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A 23-year-old woman has hooded eyelids her whole life. She is wondering if it due to her lazy eye, and asks if she is a candidate for blepharoplasty. As a cosmetic oculofacial plastic surgeon, Dr. Amiya Prasad first had baseline training in ophthalmology before specializing in cosmetic surgery. He explains that the strabismus or the lazy eye she is referring to has nothing to do with the hooding of the eyelids. As far as the hooding concerned, very often it’s a genetic trait that can run in her family. It may not be from both parents but it’s most likely someone has these genes for this particular type of look. Whether or not she is a candidate for blepharoplasty really depends on what her desired outcome is. If she has hooding that represents relative excess skin, a physical exam helps determine what the potential appearance can be. Dr. Prasad often does a simple Q-Tip rolling test where he shows the patient using a Q-Tip into the fold of the eyelid. The patient sees if it is possible to help them look the way they want to look. He always assesses whether or not he is able to have the patient close their eyes appropriately because that’s one of the most common concerns with upper eyelid blepharoplasty. In his practice, he always states that will not be a problem as it's an exceedingly unlikely event in his hands. Dr. Prasad first determines if there is a presence of extra skin. If this is a situation where there isn’t extra skin, then a non-incisional blepharoplasty, which is more of a technique he uses for Asian eyelid surgery, may be appropriate. This where he creates a fold without removing skin, which may be an option that is potentially right for her. It’s not necessarily about the age, but ultimately the appearance of the eyes. If there’s an opportunity to improve the appearance of the eyes with cosmetic upper eyelid blepharoplasty, then certainly she can be candidate for this procedure. It does require a physical examination to ascertain whether or not she is a candidate, and whether or not she will achieve the look she desires. Dr. Prasad's recommendation is that she meet with cosmetic oculofacial plastic surgeons. His advice is towards specialization with people who know the eye area very well, especially in working with a younger person. She should be comfortable with the surgeon she meets with and spend the time to determine whether or not she likes the look once the eyelid fold is addressed. She wouldn’t want to have any remorse or regret after making this important decision. If she finds someone, it would be great for her to move forward and see the shape of her eyelid. Upper eyelid hooding can make someone look tired and older, so an upper eyelid blepharoplasty will probably be a value. It’s her choice and her decision will be based on her aesthetic. For more information about upper eyelid surgery/ upper eyelid blepharoplasty, please visit our website: http://prasadcosmeticsurgery.com/pras...