Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
18Oct/170

The Brow and Upper Eyelid: An Aesthetic Unit

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Did you know that the brow and upper eyelid should both be evaluated when considering blepharoplasty? Many patients come in for upper blepharoplasty (cosmetic eyelid surgery) thinking that it will address their upper eyelid bags. However, what most don’t know is that the position of the outer brows often affects the upper lid fullness.  When the outer brow falls, which is a normal change of aging, the upper lids become heavier.

While cosmetic eyelid surgery is a very common procedure these days, it is still very important to find an eyelid specialist who knows that the brow and upper eyelid should really be approached as one aesthetic unit in order to get the best results. Dr. Guy Massry is an oculoplastic surgeon who is internationally recognized for his unparalleled eyelid rejuvenation results. Below he has put together some keep points for patients to keep in mind before having upper blepharoplasty:

  1. Always ask about the brow. If the brow has drooped, blepharoplasty alone will make things worse (more corded appearance to the upper lids).
  2. This does not mean you need an outer brow lift – but surgery of the upper lids needs to be altered to accommodate the depressed outer brow.
  3. Don’t fear brow lifts.  If done endoscopically and by an experienced surgeon, it's less traumatic than the lid surgery.
  4. Outer brow lifts, also called temporal brow lifts, DO NOT MAKE YOU LOOK SURPRISED.
  5. An outer brow lift is done for support only.
  6. They limit the length of the upper lid incision so that it only includes the eyelid and the incision is hidden.
  7. An outer brow lift provides a natural arch to the brow (which was present in youth and will increase the beauty of the lid itself).
  8. Talk to a specialist about this – ONLY an experienced surgeon should perform an outer brow lift with upper blepharoplasty.

Before & After Outer Brow Lift with Upper Blepharoplasty

Below are three examples of patients who underwent upper blepharoplasty with an outer browlift for support.

Patient 1

Upper and lower blepharoplasty with outer brow lift.

Upper and lower blepharoplasty with browlift.001

Patient 2

Outer brow lift with upper and lower blepharoplasty with Dr. Massry.

Outer brow lift upper and lower blepharoplasty - Dr Guy Massry

Book Your Consultation Today!

If you are interested in learning if you are a candidate for upper blepharoplasty with an outer brow lift, please call our office today to schedule a consultation with Dr. Massry - 310-657-4302.

Dr. Massry customizes every surgery he performs to the needs of his patients so that the results are as beautiful as possible. This means that during your consultation with Dr. Massry not only will he evaluate your needs, but he will also listen to your anti-aging goals so he can exceed your expectations. We look forward to meeting you!

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12Oct/170

Lower Eyelid Fat Grafting: Understand What You Are Doing

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Lower eyelid fat grafting (or fat transfer) has gained widespread popularity amongst plastic surgeons over the last few decades. It can be a great option for replacing lost volume in the face and is a potentially permanent option, as compared to fillers.  This is all well and good.  However, it is important to really think this procedure through prior to proceeding with it, especially when fat grating the lower lids.  Why? Because some bad complications can occur.

Here are important facts to consider about fat grafting:

  1. Grafted fat has an unpredictable survival. A 50% survival is what is quoted. This has never been proven scientifically. It is only an opinion!!!
  2. Fat is typically taken from the inner thighs, abdomen, or other areas where fat can deposit in the body. This type of fat is different than facial fat. This fat can grow as we gain weight. There have been many patients whose faces have become large over time after having fat grafted to the face.
  3. The body may attack the transferred fat (to remove it). Even though it is our own tissue, it is placed in a different location, so the body considers it foreign. When this happens, lumps, bumps and contour irregularities can occur (what Dr Massry calls "LBCs").
  4. The eyelid skin is very thin and cannot hide even minor irregularities (LBCs). These can be disfiguring to the facial appearance.
  5. Dr. Massry is soon to publish data that in a large series of patient studies this problem (#4 above) can occur in as high as 8% of patients who have fat grafting to the lower lids.
  6. Dr. Massry has treated many patients with fat grafting related LBCs to the lower lids. THIS IS VERY HARD TO CORRECT.
  7. Make sure to educate yourself about lower eyelid fat grafting before proceeding with this procedure.
  8. Most importantly, make sure that only an eyelid specialist does this procedure for you.

