Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry

Botox vs Fillers – TRUE or FALSE

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When you first decide to take your beauty routine to the next level, you quickly realize there are a lot of different non-surgical procedures available to help you erase your unwanted wrinkles. Two of the most common non-surgical procedures are Botox and fillers – they are two very different things.

To help educate patients, Beverly Hills oculoplastic surgeon Dr. Guy Massry, has put together a true or false list of the most common questions about Botox vs fillers. How many of these do you already know?

Botox and fillers are the same thing – FALSE

Although both Botox and fillers are used to rejuvenate the face, they achieve this in very different ways. Botox temporarily freezes your muscle activity so that wrinkles are not being created. Fillers add volume to the face to smooth out wrinkles, get rid of dark circles under the eyes, and plump up the lips.

Botox gets rid of wrinkles – TRUE

Botox, or Botulinum toxin, temporarily relaxes your facial muscles that create lines and wrinkles. Botox can be placed on the forehead, in your 11 lines or around your crow’s feet to erase the appearance of your wrinkles. Results last for 3 to 4 months. Furthermore, when performed by an expert injector, like Dr. Massry, Botox can be strategically placed to give you a non-surgical brow lift.

Fillers get rid of wrinkles – TRUE

As we age we lose facial volume. This loss of volume can lead to wrinkles around the mouth, under the eyes or temples. Fillers can restore this lost volume which can smooth out wrinkles.  While this is true, keep in mind that fillers are a better volume restoration procedure (ie fills hollows/folds) than fine wrinkle reducer.

Anyone can perform Botox or Filler injections – FALSE

Since injectable treatments, such as Botox and fillers, are becoming more and more popular, access to them is becoming easier. However, while everyone from nurses to primary care doctors seems to be offering injectable treatments these days, it is vital to see an expert trained injector to make sure you get the best results possible and avoid potential risks.

Are You A Candidate For Botox or Fillers?

We hope you found this information about Botox compared to fillers to be helpful! If you are interested in learning if you are a candidate for either one of these non-surgical treatments, please contact our office to make an appointment with Dr. Massry - 310.657.4302.

Read more of Dr. Massry's blogs

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The Best Cosmetic Eyelid Surgery Results

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Cosmetic eyelid surgery is not a "one size fits all" procedure. Our eyes are the most defining characteristics of our face and deserve to be treated with personalized and customized care. Dr. Guy Massry believes the best cosmetic eyelid surgery results are those that are tailored to the specific needs of the patient.

Below you can see a patient before (left) and after (right) customized cosmetic eyelid surgery. Best cosmetic eyelid surgery

So how did Dr. Massry achieve the best cosmetic eyelid surgery results for this patient? He performed a customized outer brow lift with upper and lower blepharoplasty.

What is an Outer Brow Lift?

The outer brow lift is a very important component of natural looking eyelid rejuvenation results, but many patients have never heard of an outer brow lift. Most patients come to Dr. Massry for an upper blepharoplasty thinking that all that needs to be done is to correct the appearance of sagging upper eyelids. However, what they don’t realize is that the position of the outer brows often affects the upper lid fullness. So when the outer brow falls, which is a normal change due to aging, the upper lids become heavier. If the outer brow is not lifted during surgery, the root of the upper lid sagging is not addressed.

Please keep in mind that not everyone needs the outer brow lift. This is why it is so important to find an expert oculoplastic surgeon to evaluate your needs and determine the best course of surgery for YOU.

Rejuvenating the Lower Lid

A lower lid blepharoplasty gets rid of under eye bags and can be performed a variety of ways. As a seasoned expert in lower eyelid rejuvenation, Dr. Massry generally prefers to perform the surgery through an incision on the inside of the eyelid because it significantly reduces the risk of changing the shape of the eye and there is no visible scar. Furthermore, when necessary, Dr. Massry will perform fat repositioning to smooth out the hollows under the eyes. But again, each patient is unique and Dr. Massry utilizes other lower blepharoplasty techniques when necessary to provide each patient with the best results.

Contact Dr. Massry Today!

If you are interested in learning more about the best cosmetic eyelid surgery for you, please schedule a consultation with Beverly Hills oculoplastic surgeon Dr. Guy Massry. He is happy to evaluate your anti-aging needs and refresh your appearance. Please call us at 310.657.4302 to schedule your consultation.

Read more blogs by Dr. Massry 

Lower Blepharoplasty: Why Cut From the Inside of the Lower Lid

The Brow and Upper Eyelid: An Aesthetic Unit

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Lower Blepharoplasty: Why Cut From The Inside Of The Lower Lid

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Lower blepharoplasty (cosmetic eyelid surgery) can be performed through an eyelid skin incision or from inside the lower lid.  There is no doubt surgery from inside the lid is harder and more technically demanding.  However, it is far safer, more cosmetically appealing and leads to significantly less potential complications.  The dreaded result of surgery through the skin is a pulled down (or retracted) lower eyelid.  This is VERY hard to fix, even in the best of hands.  Here are the important points to keep in mind when deciding to undergo a lower blepharoplasty.

