelling overseas on a plane whilst the expectation is a safe journey and arrival, it is understood things could go wrong. The choice of the airline based on safety record and flight path are important elements in determining risk. Similarly, for your surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk. Risks, both general and specific, will be discussed during your consultations and written information will be provided for you to take home.    

General risks include pneumonia, deep venous thrombosis and pulmonary embolism, stroke, heart attack, allergies, awareness, death, bleeding, infection, sensation change, haematoma and seroma, skin contour irregularities, damage to deeper structures, firmness, delayed healing and tissue death, exposed sutures, dog ears or additional skin golds, dressing issues, asymmetry, scars, lymphoedema and unsatisfactory results. 

Risks specific to Blepharoplasty (Eyelid) surgery are:  injury to the eye globe, need for extra tissue,  loss of vision, changes to tear secretion,  conjunctival oedema and chemosis, exposed sutures,  upper eyelid malposition, difficulty closing the upper eyelid and corneal exposure, lower eyelid malposition and eyelash loss.                                

 

BEFORE AND AFTER PHOTOGRAPHY

Our practice privacy policy prevents sharing patient before and afters online. Indicative before and after photos can be viewed during your consultation.  

 
 
DISCLAIMERS:   All surgical procedures are performed by Specialist Plastic Surgeon, Dr Naveen Somia (MBBS PhD, FRACS - APHRA Reg:  MED 0001189889).  For full information on Dr Somia's qualifications and risk/recovery information on procedures please visit the procedure page on this website.  From July 1, 2023 all surgical procedures require a GP referral.
 
All surgery carries risks.  information provided is general only.  Outcomes experienced by one person do not necessarily reflect the outcomes of others given factors such as genetics, diet and exercise.  Please seek a 2nd opinion from a qualified Specialist Plastic Surgeon.  

Book a consultation

or call: 02 9387 2110

fracs

Royal Australasian College of Surgeons

psruol

Plastic Surgery Research University of Louisville

trcosof

Royal College of Surgeons of Edinburgh

paces

PACES Plastic Surgery Atlanta USA