Focus on hooded eyes

Hooded eyes or droopy eyelids (known as 'brow ptosis') happens when excess skin folds down from the brow bone to the lash line. While hooded eyes tend to be genetic, they become more pronounced as we age.

Oculoplastic surgeon Dr Sabrina Shah-Desai of Perfect Eyes, says she has seen a significant increase in requests from people who have hooded eyes. She says: “I’ve seen almost double the numbers requesting hooded eye surgery compared with pre-lockdown.”

“As skin loses its elasticity, we often experience a noticeable droop, including around our eyes”, explains Dr Shah-Desai. “When the droop starts to cover up your eye and affect your ability to see, you may want to consider an aesthetic treatment.”

Dr Shah-Desai has conducted hundreds of upper lid blepharoplasties, which is a surgical procedure to improve the appearance of hooded eyes or saggy eyelids. “Blepharoplasty gives the eyes a more youthful look by removing excess skin, bulging fat and lax muscle from the upper lids," Dr Shah-Desai says. "This procedure, performed under local anaesthetic is best for moderate to severe excess skin and for patients looking for results that can last up to a decade. The downtime is around one to two weeks and most people leave the clinic on the same day they have the procedure."
Younger people, or people with less severe hooded eyes may want to opt for a minimally invasive procedure instead. "For younger patients, often the tail of the brow can be supported by a Silhouette Soft Thread Lift," says Dr Shah-Desai. "It provides a natural-looking and immediate lift of the eye area and the brow."

During a thread lift, which takes less than an hour under local anaesthetic, threads made of surgical, biocompatible material are inserted just under the top layer of the skin with a needle (no incisions) and pulled in two directions to lift the skin, like a drawstring "The results are impressive and less invasive than a blepharoplasty, " says Dr Shah-Desai.

Silhouette Soft provides a two stage lifting process. There is an immediate lift, while the body’s own collagen is stimulated to create a lasting effect.
Dr Shah Desai suggests Hyaluronic Acid (HA) fillers can also add volume to hollows in the upper lids, brows and temples, helping create a more youthful look. Downtime is one or two days for the swelling to go down.
For a longer lasting effect, Dr Shah-Desai also recommends collagen stimulating fillers like Ellanse. “Ellanse is effective at providing volume around the temples to lift the whole area. It both immediately plumps the skin and helps stimulate collagen in the long term. It lasts between one and three years, depending on the patient.”

Meanwhile, Dr Shah-Desai suggests radiofrequency treatments are also effective to tighten skin around the eyes. “Radiofrequency treatment Acculite lifts loose skin for a more youthful appearance”, she says. “A small metal cannula is inserted under the skin to deliver heat energy to the treatment area under local anaesthetic. The treatment takes between one and two hours and downtime is between one and two weeks – patients can expect to see eyelid swelling, redness and bruising during the first weeks after the procedure. The results can last up to five years.

If you have thick skin which is more difficult to treat, Dr Shah Desai recommends one session of Acculite, combined with two to three sessions of Morpheus 8, a tightening radiofrequency treatment which heats the dermis of the skin, kick-starting collagen production. The treatment involves a handheld device (similar-looking to an at-home laser hair removal tool) being applied to the area for a few seconds.