Case Studies - Fat Grafting Repair

Patient 1 - LUMPS & BUMPS

This patient had lower eyelid fat grafting a couple of years ago from another surgeon. In her pictures below, you can see she has lumps and bumps from the fat transfer. This appearance made her very self-conscious. To improve her appearance, Dr. Massry performed his cutting-edge procedure to remove the lumps and bumps through an incision inside the lower eyelid so he did not have to make any skin incisions.

Eyelid fat grafting repair - Dr Guy Massry

Patient 2 - CONTOUR IRREGULARITIES 

This patient was very unhappy with the results of under eye fat grafting from another surgeon. She came to Dr. Massry to remove the contour irregularities from the fat grafting to her lower eyelids. As opposed to the first patient, this patient had primarily lower eyelid prominence from fat grafting. This is another way fat grafting complications can present. In addition to the revision lower lid surgery, he also performed an outer brow lift and upper and lower blepharoplasty to rejuvenate her overall appearance.

Revision fat grafting surgery - Dr Guy Massry

See more patients before and after revision surgery with Dr. Massry.

Consult With A Fat Grafting Repair Expert

If you have experienced complications from a previous fat grafting surgery, please do not hesitate to contact Dr. Guy Massry to learn more about how he can help you. Dr. Guy Massry is an oculoplastic surgeon who specializes in complex revision fat grafting procedures. To schedule a consultation with him, please call our office at 310.657.4302. For patients who live out of town, we offer initial Skype consultations so you can have your first appointment with Dr. Massry from the comfort of your own home!

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5Oct/170

How to Inject Fillers: Much more important than the product selected

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Injectable fillers have become one of the most common facial aesthetic procedures performed in the world. They have become a standard in facial aesthetic practices and can make a profound difference in improving facial appearance.  Most patients feel fillers (Juvederm, Restylane, etc) are a simple procedure, performed quickly with immediate and gratifying results. While this is typically true, fillers can lead to many complications - some of which are very series. It is important for patients to be aware of these issues and make sure they see the most qualified physicians that know how to inject fillers so that complications can be avoided.

What Are Possible Filler Complications?

In this post, Dr. Guy Massry will review the most serious of complications - vascular occlusions (a blocked facial blood vessel) which can lead to skin necrosis (death) and even blindness. These are very RARE complications which most injector will never see in their careers. This is not meant to scare patients, but rather to inform them of the issue and educate them on how important it is to see a well-trained physician injector.

Here are the important points:

  1. Facial blood vessels interconnect (communicate with each other). This means if one blood vessel is penetrated by a needle or cannula when the filler is injected, the filler can get to another area on the face. When this occurs, a nearby or distant area blood vessel can get blocked by the filler material. This is how vascular events occur.
  2. To prevent this, an intimate "MEDICAL" knowledge of facial vascular anatomy is needed (through continued medical education).
  3. Injections can be given with a sharpe needle or a blunt tipped cannula. There is no scientific evidence, that cannulas are safer (less vascular events) - but most feel this is true. There is a learning curve to using the cannula. In Dr. Massry's opinion, it is worth it. Also, recent scientific publications have shown that cannula delivery of filler is more exact/precise than filler given by a needle delivery.
  4. Injection technique is also critical to prevent such consular issues. Injections should be placed away from vessels, with fine movements, when the needle or cannula is drawn out, and not until there is an assurance that the injection is not in a blood vessels (by drawing back on the plunger of the syringe). Also very small amounts of filler should be given, with very low-pressure injection. ALL THESE STEPS ARE CRITICAL.
  5. Finally, NEVER have filler given (Hyaluronic acid gels such as Restylane, Juvederm, etc.) without a reversal agent (Hyaluronidase) available. THIS IS CRITICAL. Make sure your injector has this product for all injections or DO NOT DO IT.