  1. Only an experienced eyelid surgeon (oculoplastic surgeon) should perform this procedure.
  2. Surgery through the skin has an overall 6-20% chance of pulling down the lower lid and changing the shape of your eye (this is based on published data).
  3. Excess skin can be removed after inside eyelid surgery at the time of the procedure (called a pinch procedure).  This technique tends not to change the eyelid shape.
  4. An eyelid tightening procedure can be added as needed (called a canthal suspension).
  5. Canthal suspension is A VERY specialized procedure which really needs surgical expertise.
  6. Lower blepharoplasty addresses “eyelid bags” (skin and excess fat).
  7. Dark circle correction often also requires a laser or non-laser peel, fillers or other interventions.
  8. Do not go into this surgery without doing your research. You must feel confident with your surgeon and this only comes from doing your research ahead of time and understanding the procedure yourself.

Before & After Lower Blepharoplasty

Lower blepharoplasty, upepr blepharoplasty, brow lift

This patient underwent lower blepharoplasty with Dr. Massry in which he made the incision inside of the lower lid. Dr. Massry also performed an upper blepharoplasty and brow lift to give this patient natural looking results.

Find A Lower Blepharoplasty Expert

We know how overwhelming it can be to choose a surgeon to perform your lower blepharoplasty. Today, it seems like there are more cosmetic and plastic surgeons than ever before, so it is very important to make sure the surgeon you choose is qualified and very experienced with eyelid surgery. Oculoplastic surgeons are eyelid experts who undergo specialized training in eyelid plastic and reconstructive surgery. Make sure the surgeon you choose for your lower lid blepharoplasty is an oculoplastic surgeon so you get the best results possible. In addition, make sure you ask the surgeon how many lower bleph procedures they perform per year, what surgical techniques they use, do they write peer-reviewed articles or textbook chapters, etc. Also, ask to see before and after pictures of patients who are similar to you so you can get a good idea of how the surgeon's results look.

Contact Dr. Massry Today!

If you are interested in lower blepharoplasty, please contact our office today to schedule a consultation with Dr. Guy Massry - 310.657.2203.

Read More of Dr. Massry's Blogs

Lower Lid Blepharoplasty: Both an Art & a Science

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Lower Lid Blepharoplasty: The Difference Between Fat Grafting And Fat Repositioning

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Lower blepharoplasty is a great facial rejuvenation procedure.  Modern surgery can be performed from inside the eyelid or from the skin.  There are pros and cons to each approach.  Today Dr. Massry is going to talk about the differences of filling the lower lid hollows with fat.  There are 2 ways to do this.

  1. Fat transfer or grafting (two names for the same procedure)
  2. Fat repositioning

What is Fat Grafting?

Fat grafting is when fat is harvested from another part of the body (ie. abdomen) via a liposuction technique and then injected into the eyelid hollows.  While this is widely used amongst aesthetic facial surgeons there is a reasonable risk of lid irregularities, such as lumps and bumps.

Eyelid fat grafting repair - Dr Guy Massry

In the picture on the left, you can see that the patient experienced lumps and bumps after fat grafting with another surgeon.  Luckily, she found Dr. Massry and he 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.

What is Fat Repositioning?

Fat repositioning is when local eyelid fat (if present) is shifted (repositioned) to the adjacent eyelid hollow.  The risk of irregularities is exponentially lower in this technique.

Under eye bag rejuvenation surgery - Dr Guy Massry

This patient underwent lower lid blepharoplasty with fat repositioning with Dr. Massry. Her results were very natural looking and she is very happy!


Male lower lid fat respositioning

This is an example of a male patient underwent upper and lower blepharoplasty with fat repositioning with very natural and masculine looking results. 

Be Smart About Lower Lid Blepharoplasty

Please beware of these issues with fat grafting when having your surgery done. Dr. Massry strongly urges patients to educate themselves about the procedures and to find an eyelid specialist to perform their surgery to mitigate the risks. Once the surgery is performed poorly, it is very difficult to reverse lumps and bumps from fat grafting.

Contact Dr. Massry Today!

If you are interested in learning more about fat grafting vs. fat repositioning, please contact our office today to schedule your consultation with Dr. Massry - 310.657.4302.

Read More of Dr. Massry's Blogs

Lower Eyelid Fat Grafting: Understand What You Are Doing

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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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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


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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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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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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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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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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