Could you be more specific? Which game and what patch?
Examples:
- TombATI (patch for Tomb Raider 1): The patch seems to launch the game only at the same resolution as the Windows desktop, regardless of settings. Win7 and later desktop gets oversized and mostly offscreen at low resolutions, so I use a 3rd party program like "Res-O-Matic" to automatically & temporarily change the resolution to 640x480 when launching this game.
This might be helpful if your top-down games are matching your Windows resolution (although it's not an issue in most 3d games because only the UI elements like the health bar get smaller).
- Baldur's Gate 2, C&C, Red Alert: these 2d games will look twice as small at double the resolution. Do your Widescreen patches allow you to lower your resolution further? (e.g. if a game was originally meant to be played at 640x480, then the widescreen 16:9 aspect equivalent would be 854x480 to fully fill your screen. Or you could just play the games without widescreen patches and rely on the full screen scaling options of your display card, if it can maintain aspect ratio so you will see the games as they were meant to be but with black-bars on the sides of your widescreen monitor).
- Older games that either run at 320x240 (e.g. Outcast) and end up having black borders all around because most modern display cards can't scale them up, or use older DirectDraw versions and don't run at all: I use DGVoodoo2 (by placing the "dx" dll files in the game's exe folder) to set a higher resolution for these games (e.g. at least 640x480, then most display cards know how to scale them up to fill the vertical part of the screen at least), or to use the newer DirectX instead of DirectDraw.