Dark Circles under the lower eyelids are very troublesome, detract from appearance, and impart an aged look on people. In fact dark circles under the lower eyelids may be the most common concerns patients present with to an eyelid specialist (oculoplastics or ophthalmic plastic surgeon’s).
Why do dark circles under the eyes develop? Well, there are a variety of causes:
- First-prominent, puffy eyelid bags above can allow a shadow to be created which can impart a dark appearance below.
- Second-pigment cells in the skin (melanocytes) can be overly active causing darkening.
- Finally-the muscle under the thin eyelid skin and blood vessels in the same area often appear dark. When the skin is thin enough this darkness can become apparent.
Dr. Guy Massry, Beverly Hills Ophthalmic Plastic Surgery, is a blepharoplasty surgeon (eyelid surgery) expert, who has a particular interest in reducing dark circles around the eyes. The best treatment depends on the primary cause and this can be identified upon evaluation in the office. If eyelid dark circles concern you please contact Dr. Massry at his office (310) 657-4302, or through his web site.
Blepharoplasty (cosmetic eyelid surgery) is one of the most frequently performed aesthetic surgical procedures performed in the United States today. General plastic surgeons, ear nose and throat trained facial plastic surgeons, general non-cosmetic surgeons and dermatologists all perform blepharoplasty surgery. While all of these specialists can attain good results to surgery, none of them have specific specialized training in eyelid surgery. Only ophthalmic plastic or oculoplastic surgeons have this background. Dr. Guy Massry, a well-respected Beverly Hills oculoplastic surgeon is such a specialist.
Because such a wide array of surgeons with varied backgrounds, expertise, level of training and experience with eyelid surgery are involved in blepharoplasty surgery - procedure outcomes also vary. One of the most common problems seen after surgery is hollowed eyelids. This occurs when too much skin/muscle and/or fat is removed during surgery. This aggressive tissue excision has been referred to as “subtractive blepharoplasty.” It is an older way of thinking and typically leads to a gaunt or skeletonized appearance. Modern blepharoplasty techniques are aimed at preserving tissue (especially fat) during surgery –ie. fat repositioning or fat preservation blepharoplasty. Dr. Guy Massry has helped innovate the development of such procedures.
What happens when too much fat has been removed and the eyes (eyelids) look hollow (ie depressions, dark circles, and an altered appearance)? This is a tough problem to fix and really requires the attention of a specialist such as Dr. Guy Massry. In these situations a detained evaluation will identify the best course to take whether it be surgical - such as fat grafting or non-surgical - such as filler injections.
If you would like to know more about eyelid hollows after blepharoplasty, you can contact Dr. Massry through his website above or at his office at 310 657-4302.
Lower eyelid paralysis (weakness) can occur from a variety of causes – most commonly in association with facial paralysis such as Bell’s palsy. One of the major problems which occur in eyelid paralysis patients is a lower lid droop also referred to as paralytic lower lid retraction. In addition to a droop, the lower lid can also turn out, which is medically referred to as a paralytic lower lid ectropion. Traditional surgery to correct paralytic lower lid retraction or ectropion has involved a variety of aggressive surgical procedures which often cut through the weakened lower lid muscle (orbicularis oculi muscle). This unfortunately can reduce muscle function more and lead to worsened lower lid function – NOT A DESIRED OUTCOME.
To address this issue Dr. Guy Massry, Beverly Hills eyelid specialist, has developed a new surgical technique which repositions, elevates and corrects the lower lid position in this patient population. The important point is the procedure does so without weakening the lid further (it protects the orbicularis muscle) and through only a small incision hidden in the outer upper lid crease (invisible procedure). This novel procedure is called the MIOS, or minimally invasive orbicularis sparing lid recession surgery, and it has been presented at national meetings, covered by the press and has been submitted for peer review publication. Dr. Massry anticipates its publication soon.
If you are interested is discussing the MIOS procedure with Dr. Massry, he can be contacted through his web site, or at his office in Beverly Hills (310) 657-4302.
The term canthal suspension is a general description of procedures used to tighten or suspend the lower lid. These procedures are needed during initial lower blepharoplasty (cosmetic eyelid surgery) to prevent complications (eyelid droop), and are also used for patients who have developed complications from previous cosmetic eyelid surgery (eyelid retraction or pulled down lower lids). There are a variety of canthal suspension techniques which can be used. A canthoplasty is the most aggressive and powerful procedure. In this procedure the outer attachment of the lower lid is releases and re-attached. This way a complete new and firm attachment is created. A canthoplasty can be performed in an open (external incision at the outer corner of the eye) manner, or in a closed fashion (no skin incision at the outer corner of the lids). The closed technique, when appropriate, is a more advanced procedure – but also more aesthetic as an incision is avoided. Dr. Massry advocates and has published on this technique.
A canthopexy is a less powerful procedure that tightens the lower lid in a more indirect fashion. It causes less tissue disruption but often times is not adequate to support the lower lid.
Identification of which procedure is best for you requires a detailed evaluation by an eyelid expert. Dr. Guy Massry, Beverly Hills Oculoplastic Surgery, is such an expert. He is a leader in his field, who has published and lectured extensively on eyelid surgery. Dr. Massry would be happy to see you at his Beverly Hills office. Dr. Massry can be reached through his web site above or directly at his office at 310 657-4302.