Remember, always be safe and fillers can be an amazing facial aesthetic treatment!

Contact Dr. Massry To Learn More

If you are interested in learning more about facial fillers, please contact our office to schedule a consultation with Dr. Massry. He is highly experienced in filler injections and provides his patients with safe and beautiful results! Call us at 310.657.4302!

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3Oct/170

Cannula vs Needle For Facial Filler Injections – The Great Debate

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Cannula vs needleFacial fillers are an increasingly more common cosmetic intervention throughout the United States, and the world, in general.  We have learned much about filler materials, injection techniques, and how to prevent complications.  What is still “hotly” debated is how to best deliver the filler material - a cannula vs needle?

Here are some points to consider for the patient when the filler treatment is performed.

  1. Fillers were initially given only with needles.  The cannula – a blunt tipped delivery device – was introduced in the last 5 years to give an option other than using a sharp needle, which can cause more bruising than a blunt device and can more easily potentially enter a blood vessel which can lead to severe complications.
  2. There is a learning curve to using the cannula, so make sure your injector is well-experienced in using one.
  3. All well-trained and experienced injectors should be comfortable with both the cannula and the needle.
  4. Experience has shown that both techniques are effective and there are no evidence-based studies showing superiority of one over the other.  However, a recent cadaver study has shown the cannula delivery is more precise in where the filler is placed.
  5. When the cannula is used one entry site is usually sufficient to deliver the filler to many locations.  With the needle, this is less so, and more entry sticks are needed, which is more traumatic

While the needle and cannula can both be used to deliver filler, patients should know the differences so they can be involved in their treatment plan.

Contact Dr. Guy Massry To Learn More!

If you would like to learn more about cannulas vs needles for filler injections, please feel free to contact Dr. Massry to schedule a consultation - 310.657.4302. Dr. Massry is dedicated to educating his patients so they feel comfortable and confident before any treatment.

Read more of Dr. Massry's blogs about fillers: 

A Filler Warning - Not All Hyaluronic Fillers Are The Same

5 Things to Know About Eyelid Fillers

What Are Eyelid Fillers And How Should They Be Used?

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28Sep/170

Fat Grafting Repair

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Fat grafting of the lower lids can lead to complications that are very difficult to treat. This wonderful woman had fat placed in her lower lids (grafted) years ago with another surgeon and had poor results (lids very puffy with bags) that were devastating to her. In her before & after pictures you can see the beautiful transformation. The before picture (left) Dr. Massry took – the after picture (right) she sent to Dr. Massry today because she lives out of town.

Revision fat grafting surgery - Dr Guy Massry

In addition to removing the fat graft to the lower lids, I also performed an outer brow lift and upper blepharoplasty.

When she sent Dr. Massry her after picture, she also sent a beautiful email about how happy she is with her results. Here it is:

Dear "Miracle Worker" Dr. Massry!

I just wanted to check back in and say that all is well and that literally every day I wake up excited to get out of bed --- whereas before I dreaded going out in public at all. This is no exaggeration.

I owe this all to you and your unparalleled skills.

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27Sep/170

A Filler Warning – Not All Hyaluronic Fillers Are The Same

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Filler Differences - Dr Massry

In general, the patients Dr. Massry sees come into the office already knowing the names of all the hyaluronic acid gel (HAG) fillers (i.e. Restylane, Juvederm, Belotero, etc.). But few patients know the differences between them. It is very important for patients to learn there are significant differences between fillers so they can have a safe treatment.

This post highlights 5 IMPORTANT POINTS about HAG fillers that Dr. Massry wants patients to consider prior to having facial injections.

1. Not all fillers are the same.

Fillers are made differently, have different names, different biochemical and flow properties (i.e. how they work in the face). When you go in for a filler consultation, ask your injector about these differences - this is very important. When you buy a house or car you ask about specifics such as size, efficiency, upkeep etc. The same applies here.

