Hooded Eyelid Surgery: Everything We Know

Hooded eyelid

Hooded eyelid is a facial feature in which there appears excess skin and fat muscles under the eyebrow. They are also referred to as droopy eyelids. Hooded eyelids surgeries remove the excess skin and fat tissue from the levator muscles on the eyelids. 

Eyelid surgeries include both invasive and non-invasive procedures. A hooded eyelid surgery gives you a welcoming aesthetic improvement helping you look and feel youthful. Cosmetic enhancement is one crucial factor for undergoing hooded eyelid surgery. 

Common eyelid shapes and hooded eyelids


A monolid is an eye shape that doesn’t have a crease or appears to lack a crease. The brow sits together with the lash line hiding the eyelid from view. 

Round eyes

Rounded eyes are rounded both at the center and in the corner. They look heavy in the middle with outside and inner corners that taper naturally. A rounded eye generally appears more prominent than most other eye types.


If the outer corners of the eyes turn downward and inner corners turn up. Downturned eyes appear large and heavy as they tend to have more skin around them. 

Upturned eyes

Suppose the outer corners of the eyes lifts upward. The outer corner is higher than the inner corner. This eye shape is also known as the cat-eye shape. Upturned eyes appear narrow at the outer edges and higher at the outer corners.    

Almond eyes

Almond eyes are eye shapes that look like almonds laid on the side. They are heavy and rounded on the outer corners and the inner corners slightly narrow. 

Protruding eyes

Protruding eyes have the appearance of eyes that seem to bulge out. They create the appearance of projected eyelids. Protruding eyes are also generally round and large as compared to other eye types.

Deep-set eyes

Deep-set eyes, in comparison to protruding eyes, are large and set deeper into the eye socket. They give the appearance of a more pronounced brow bone. 

Close-set eyes

The eyes are set closer together. Close-set eyes are less than one eyeball width apart.

Wide-set eyes

Wide-set eyes, in contrast to close-set eyes, are more than one eyeball width apart.

Hooded eyes

A small flap of excess skin appears under the eyebrow. The excess skin drops over the crease, or the folded skin is above the eyelid. The extra layer of skin causes the eyelids to appear smaller among people with hooded eyes.  

Causes of hooded eyelids

Many factors may cause a hooded eyelid. It could be passed down as a genetic trait or a sign of the aging process. However, an overwhelming case of hooded eyes occurs because of an underlying medical condition known as ptosis.

Ptosis can affect people of all ages, including newborns. It can obstruct, block or reduce vision and, in some cases, lead to vision impairment. Ptosis can be caused due to variety of reasons that include 

  • Injury or damage to the nerve controlling eyelid muscles
  • A complication of eye surgery
  • A side effect of Botox injection

Non-invasive treatments for hooded eyelids

Treatment for hooded eyelids includes various invasive and non-invasive surgeries. One of the standard procedures of treating ptosis is an invasive surgery to tighten the stretched levator muscles of the eyelids. 

A ptosis crutch is another popular non-surgical option.  It involves adding an attachment to the frames of eyeglasses that obstruct the eyelids from closing.

There are other creams, drops, and ptosis treatments using radiofrequency, but the efficacy of these treatments has not proven to be convincing. A dose of Botox may unfortunately result in hooded or droopy eyelids. 

Botox (botulinum toxin) injected into the forehead works by inhibiting and weakening the facial muscles responsible for the lines and wrinkles on the face. However, Botox may migrate over to the levator eyelid muscles causing droopy or hooded eyelids in some cases. 

The effects usually wear off between 3-4 months from the administration of Botox. Additionally, Botox may be recommended to treat and improve ptosis. 

Hooded eyelid before and after surgery

Before considering surgery, you should properly consult with a plastic surgeon, an ophthalmologist (eye specialist), or seek the advice of an oculoplastic specialist (a plastic surgeon who specializes in eye surgeries).  

Blepharoplasty is perhaps the best-known surgery for the removal of excess skin and fat tissues from the eyelids. Before the procedure, numbing medicine is applied to the eyelids, followed by intravenous sedation and anesthesia to help you calm down.

Blepharoplasty surgeries are usually performed in an outpatient setting. You may also have to undergo a physical examination and a vision test to assess your health and to support any insurance claims later.  After the surgery, you may temporarily experience:

  • Blurred vision
  • Watery eyes
  • Swelling and bruising
  • Double vision.
  • Numb eyelids  

A cut or incision may be made on the lower or upper lash line, depending on whether surgery is for the upper or lower eyelid. Excess skin and fat deposits are removed after the incisions have been made. The incisions are closed using removable sutures, surgical tapes, and unique skin adhesives.

After the surgery, it is vital to avoid any strenuous activity or exercise plan for at least two weeks. Stitches may be removed by the third or fourth day after the surgery. Your surgeon will give specific instructions, including medications. A follow-up session with your doctor is essential to help you cope with any signs or symptoms post-surgery.

The takeaway

A hooded eyelid is a condition of the eyes where a small flap of excess skin droops under the eyebrow and above the eyelid. This causes the eyes to appear smaller among people with hooded eyes.  

A hooded eyelid may be caused by many factors, a hereditary trait, a natural sign of aging, or an underlying medical condition.

There are both invasive and non-invasive surgeries to treat people with hooded eyes. Although there is a lot of non-invasive treatment in creams, balms, capsules, and Botox, there isn’t much evidence about their efficacy. 

Invasive procedures involving a Blepharoplasty surgery effectively remove fat and skin tissues from the eyelids. However, before going ahead with any treatment, it is best to refer to your healthcare provider(an oculoplastic surgeon or an ophthalmologist) to ensure a satisfactory end result.   


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