Upper eyelid hoods

These extra skin folds above your eyes can get so big that they interfere with eyesight. Long before they get to this stage, though, they just look old and sad. Here’s what can be done about them.

As the skin and soft tissues above the eyeball and below the eyebrow age and change, some persons develop an excess of skin, and sometimes skin and fat in combination. The excess skin hangs down to make you look tired, like a sleepy dog, and may even hang so far as to create a weight on your upper eyelid. Some patients deal with this, at least initially, by developing a habit of raising their eyebrows. The elevated eyebrows drag up some of the excess skin, but at the cost of creating rows of lines across the forehead. This is a very common process, widely seen in people if you look for it. Others don’t develop this habit, and simply cope with the extra skin flopping on their upper eyelids, but eventually vision can be impaired.

The management of this problem is surgical; the upper blepharoplasty operation. In essence this is a very straightforward and simple operation, but it is not commonly done well. We can all think of TV stars, movie stars and other public figures who have had this surgery performed without getting a great result. So, it is important to approach surgeon selection very carefully, and present to the surgeon in a way that will get you the best result.

Patients seeking upper eyelid surgery fall into two groups. One group have upper eyelid skin that is of a shape that they essentially don’t like and have never liked. Looking at old photos, they identify that the problem has been present since childhood. They are seeking a different look to that they were born with.
The other group are typically older, and were happy or at least content with the way their eyelids used to look, but are not happy about the age-related changes that have occurred since. Looking at old photos, they can show you that they want to look the way they used to.

The goal result for these two groups is very different, but not all surgeons perceive this. Some surgeons believe there is such a thing as a “perfect eye” and will want to correct your eye to a textbook description of perfection: if you are in the group wanting to recover your former look, rather than change your essential look, be careful to make this point clear to the surgeon and ensure that you have been understood. Otherwise you will end up having too much skin removed and you will look different to your friends, rather than simply rejuvenated.

If you are trying to look the way you used to look, be sure to take old photos of yourself along to your consultation and make it clear to your surgeon that you want your former look back, not the look of a different person.

Agree with your surgeon on a conservative approach. Excessive skin removal carries a higher risk of an unnatural and “you’ve had your eyes done, haven’t you?” look. Accept a good improvement to the degree of excessive skin present rather than aiming for a tight result; that way you will look better and younger but still the real “you”.

Resist the temptation to think that by taking more skin the surgery will keep you looking younger for longer. More is not better, and is not better value.

The other determinant that I think helps differentiate a good surgeon from an average surgeon is the planning. I believe good surgeons spend the time to precisely plan their excision lines and, in particular, use calipers or a similar instrument to ensure their excisions are exactly symmetrical (assuming the patient is symmetrical in the first place: dealing with asymmetrical patients is of course more complex). This is because it is so critically important to get the incision lines correct.

Come to talk further to me about blepharoplasty in consultation

02 9368 0100