2. Fillers act by sucking in fluid to expand and thus fill lines and folds.

It is critical that the right filler is used in a custom way to address your specific needs. For deep grooves, very expansive fillers are needed. For shallow lines, a filler which expands less and flows more is needed. Choosing the wrong type of filler is what leads to complications of lumps, bumps, swelling, and contour issues.

3. Filler properties to assess include concentration and cross-links.  

Fillers have a concentration (particles per unit area); this property controls fluid expansion. Fillers are also cross-linked (how each filler molecule is connected together - tight or loose); this property controls stability and longevity. The mix of these properties is the key to success.

4. Fillers give beautiful anti-aging results but there is the potential for complications.

Fillers are a great way to treat lines and folds but complications can occur (i.e. swelling, irregularities, overfill, etc.). Most of these complications can be controlled with how the filler is delivered (i.e. a little in the right place goes a long way - but in the wrong place it's a problem). Expert injectors know this well.

5. Fillers can be delivered with a needle or cannula.

A needle is a more traditional technique for filler treatments. In recent years, many injectors have started to utilize the cannula approach. The cannula utilizes just one entry point, instead of several. This means fewer needle marks and usually less bruising. The debate between which is better, needle or cannula, is an extensive topic in terms of pros and cons. There is equal post-injection swelling with both - but less bruising with the cannula. Recent studies suggest the cannula is more precise in filler placement.

Finding An Expert Filler Injector

Like with any consumer purchase, always ask the right questions to get the best outcome. When you see a new physician for filler injections, make sure they are very well educated in the different types of fillers so the best one for you is used for your treatment.

Before & After Filler

This patient had filler injections under the eyes to fill hollows with Dr. Massry.

Restylane under the eyes - Massry

Contact Dr. Massry Today!

Dr. Guy Massry in Beverly Hills specializes in filler injections and has written countless peer-reviewed articles about differences in filler products and filler injection techniques. If you are interested in filler treatments, you can rest assured you are in the hands of a qualified expert. To schedule a treatment with Dr. Massry or to learn more about the different types of fillers, please call us at 310.657.4302.

Read more of Dr. Massry's blogs about fillers:

5 Things to Know About Eyelid Fillers

Getting Rid of Eyelid Bags, Dark Circles and Hollows with Fillers: What To Do and What Not To Do

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22Sep/170

5 Things to Know About Eyelid Fillers

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5 THINGS TO KNOW ABOUT FILLERS (2)The demand for non-surgical filler treatments has skyrocketed in the recent past. While injectable fillers can provide patients with beautiful and rejuvenating results when performed by an expert, it is also important to understand that in the hands of an inexperienced injector, fillers can be risky and lead to many complications.

As an experienced eyelid filler injector, Dr. Guy Massry in Beverly Hills wants to make sure patients are well-educated wants to make sure patients are well-educated on the risks and benefits of fillers around the eyes. He has put together a list of the top 5 things you should know about eyelid fillers.

1. All fillers are not all the same.

Today there are several different types of eyelid filler options available, including Juvederm, Restylane, Belotero, and Voluma, to name a few. While all of these products are hyaluronic acid fillers, they all have unique and specific properties that make some better than others for volume restoration and/or wrinkle reduction around the upper and lower eyelids. An in-depth discussion of the differences of the various filler products is lengthy and beyond the scope of this discussion, but, suffice it to say that differences in biochemical, structural and flow properties of these products makes each unique in how they behave and what results they give.

Dr. Massry feels: “With new fillers coming to the market all the time, it is very important to find an injector who stays up to date on the product info so you are getting the best treatment possible."

2. Although fillers are very common, they must be injected by an expert.

According to the American Society of Plastic Surgeons, in 2015 over 2 million people in the United States had a hyaluronic acid filler treatment. With this increased popularity, more and more physicians and nurses are starting to offer filler injections. However, this does not mean that everyone who is injecting filler is truly qualified to be doing so, especially in the eyelid area. When looking for a physician to inject filler either for under eye circles, hollow upper eyelids or hollow temples, it is very important to find an oculoplastic surgeon who had years of specialized training in this area. An oculoplastic surgeon has extensive knowledge of the eyelid structures and anatomy to ensure you have a safe and successful treatment.

