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What is the treatment for upper eyelid hooding?

Upper eyelid hooding: First of all, what is upper eyelid hooding? This is when patients have too much skin on their upper eyelids, particular to the outer edge. And that drops down onto their eyelashes or maybe just drops down over the area of the upper eyelid. If they are women where they would put their makeup. It can get in the way of the vision. It can feel heavy.
So first of all before treating, I assess the patient. I ask them how long they had it for, how interferes with them, whether it’s purely a cosmetic problem or whether it’s more of a practical problem. Like they can’t get their makeup on or it’s touching the eyelashes. And as soon as they put the mascara on, it runs.
Sometimes it can cause headaches because they try to lift eyebrows during the day to try and lift their upper eyelid hooding off the eyelids. And so they are fine for the first half but towards the end of the day, they are very tired. And there can be some dissent infect behind the hooding that can feel heavy. The actual presence of the hooding can interfere with the visual field and cause them a medical problem for which they really have to have a surgery.
The treatment of eyelid hooding is eyelid surgery. It’s upper eyelid blepharoplasty. Meaning: Oculoplastic surgery on the eyelid skin with a little bit of the underlying muscle. Just removed to de-bulk it so that everything fits nicely.
This surgery is delicately done under local anaesthetic. Your surgery will be done here, at Clinica London. You’re invited up about an hour before and you see the nurse for the pre-assessment where she goes over the post-operative management of the surgery. And we both together go over the consent form.
The eyelid surgery under local anaesthetic involves sitting initially in a very comfortable operating chair cum bed, it can go up and down, and I mark the skin crease and I mark the amount of skin that needs to be removed.
It is very important that it is done under local anaesthetic because then you are what we call fully cooperative and aware. That means that you can look up and down, you can sit up and down. Now we can judge exactly the right amount of skin that needs to be removed to correct your hooding.
The other thing that is important is that you bring along some photographs of how you looked like when you were younger. Because the last thing I want to do is to change your appearance from what you really are. So for instance, if you have always had a low skin crease because that runs in your family, then the last thing you want me to do is to put it higher. So I have to see what you have looked like when you were 20, 23, 25 and make a judgement on that with you and make a decision of where to make the skin crease.

More about Jane Olver

Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.

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