What Are Hooded Eyes?

Dr Michael Kernohan MBBS, MSc, BDS, MRCS, FDSRCS, FRCS(Plast), FRACS (Plast

Causes and Treatment for Excess Eyelid Skin

Eyelid ptosis (sag) can blur your vision and make it harder for you to see or read. Some people are born with hooded eyelids, while others develop them as they grow older.

Dr Michael Kernohan is a Sydney specialist plastic surgeon with many years of experience performing surgical and non-surgical cosmetic procedures that help lift the eyelids. 

Continue reading to learn more about some of the causes of hooded eyes and ways to help make your eyes look bigger with and without surgery. 

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What Are Hooded Eyes?

Hooded eyes, also known as eyelid ptosis, have excess skin folds just below the eyebrows that drop down over the upper eyelids. The excess skin can pull down all the way to the lash line. 

Hooded eyelids can make the eyes look smaller than they are and give them a tired appearance. If the upper eyelids drop too much, they can even block your sight and cause vision problems.

You may experience issues with either one or both your eyelids, but people usually have hooded eyelids in both eyes.

How Do You Know If Your Eyes Are Hooded?

You can tell that you have hooded eyes if the skin below your eyebrow folds down and covers part or all of your upper eyelid.

As a result, when your eyes are open, you won’t see a well-defined, curved eyelid space. Instead, you’ll see only a crease right above your lashes.

What Causes Hooded Eyes?

Dropping of the upper eyelid can be congenital (inherited). Some people develop hooded eyes with age or because of an injury or medical condition affecting the eyes.

Possible causes of hooded eyelids include:

  • Congenital: This is a common cause of hooded eyes. Some people are born with excess skin in one or both upper eyelids. That happens because the levator muscle, responsible for holding up the eyelid, doesn’t develop properly. As a result, they grow up with excess skin on the upper eyelid that can obstruct vision and make the eye look weak or lazy, a condition known as amblyopia or lazy eye.
  • Ageing: This is the most common cause of hooded eyelids. The skin around your eyelids is one of the thinnest on your entire body. As you grow older, your skin relaxes, loses its elasticity, and begins to drop, including the skin above your eyes. This causes the appearance of excess skin on your upper eyelids. The levator muscle responsible for holding up the upper eyelids in place also thins and becomes less toned with time.
  • Eye injury: Wearing contact lenses for a long time, an eyelid cyst, or getting hit in the eye can damage the function of your levator muscle and cause your eyelid to droop
  • Eye surgery: You can develop eyelid ptosis after eye surgery, such as cataract, glaucoma, or LASIK surgery. However, when this occurs after eye surgery it is usually temporary and will resolve without treatment.
  • Wrinkle Treatment: Upper eyelid ptosis is one of the most common complications of wrinkle treatment between the eyes (frown lines), in the forehead, and around the eyes. That happens when some of the substance accidentally gets into the upper eyelid muscle causing it to relax. This usually resolves as the treatment wears off. Some studies suggest that a prescribed topical brimonidine gel can help relieve this type of eyelid ptosis.
  • Underlying medical conditions: Some medical conditions can cause hooded eyelids/eyelid ptosis, including Myasthenia Gravis, diabetes, an eye infection, and an eyelid tumour.

When Should You Treat Hooded Eyes?

Hooded eyelids are often a sign of ageing and is not something to worry about. With that said, you may want to seek treatment for your hooded eyelids if they’re causing you any of the following concerns:

  • Cosmetic concerns: Hooded eyelids can make the eyes appear small, wrinkled, uneven, and tired.
  • Impaired vision: Saggy eyelids can block your pupils and blur your vision. Consult a plastic surgeon if you can’t see clearly because of your hooded eyelids
  • Headaches: You might have to squint too much to see better if you have drooping eyelids. Excessive squinting strains the muscles around your eyes and can cause headaches
  • Dry eyes: Your upper eyelids contain glands responsible for keeping your eyes wet. Hooded eyelids can’t keep your eyes as moist as they should be, which causes them to become dry and irritated

You should also inform your surgeon if you’ve recently undergone Wrinkle or Volumising Treatment and notice a heaviness in one or both eyelids. In this case, these treatments may be the reason behind your hooded upper eyelids.

How to Treat Hooded Eyes?

There are surgical and non-surgical ways to treat hooded eyes depending on its cause and severity.

Dr Michael Kernohan regularly performs eyelid procedures. He will carefully examine your eyes to determine whether an underlying medical condition is causing your eyelid ptosis. 

He will then offer you the optimal solution for your hooded eyelids.

How to alleviate hooded eyes “at home”

Below are several tips that may help alleviate the appearance of eyelid ptosis and sleepy eyes without surgery:

  • Chamomile tea bags: Chamomile contains various essential oils and is a natural anti-inflammatory. It can aid your skin and help reduce puffy eyelids. Steep chamomile tea bags in hot water, wait for them to cool, then apply them to your eyelids for several minutes.
  • Chilled cucumber slices: Cucumbers have anti-inflammatory properties and have been long used by women to treat red, tired, and puffy eyes. The cooling effect and anti-inflammatory activity of chilled cucumber slices can help reduce the appearance of puffy eyes.
  • Iced water: The cold temperature of iced water tightens the skin around your eyes, which leaves them looking more refreshed.