3. Results depend on the injector’s skill.

A skilled injector will know what filler will you give you the best results and will know how to properly place the filler so your results look natural and beautiful. There are several different techniques when it comes to injecting around the eyes, and you want to make sure your injector uses the best techniques available.

4. Most fillers can be reversed if you are unhappy.

Dr. Massry likes to only use fillers that can be reversed if necessary. He never uses anything permanent to avoid the risk of a complication that cannot be corrected. If you, unfortunately, go to an injector who is not as experienced as you may have thought, and you are unhappy with the results, a product called hyaluronidase can be used to reverse or dissolve the effects of hyaluronic acid fillers.

5. Fillers can be used to treat under eye bags, hollow temples, and hollow upper eyelids.

Most people know that filler can be used under the eyes to get rid of dark circles, but did you know filler can also be used to revolumize hollow temples or lift sagging and hollow upper eyelids? These are very specialized treatments that can make a dramatic improvement in the facial appearance. Restoring volume to these different areas around the eyes immediately rejuvenates the overall facial appearance!

Dr. Massry – The Eyelid Filler Expert of Beverly Hills

Now that you have learned the complexity and potential risks of eyelid filler treatments, you know how important it is to find a true eyelid filler expert. Dr. Massry is one of the world’s leading oculoplastic surgeons and lectures internationally about his approach to eyelid fillers. He has also conducted many studies and published hundreds of articles on his filler injection and eyelid surgery techniques. You can rest assured that in the hands of Dr. Massry you will have safe and stunning eyelid filler results!

 

Contact Dr. Massry Today!

If you are interested in eyelid fillers, please contact our office to schedule your appointment with Dr. Massry today – 310.657.4302.

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18Sep/170

6 Questions To Ask Your Surgeon Before Upper Blepharoplasty

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Eyelid rejuvenation surgery consultation with Dr Massry

Eyelid rejuvenation surgery consultation with Dr Massry

Upper blepharoplasty (cosmetic eyelid surgery for the upper eyelid) is a fantastic age reversing procedure for many people.  With time, the upper eyelids begin to sag and droop and create a tired and aged appearance. An upper blepharoplasty can address this sagging and drooping and restore a more youthful look!

While an upper blepharoplasty is a very common procedure these days, it is very important to find a surgeon who specializes in this type of surgery to ensure you get the best results possible. Dr. Guy Massry in Beverly Hills is a board-certified oculoplastic surgeon who specializes in cosmetic surgery of the eyelids. To help patients find the best upper blepharoplasty surgeon, Dr. Massry always tells people to ask a surgeon these 6 questions during a consultation:

  1. Are you an eyelid specialist? Cosmetic eyelid surgery specialists are called Oculoplastic Surgeons or Ophthalmic Plastic Surgeons. This means they first trained as an ophthalmologist and then underwent specialized training in eyelid plastic (cosmetic) surgery. Oculoplastic surgeons perform more upper blepharoplasty procedures than any other type of cosmetic surgeon and have a very thorough understanding of the complex and delicate eyelid anatomy - a must for a successful surgery.
  2. Can you handle a revision should something go wrong? Although in the hands of an eyelid expert complications from upper blepharoplasty are rare, you want to make sure the surgeon is capable of handling any complications that may arise.  This includes performing a revision surgery in the rare instance it is needed.
  3. Will you be removing skin, muscle, fat or a combination of these tissues during surgery? Every upper blepharoplasty procedure should be customized to the specific needs of the patient. Upper eyelid bags can result from abnormalities in skin, muscle or fat. After an in-person evaluation, the surgeon should tell you what technique he plans to use to rejuvenate your upper eyelids. This may include addressing skin, muscle, fat or some combination of these tissues.
  4. Will I have eyelid closure issues after surgery? An experienced surgeon will perform the surgery in such a way that you should not have any issues closing your eyes after the surgery.
  5. Can I get dry eyes after upper eyelid blepharoplasty? Again, an experienced surgeon will perform the surgery in such a way that you should not experience dry eyes after upper blepharoplasty.
  6. How many cases do you do a year? This is always a great question to ask about any surgery as it gives you a good idea of how experienced the surgeon is with performing the surgery. An oculoplsatic surgeon will likely perform at least 100 upper blepharoplasty surgeries per year.

