Upper Blepheroplasty for Hooded Eyelids? (photo)

HI, I'm a 38 yr old Hispanic woman and have very hooded eyelids. I want to get this procedure done within 3 months, so my question is; Should I go to a plastic surgeon or an Occuloplastic surgeon?

Doctor Answers 21

Hooded eyelids

Your photo is not very good, but it appears that your eyebrows are in good position so an upper lid blepharoplasty may be of benefit. Both a board certified plastic surgeon or ophthalmic plastic surgeon should be able to help you.

Miami Plastic Surgeon
4.7 out of 5 stars 62 reviews

Solutions for Hooded Eyelids

The eyes are the windows to the soul. All too often, however, they seem to reveal exhaustion. The very delicate skin around the eyes tends to get crepey and puffy due to fatigue and stress. Eyelid surgery has become one of my most popular procedures. If excess upper eyelid skin is hooding the eye and needs to be eliminated, an incision is made in the crease at the top of the lid and excess fat and skin are removed. The incisions are closed and sutured on the underside of the skin.

An effective non-surgical option that might benefit you is Thermage, which can tighten the skin around the eyes. The new and improved Thermage is a virtually painless, non-invasive (no incision!) treatment that can tighten skin and stimulate your body to make healthier collagen—the building block that provides structure to your skin. Fast and easy, Thermage requires no downtime from normal activities.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Plastic surgeons can perform upper lid surgery and other cosmetic procedures.

Both plastic surgeons and oculoplastic surgeons are trained to perform upper blepharoplasties.  An advantage in seeing a plastic surgeon is that if you need other cosmetic procedures, such as an endoscopic forehead lift, a plastic surgeon may be able to perform this simultaneously or at a later date.  You have some brow asymmetry and sagging of your brows ("brow ptosis") so you are actually a candidate for this procedure as well.  I've noticed that eye surgeons (oculoplastic surgeons are eye surgeons) sometimes limit their incisions to just within the upper lid.  Some patients (and you are one) require the lateral hooding to be treated as well, necessitating a longer incision that goes beyond the orbital rim.  But there is a range of capabilities among all surgeons.  The  most important consideration is the individual's capabilities regardless of their training.  Insist on seeing plenty of before and after photos.  I have a rule called the rule of 10.  You should see 10 examples of outcomes you like performed by your surgeon.  If you do, chances are good that you will be satisfied.  I've attached a link to my website.  Check out patients CK and MC, who are also Hispanic. 

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 57 reviews

Appropriate Surgeon for Upper Blepharoplasty for Hooded Eyelids

Plastic surgeons, facial plastic surgeons, and oculoplastic surgeons can all perform upper eyelid surgery appropriately. You may consider consulting with more than one surgeon for another opinion. Upper eyelid surgery can be performed in the office via local anesthesia. Younger patients like yourself need minimal tissue tightening. Best of luck.


Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Upper eyelid surgery

For upper eyelid surgery (blepharoplasty) you should choose a surgeon with a lot of experience focusing on the face. In your area, I would recommend Dr. Daniel Ward. He has excellent experience with the procedure.

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 131 reviews

Facial plastic surgeon for eyelid surgery

  The primary goal of upper eyelid surgery is to remove the hooded appearance of the upper eyelids. This is accomplished with removal of excess skin and fat with an incision located right in the upper eyelid crease.  An upper blepharoplasty can be performed under local or general anesthesia. Look for a plastic surgeon, facial plastic surgeon or oculoplastic surgeon who performs lots of blepharoplasty procedures to best  suit your needs. A surgeon with lots of experience  should give you a great result.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Hooded Upper Eyelid

From what I can see in your photo, I can tell what is bothering you.  Hooding of the eyelids is a common concern and treated effectively with an upper blepharoplasty.  In order to fix this, the incision must be extended into one of the crows feet.  If you stop the incision short (where the natural crease ends) it will not fix the hooding and sometimes make it a little worse.  The incision heals beautifully, especially in hispanic skin.  I am a Board Certified Facial Plastic Surgeon, so, obviously that is what I would recommend.  But, I am certain there a many excellent surgeons, plastic surgeons, facial plastic surgeons, and oculoplastic surgeons who could do this well.  I have provided a link to some before-and-after photos who had similar problems before surgery.

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 87 reviews

Qualified surgeon

This is an age old question that cannot be answered with a simple answer.

There are 3 different types of plastic surgeons that perform blepharoplasty:

General plastic surgeon

Facial Plastic Surgeon

Oculoplastic Surgeon


Plastic surgeons do full body plastic surgery, from breast augmentation to tummy tucks, to calf implants, as well as facelifts, nose jobs and eyelid surgery.

Facial plastic surgeons focus the practice on plastic surgery of the face, such as nose jobs, facelifts, browlifts, chin and ear surgery.

Oculoplastics surgeons focus on plastic surgery of the face but more focused on the area around the eyes, such as eyelids, eyebrows, and cheeks.

All three surgeons are trained in blepharoplasty. The previous experts have provided excellent criteria for choosing your surgeon, such as training, experience, before and after results, and patient satisfaction.

I would recommend seeing a few surgeons until you are comfortable not just with their results, but also with their demeanor and bedside manner.

Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

A good surgeon

Whether an occuplastic or plastic surgeon isn't the most important factor.  Board certification and surgeon experience are more important.  I'd ask to see some before and after pictures and see if you feel comfortable with the surgeon. Best regards!

Guy Cappuccino, MD
Mount Airy Plastic Surgeon
5.0 out of 5 stars 90 reviews

Upper blepharoplasty

Great question.

When evaluating and considering a physician or surgeon for any mdeical concern, I would recommend using the following criteria in making your evaluation:

1- Training - Was the surgeon trained in a residency/fellowship program to perform the procedure you're interested in?  With this in mind, you could reasonably visit a plastic surgeon, an oculoplastic surgeon, or a facial plastic surgeon.

2- Experience - How often has does the surgeon perform this procedure, and how many of the procedures has he/she done?

3- Your impression - Are you comfortable with the surgeon, his/her personality, demeanor, and attitude?  The relationship that you establish with the physician and your ability to interact and comfort level are just as important as the first two factors.

There are other considerations as well, but these are some of the most important.  Hope this helps.

Scott K. Thompson, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 107 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.