October 21, 2026, 6:13 pm | Read time: 5 minutes
No question, beauty is in the eye of the beholder. What one person–usually the individual concerned–perceives as a flaw, others hardly notice. However, supposed beauty issues are not always just a matter of aesthetics. Some of them can also bring health problems. An example of this is so-called hooded eyelids, medically referred to as dermatochalasis. FITBOOK spoke with a doctor about it.
What Are Hooded Eyelids and Where Do They Come From?
Hooded eyelids are a common visual feature that often bothers those affected for aesthetic reasons. The term refers to excess, sagging skin on the upper eyelid that hangs as a fold over the movable lid.1
There are various possible causes for hooded eyelids, including entirely natural ones. As we age, the skin loses its elasticity, and simultaneously, the fatty tissue and bony structures around the eyes change. This can cause the eyelids to sag and fat pads to become more prominent. The fact that hooded eyelids can also appear at a young age shows that genetic predisposition plays a role.
Sometimes hooded eyelids also result from allergies or illnesses. Lastly, lifestyle can accelerate skin aging.
Aesthetic Consequences of Hooded Eyelids
Drooping eyelids often lead to a tired appearance, making those affected look sad or exhausted. For mildly pronounced hooded eyelids that do not cause physical discomfort or vision problems, cool compresses can temporarily help reduce swelling. Suitable options include chilled cucumber slices or cotton pads soaked in cooled black tea. The tannins they contain can have a slight astringent effect on the skin. However, the hooded eyelids themselves do not disappear as a result.
Those seeking a more lasting change may opt for an upper eyelid lift (blepharoplasty). The desire to look permanently fresher and more alert plays an important role in this decision, reports Prof. Dr. med. Jörg Borges, a specialist in plastic surgery, in an interview with FITBOOK.
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Physical Complaints Like Tension and Even Migraines
Hooded eyelids do not always just affect the visual appearance. In cases of pronounced hooded eyelids, the upper field of vision may be restricted if the drooping skin obstructs the upward view. Other possible physical complaints are often not initially associated with hooded eyelids by those affected.
“Many of our patients report quickly tiring eyes, such as during screen work or driving,” says Prof. Borges to FITBOOK. Shoulder-neck tension, tension headaches, and even migraines are also frequently mentioned. But as mentioned: only upon inquiry. The women and men interested in an upper eyelid lift are often unaware that their complaints could be related to their hooded eyelids, the expert emphasizes.
How Exactly Do the Complaints Arise?
The doctor explains the possible connection with the mechanics of vision. Depending on the severity of the hooded eyelids, those affected–often unconsciously–try to keep the eye area clear by raising their eyebrows. This puts more strain on the forehead muscles. If excess skin on the upper eyelid restricts the field of vision, this muscle activity can persist for many hours a day. And this is where the tension originates.
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Upper Eyelid Lift Can Often Alleviate Complaints
Important: Hooded eyelids and migraines can, of course, also occur independently of each other. “Especially with migraines, numerous other triggers are possible,” the doctor emphasizes.
However, if the complaints were indeed related to the hooded eyelids, they often subside shortly after an upper eyelid lift, according to Prof. Borges, based on many years of experience. A possible explanation: When the eyebrows no longer need to be constantly raised to keep the field of vision clear, the forehead muscles can relax. This could also alleviate muscle-related headaches and tension.
Can Botox Be an Alternative?
For those who do not wish to undergo surgery, a Botox treatment can be a possible alternative–especially for certain types of headaches and migraines. It can relax the muscles and alleviate complaints. The effect is temporary and usually lasts about four to six months. According to Prof. Borges, such a treatment could also serve as an orientation. If the complaints improve, it may indicate a muscular connection. Whether an upper eyelid lift is advisable should then be clarified medically.
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How an Upper Eyelid Lift Is Performed
An upper eyelid lift is usually performed on an outpatient basis under local anesthesia. If desired, patients receive additional twilight sleep, a light sedation. A fine incision is made in the natural eyelid crease, and excess skin and, if necessary, protruding fatty tissue are removed. The wound is then closed with a fine suture. The procedure typically takes about 45 minutes.
What to Consider When Thinking About a Procedure
Aesthetic procedures can certainly have a functional or medical component. This applies not only to hooded eyelids but also, for example, to macromastia (very large breasts in relation to a woman’s body size and stature), which can cause issues ranging from back pain to psychological problems to various types of complaints. Conversely, many affected individuals report a sudden improvement in their ailments after a breast reduction.
However, it is also clear: Not every hooded eyelid or other deviation from personal beauty ideals is automatically a health problem. And, of course, it is also legitimate to decide on a procedure for aesthetic reasons. What is important is to consciously consider the possible risks before surgery and to realistically assess one’s expectations. Whether for aesthetic or medical reasons, surgery should always be well thought out.