Hooded EyelidsWhat it is, and what we can do about it.

What hooding actually is

A hooded eyelid is one where skin from the upper lid folds downward and rests over the crease, sometimes reaching or covering the lash line. It can be something you have had your whole life, or something that has developed gradually and that you noticed one day in a photograph.

Both versions are common, and they are not the same problem.

Three separate contributors

Inherited anatomy. Some people simply have a lower-set brow, a fuller upper lid, or a crease that sits closer to the lash line. This is a normal variation in eyelid shape, present from young adulthood, and it is not a sign of anything having gone wrong.

Eyelid skin laxity. Upper eyelid skin is the thinnest on the body, and it loses elasticity earlier and more visibly than skin elsewhere. As collagen and elastin decline, the skin stretches, and the excess has nowhere to go but downward.

Brow descent. This is the one people miss. The forehead and brow drift downward over time, and as they do, they push forehead skin into the upper eyelid space. The result looks like an eyelid problem, but the tissue has come from above.

Distinguishing these is the entire point of an assessment. Treating lid skin in someone whose issue is brow position, or attempting a brow lift in someone with genuinely excess lid skin, are both ways to spend money and be disappointed.

The compensating habit

Many people with hooding unconsciously use their forehead muscle to hold the brows up, all day, every day. This does two things: it deepens horizontal forehead lines over time, and it means that relaxing that muscle with a neuromodulator has to be done carefully, because removing the compensation can make the hooding look worse rather than better.

This is a real technical consideration and it is why forehead treatment in someone with heavy hooding needs an injector who has looked at the whole picture rather than just the lines.

What we can offer

Non-surgical blepharoplasty using Plexr. A plasma device is used to create a controlled pattern of tiny superficial points on the excess upper lid skin. As those points heal, the skin contracts and the amount of loose skin is reduced. It suits mild to moderate hooding in people who want to avoid surgery and who can accommodate genuine downtime, which includes visible small crusts and swelling in the days afterwards.

Botox, Dysport or Xeomin brow lift. Relaxing the muscles that pull the brow down allows the elevating muscles to act with less resistance, producing a modest lift of the brow and, with it, a small opening of the upper lid space. It is subtle, it is temporary, and it works best where brow descent is the main contributor.

PDO threads can be used to reposition brow tissue in appropriately selected cases.

When the answer is surgery

If you have significant excess upper lid skin that rests on or over the lash line, or hooding that is affecting your field of vision, non-surgical treatment will not give you the result you are picturing. Surgical upper blepharoplasty removes skin; nothing we offer does.

We will tell you if that is what we see. Referring you to a surgeon costs us a booking, and it is a much better outcome than a course of treatments that was never going to be enough. If your vision is affected, please raise it with a physician, because that is a functional issue rather than a cosmetic one.