Asking a surgeon these questions during your upper blepharoplasty consultation will give you a great understanding of the surgeon’s skill set. In addition, Dr. Massry also recommends you review the surgeon’s website to see their credentials.

Why Choose Dr. Massry for Your Upper Blepharoplasty?

Dr. Massry is one of the world’s leading oculoplastic surgeons. He has published 5 textbooks on eyelid surgery and has written hundreds of peer-reviewed articles on upper blepharoplasty and revision eyelid surgery. Furthermore, he has a special interest in furthering knowledge in the field of oculoplastic surgery and routinely lectures and teaches other surgeons from around the world his surgical techniques. As a result of all of Dr. Massry’s experience and expertise, you can rest assured that you are in the best hands with him!

Contact Dr. Massry Today!

If you are interested in scheduling an upper blepharoplasty consultation with Dr. Massry, please contact our office today – 310.657.4302. We also offer Skype consultations for our out of town patients.

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5Sep/170

3rd Triennial Multidisciplinary Masters’ Symposium On Blepharoplasty And Facial Rejuvenation

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Dr Massry in AustraliaDr. Guy Massry was honored to be a keynote speaker at the 3rd Triennial Multidisciplinary Master’s Symposium on Blepharoplasty and Facial Rejuvenation in Sydney, Australia.

The goal of this Masters Symposium is to gather the world’s experts in the field so they can share exciting advances and innovations in this highly specialized field. Attendees came from all corners of the globe and included oculoplastic surgeons, facial plastic surgeons, plastic surgeons, cosmetic surgeons, dermatologists, and reconstructive surgeons.

“It is such an honor to be invited to lecture and teach my fellow surgeons from around the world. The Master’s Symposium is a wonderful meeting, as it allows us all to push the limits of what we can achieve for our patients.” – Dr. Massry

In addition to presenting the keynote lecture, Dr. Massry presented five other lectures:

-15 Principles for Enhanced Success in Endoscopic Brow Lifting: My Approach

-De-confusing Aesthetic Canthal Suspension Surgery: My Experience


-Contemporary Thoughts on Post-Blepharoplasty Lower Eyelid Retraction

-Nuances in Lower Blepharoplasty: Lessons Learned Along the Way

-Improving Periorbital Aesthetics with Hyaluronic Acid Gel Volume Replacement

See some of the other conferences Dr. Massry has lectured at. 

aafps-symposium-2017

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29Aug/170

Revisional Lower Lid Surgery: Lower Eyelid Retraction – Don’t Settle For Less than the Best

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The most dreaded complication of lower blepharoplasty (cosmetic eyelid surgery lower lids) is a pulled down lower lid - also called lower lid retraction.  This is a difficult problem to fix and often leads to multiple surgeries to restore function and a normal appearance.

Revisional lower eyelid surgery is very complex and should only be performed by an expert oculoplastic surgeon. Dr. Guy Massry is a world renown expert in oculoplastic surgery (eyelid surgery).  He has written several textbooks in the field, including Master Techniques in Blepharoplasty and Periorbital Rejuvenation and Lower Lid and Midface: Multispecialty Approach and lectures all over the world on these complicated problems. Here is more information about complicated revision eyelid surgery:

Before & After Revisional Lower Eyelid Retraction Surgery

Below is a typical example of a correction to revisional lower lid retraction surgery.  Look at the improvement in the lower lid droop before (left) and after (right) surgery.

Lower eyelid retraction surgery - Dr Guy Massry

Watch Dr. Massry Discuss His Approach To Lower Eyelid Retraction Surgery

Contact Dr. Massry Today!

If you are interested in learning more about the topic of revision lower lid surgery please call Dr. Massry’s office at 310.657.4302.

 

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