A patient with upper lid hooding, a very common development as we age. This can cause a cosmetic problem and can prevent the application of make-up in the upper eyelids, but it can also cause a functional problem with a restriction of vision. In some patients, this leads to headaches from the fatigue of the having to constantly raise the eyebrows. This patient shows the result of a bilateral upper lid blepharoplasty performed under ‘twilight anaesthesia’ on a day case basis. The surgery is performed conservatively to ensure that blinking is not compromised and to avoid an operated look.