Hooded eyes refers to a condition of the eyelids in which extra skin has developed in the upper eyelids. This extra skin can droop so much over the eyes that the natural crease in the eyelid cannot be seen. Hooded eyes can be corrected with a procedure called blepharoplasty. The reason for having this procedure is different for everyone, but for someone who has hooded eyes, there are really only two reasons for choosing blepharoplasty: cosmetic or functional.

Cosmetic Reasons for Blepharoplasty
The eyes play an important part in the appearance and are probably the first feature in the face to show signs of aging, often in the form of hooded eyelids. Typically, most people who have blepharoplasty to correct their hooded eyelids, do so to improve their appearance. Regaining some or their youthful appearance can go a long way towards restoring self-confidence. Women with hooded eyes often complain that they don’t have enough exposed eyelid on which to apply makeup. Hooded eyelids can give a face a very severe appearance that makes someone look tired, angry, or sad.

Functional Reasons for Blepharoplasty
Some people can have such severe hooding in their eyelids that their peripheral vision is obstructed. It may even be difficult for them to use the muscles in the foreheads to lift the eyelids enough to allow them to see clearly. In cases like this when the surgery is done for medical reasons and not to improve the patient’s appearance, medical insurance may cover the procedure.

The Blepharoplasty Procedure, Recovery, and Cost
Eyelid surgery known as blepharoplasty removes the extra fat, skin, and even atrophied muscle tissue from the eyelids. The procedure is done on an outpatient basis by a plastic surgeon using local anesthetic. The surgeon will make an incision along the eyelid’s natural crease and then the excess skin, fat, and muscle is removed. The surgeon will then close the incision either with tiny stitches that are virtually invisible or with skin adhesives or surgical tape.

Blepharoplasty to correct hooding of the upper eyelids should only take about an hour. When the surgery is complete, an ointment is applied to keep the eyelids lubricated. Immediately after the surgery, it is possible that the patient may have some tearing, double vision, and sensitivity to light, but this should go away shortly. There will be some redness and puffiness around the incisions for a few days, and the eyelids may feel numb from the anesthetic. In addition, the eyes will be black and blue and swollen for about a week. This should be treated with ice or cold compresses.

There is little pain involved with the procedure, and if the incision was closed with stitches, they will be removed in 3 to 4 days. The surgery scars could last as long as six months before they fade completely. The patient should be sure to protect the area around the eyes from sun until the scars are gone.

The cost of blepharoplasty to correct hooded eyes can run anywhere from $1800 to $2500, depending on the surgeon. This price does not include extra hospital costs and the pre-operative blood tests that are required.

Many people who are interested in cosmetic eyelid surgery tell their Doctor that they are interested in blepharoplasty but that they truly are not “vain.” They’re right! Most people are not looking at cosmetic eyelid surgery as a way to just look better. They realize that although cosmetic eyelid surgery does make the eyes look more beautiful, the appearance of the eyes conveys a deeper quality. The eyes express to those we know and meet something deeper about ourselves before we have a chance to communicate in other ways.

Once it is understood what makes a good candidate for cosmetic eyelid surgery, then it is easy to see who is not a good candidate. A poor candidate for cosmetic eyelid surgery is one who doesn’t truly feel energetic, vital, or interested and is hoping that the surgery will make them so. In other words, those who are hoping the eyelids can be brought into better harmony with who they are on the inside do very well with cosmetic eyelid surgery. However, those who hope the surgery will change who they are on the inside are not as good candidates.

Although cosmetic eyelid surgery is a relatively safe procedure, it is important to review the potential risks. The most dangerous complication from surgery is excessive bleeding after the surgery. The nerve that is responsible for eyesight could be potentially squeezed by excess blood and cause permanent loss of vision. By stopping any blood thinning medications two weeks prior to surgery the chances of such a problem are greatly diminished. Other potential risks of surgery include double vision, dry eyes, infection, a retracted or pulled down eyelid, asymmetry, undercorrection, overcorrection, and the need for more surgery. A brow lift has its own unique set of complications. These include tenderness along the hairline and weakness of the facial nerve. Fortunately, with good surgical technique such problems are rare.

One effect of surgery that is quite common is the formation of milia during the healing process. These are small cysts that can form along the incision line in the weeks after surgery. These cysts are hard to see with the naked eye but can be seen with a magnifying mirror. They are treated at first with simple observation since they usually resolve on there own and they are so difficult for anyone to see. If they don’t go away spontaneously after a few months, a Doctor can remove them in the office very easily.

For cosmetic eyelid surgery the simple answer is about two weeks healing time. The reality is there are so many factors that go into the healing process that in an individual’s case the healing time can vary. Some factors that affect healing are which procedures are performed, how easily the patient bruises, how well the eyelids are taken care of during the postoperative period, and how good of a healer the patient is.

Upper eyelid blepharoplasty causes bruising and swelling that starts soon after the surgery. The bruising and swelling will worsen the day after the surgery. Most patients will start improving on the third day after surgery and many patients feel comfortable driving on this day. Simple tasks around the house can be done as long as there is no heavy lifting.

Stitches will be removed by a Doctor between the fifth and seventh day after surgery. Patients who can work while still being bruised and swollen often choose to work after their stitches come out. There is no exact time when the healing stops. Rather it is a process that involves many stages. Most patients look very good after two weeks. Nevertheless, there is often a slight amount of swelling that can slowly resolve for even twelve months after surgery. Also, the hidden incision in the eyelid slowly loses its red color and becomes thinner. This process can take months to heal as well, but since the incision is hidden it is not an issue. Of course, if more surgery is performed then the healing process takes longer. A brow lift or surgery to remove the under eye bags will increase the healing time somewhat.

Dr. Daniel Ebroon is a board certified Oculoplastic Surgeon whom frequently lectures on the Cosmetic Eyelid Surgery (Blepharoplasty) procedure.

By Daniel Ebroon, M.D.

If you have any of the following conditions you should research this surgery further as you could be a good candidate.

1.Excess or loose skin either hanging down from or obscuring the fold of the upper eyelids.

2.The upper eyelids appear puffy and the eyes look tired.

3.The lower eyelids are “droopy” and/or there is excess skin and wrinkles on them.

4.The eyes have extremely dark circles and “bags” under them.

Eyelid Lift Surgery in most cases can correct these issues provided that there are not other issues as well that need to be addressed. Your plastic surgeon would be able to tell you if you would need any other treatments as well such as Botox, fillers or chemical peels. This would depend on if for example you also had sagging of the eyebrows or something of that nature.

What Can I Expect?

You may be wondering what results you can expect from this type of procedure. Well, the main benefit is that after you are done healing which usually takes several weeks, you will appear more rested and refreshed. In time, the incisions will fade and be hardly noticeable at all. These results typically will last for a very long time but this will vary from person to person based on your lifestyle and hereditary factors. Also, the skin will still continue to age so eventually these conditions may start to appear at some point in the future. Most patients are happy with the results and their appearance but some do opt to have more improvements done as they age.

What Are The Risks?

There are thousands of people a year who have eyelid lift surgery and the vast majority never have any major complications. But as with any surgery there can be some risks involved including hematoma which is blood accumulating under the skin, infection, scarring, allergies, and damage to underlying foundations. Thankfully, these complications are very rare but you should still discuss all of these things with your surgeon or his staff.

If you feel that eyelid surgery would be a good option for you, find a qualified plastic surgeon and discuss your options. Also, make sure you follow your surgeon’s instructions and advice both before and after the surgery.

By: Sarah McCurdy

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