Non-Surgical Treatments for Hooded Eyes

If you only have mild eyelid ptosis in your upper eyelids, some non-surgical treatments for hooded eyelids may be enough to alleviate your concerns.

Treating hooded eyes without surgery can be done using:

  • Ptosis eye crutches: These are special glasses with crutches that will lift your upper eyelids. Eyelid crutches can keep your eyes open to help you read and see better. They offer a temporary solution for people with only slightly hooded eyelids who want to avoid surgery
  • Brow lift Treatment: A brow-lifting treatment uses specific substances placed subdermally into targeted areas around the eyes. This approach relaxes specific muscles in the forehead, which may allow the brow to elevate slightly. This effect can help reduce the appearance of heaviness in the eyelids, creating a more open and refreshed look. Consult a qualified healthcare provider to determine if this treatment is suitable for your needs.
  • Eyelid Volumising treatment: You can receive Volumising treatments into your upper eyelids. These treatments can expand hollow areas of your eyelids and give them more volume.

These non-surgical options can alleviate the appearance of slightly hooded eyelids. However, they’re not permanent, and you’ll need repeated treatments to maintain results.  

How to Alleviate Hooded Eyes with Surgery?

Although non-surgical treatments for puffy eyelids and weary eyes are available, they won’t help you much if you have significant eyelid ptosis.

Plastic surgery is the only way to permanently and effectively treat hooded eyes.

Dr Kernohan offers surgical eyelid-lifting procedures that can alleviate the appearance of excess upper eyelid skin and hooded eyes.

Watch Dr Kernohan Explains What’s Involved in Blepharoplasty
Watch Dr Kernohan Explains What’s Involved in Blepharoplasty

1.    Upper Blepharoplasty

Upper Blepharoplasty is a cosmetic procedure that removes excess sagging skin and tissue from the upper eyelids.

Your upper eyelid lift will involve the following steps:

  • First, Dr Kernohan makes a small incision along the fold of your upper eyelid
  • Then, he cuts out any excess skin and fat weighing down on your eyelids
  • After that, he tightens the levator muscle that controls your upper eyelid and lifts it into a more aesthetically appealing position
  • Finally, he closes the incision using delicate suturing techniques that reduce the appearance of a scar

2.    Brow lift

A brow lift, also known as an upper facelift or forehead lift, is a cosmetic procedure that raises the brows and refreshes the appearance of the forehead. 

Brow lift surgery can be performed with:

  • A single, long incision along the hairline extending from one ear to the other (coronal brow lift)
  • Two shorter incisions, one above each temple (limited-incision/temporal brow lift)
  • Very small incisions behind the hairline (endoscopic brow lift)

During a forehead lift, Dr Kernohan repositions the skin and soft tissue in the forehead to reduce the appearance of forehead wrinkles. He also lifts the deep forehead muscles to raise the eyebrows and pull the upper eyelids up.

As a result, your forehead wrinkles will diminish and your eyes will look wider and more alert.

A brow lift can be done alone or alongside a blepharoplasty to lift the forehead and eyelids at the same time.

What’s The Best Treatment for Hooded Eyes?

There isn’t a one-size-fits-all solution to hooded eyelids. The treatment will depend on the cause and severity of your upper eyelid ptosis.

If you have only a little excess skin on your upper eyelids, non-surgical treatments such as wrinkle and volumising treatments may be suitable, however, these results aren’t durable.

Iif you have significant upper eyelid ptosis then surgery may be more suitable. Upper blepharoplasty and brow lift are surgical options that can alleviate eyelid ptosis long term. 

An upper eyelid lift removes excess skin and fat that fold down over your eyelids. It also lifts the levator muscle that controls your upper eyelid. Although, it can’t raise your eyebrows.

A brow lift tightens the forehead and raises the brows, which lifts the upper eyelids.

If your eyebrows sit high but you have excess skin over your upper eyelids, an upper blepharoplasty may be a more suitable option. Alternatively, if you have low eyebrows pressing down on your upper eyelids, then a brow lift may be a more suitable choice. 

Some patients may undergo a brow lift and an upper eyelid lift at the same time if they desire a more dramatic change to their eyes and the entire upper portion of their face.

During your consultation, Dr Kernohan will thoroughly assess your eyelids and eyebrows to determine the right treatment for your hooded eyelids.

FAQs about Surgical and Non-Surgical Solutions for Hooded Eyes

Can your eyelids drop after cataract surgery?

  • Yes, it is a possible complication of cataract surgery. Usually, this form of upper eyelid ptosis is temporary and goes away without treatment.

Can a brain tumour cause eyelid ptosis?

  • In most cases, eyelid ptosis is a result of ageing or a congenital condition. Although, they can also be a sign of a serious underlying medical condition, such as a brain tumour, Myasthenia Gravis, or diabetes.

When should I be worried about a eyelid ptosis?

  • Eyelid ptosis isn’t usually a health concern. You should consider surgical intervention for your eyelids if it interferes with your vision. However, you should contact a healthcare provider if you suddenly develop eyelid ptosis, especially if it’s only one-sided or you experience other concerning symptoms simultaneously. 

Further Reading

Medical Resources: