Hooded Eyelids and Anti-wrinkle injections – by Dr. Aicken – Visage Academy

Everyone’s face is unique. I am often asked for advice from my previous trainees when it comes to treating a specific area or how to approach a patient’s particular characteristics. (See my previous post about “Tall foreheads”.) Recently, a brilliant question that came up I’d like to share is regarding a “hooded eyelids” and anti-wrinkle injections.

Hooded eyelids, anti-wrinkle, visage aesthetics, visage academy

“What precautions do I take when injecting the frown lines with slightly hooded eyelids?”


  1. You need to assess the patients hooding without them frowning. When frowning, the eyelids move down. A true assessment is eyes open, relaxed, with your face directly in front of theirs. If less than 2mm between their eyelid and iris, I’d avoid forehead or frown botox. There’s always a risk of 1-2mm drooping, so if you start with less than 2mm leeway, you are taking unnecessary risk.
  2. Make sure your frown injections are 1.5cm above the orbital rim. Not the eyebrow. 
  3. Mark off with the face at rest. If raising eyebrows or frowning, the injection sites will be wrong. 
  4. Inject with the face at rest. If squeezing eyes shut, the injection sites will be wrong.

I hope this helps. Do you need any advice or need any specific questions answered? Drop me an email following your training.

Thanks for reading,

Dr. Michael Aicken,
Founder and Lead Clinician of Visage Academy and East London Clinic

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