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Dermatochalasis (Hooded Eyelids)

Hooded eyelids (dermatochalasis) are a result of excess skin on the upper eyelid, thanks to skin losing elasticity over the course of the aging process. In rare cases, inflammation can cause this to occur in children, a process called “blepharochalasis”. It is treated in the same way in both cases.

Male and female eyelids

The upper eyelids of men and woman are different by nature. These differences are easily recognized by the experienced eye and we take these into account when performing the surgery. The picture shows the upper eyelid of a 30-year-old woman and a 30-year-old man.

Female

Male

The most important feature in both sexes is the eyelid furrow, which is formed by the uniform irradiation of the fibers of the levator aponeurosis (tendons) into the tarsus (a dense piece of connective tissue in the eyelid). In women, this usually lies at a height of 8-10 mm above the upper lid edge. On the other hand, in men, the eyelid furrow is set much lower, only 6-8 mm above the upper lid edge.

There are clear differences between the upper eyelids of men and women. A male upper lid typically has more skin excess than a female upper lid. This surplus should not always be completely removed: in men, we usually leave a certain excess on the upper lid in order to preserve the natural ‘male’ aspect of the lid.

Preserving your self-image

There are an infinite number of slightly different upper eyelid shapes – and the one we aim for requires a lot of consideration before the procedure. Normally, we aim to restore the eyelid shape that people had in early adulthood.

Some patients show no excess eyelid skin at a young age and, accordingly, more tissue should be removed from such patients. In other words, what represents a “normal” amount of tissue to be removed for one patient may already be too much for another patient. 

On the following pages, you can see from “before – after” pictures that are individually different: in some patients, we remove only a little excess, in others more, so that the result corresponds to the patient’s self-image of years ago.

The consideration of these elementary differences is a matter of course for us and for this reason we also ask you to bring older portraits for the first meeting.

52 years old

18 years old

The illustration shows a patient aged 52 and 18 years. It is noticeable that in this man already in the teenage years a clear skin surplus, so a small amount eyelid droop existed. In this case, only a little amount of skin and fat excess should be removed to restore the patient’s self-image.
 

The operation

Upper lid blepharoplasty can be performed on hooded eyelids on an outpatient basis under local anesthesia. The procedure can usually be performed on both eyelids in the same session and takes about 30 minutes.

Before the actual procedure, we decide on the cut that should lead to the optimal result. With a pen, we draw a precise sketch on the skin. The excess skin and a fine muscle strip are delicately removed in with a scalpel using extreme care. If there is also an excess (or an unexpected distribution) of fatty tissue, this will also be corrected. Finally, the skin is closed with a fine continuous suture.

The so-called “intracutanous suture” is deliberately omitted. In other dermatological procedures, this approach can bring many benefits, but this is not the case with the upper eyelid: there’s no benefit in terms of scar appearance, and it’s also mechanically less resilient too.

The procedure takes about 45 minutes, and upper eyelid blepharoplasty can also be combined with removal of the bags under the lower eyelid (blepharoplasty).

The upper eyelid blepharoplasty on hooded eyelids can also be combined with removal of the bags under the eyelid (blepharoplasty). 

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Augeninstitut ELZA
4.8
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mike
mike
09:02 04 Jan 23
Overall as a 50 year old, who wanted to continue to avoid wearing glasses and/or contact lenses, my goal was 100%... achieved with ELZA and Dr. Hafezi. I greatly appreciated the overall approach by Dr. Hafezi and his friendly and competent team in reviewing my vision at the start and following a comprehensive eye exam- the explanations of my options. For me I chose PRK in one eye for a monovision solution to correct short sightedness which was becoming more prevalent in night driving and sports such as skiing and cycling. PRK heals slowly but the outcome is worth the wait- and the cost- you use your eyes every waking moment- and for me I cannot see any reason not to pursue better vision with the ELZA team! A great quality of life enhancement!read more
Zuzana Fecko
Zuzana Fecko
21:48 31 Oct 22
Thank you so much, Dr. Torres and prof. Hafezi. 26 years I was only “dreaming” about the eye surgery due to possible... complications. I was worried ..Thank you for encouraging me to make a decision and thank you for your professionalism, explanations and great work!I wish you all the best, lots of success and only happy patients!read more
Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
Michele Aggiato
Michele Aggiato
18:17 10 Jan 20
The day I had Prof Hafezi checking my keratoconus I knew I was finally in the right place after years of searching for... a good ophthalmologist. Prof Hafezi recommended a surgery due to a drastic degeneration of my cornea. The surgery was performed by himself with the assistance of Dr Rodriguez, one more collaborator of Prof Hafezi’s team who got my full trust.read more
Ashley Faulkes
Ashley Faulkes
15:30 21 Mar 16
Professor Hafezi and the team at the ELZA Institute have done an amazing job of creating a first class eye clinic, with... cutting edge technology and support. I went there for a dry eye issue and other issues with my prescription, and they were easily able to help me and put me on the road to better vision! High recommend them to anyone in the Zurich/Aargau area.read more
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Augeninstitut ELZA
4.8
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