Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry

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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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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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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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. 


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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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Lower Lid Blepharoplasty: Both Art & Science

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What is lower eyelid blepharoplasty?

Lower eyelid blepharoplasty is a common facial aesthetic procedure to rejuvenate the under eye area. Most commonly, it addresses under eye bags, sagging skin and fat pockets.  Unfortunately, since this is such a delicate area, many lower lid blepharoplasty patients are left with unwanted complications and an unnatural look.  Issues such as a droopy lower lid (lower lid retraction), a change in the shape of the eye, and a rounded eye (canthal rounding) can be devastating and a lifelong issue.

Lower Blepharoplasty Beverly Hills CAHow can you avoid lower eyelid blepharoplasty complications?

When undergoing this type of plastic surgery, it is very imporant to see an expert with specialized training and experience with cosmetic blepharoplasty.  Simply stated, there is no other option.

I am Guy Massry, MD and I am an ophthalmic plastic surgeon or oculoplastic surgeon.  What does this mean?  It means I only focus on eyelid surgery.  I have a special interest in lower lid surgery and have done much research in the area.

To help my patients achieve the most natural results, I customize every surgery I do to meet the specific needs of each individual patient. This approach ensures that the techniques I use are best suited for the patient and provides the best possible results.

Watch Dr. Massry Explain His Approach to Lower Eyelid Blepharoplasty

See more examples of patients before and after blepharoplasty. 

Contact Dr. Massry Today!

If your under eye area bothers you and you are considering lower lid blepharoplasty, please contact my office today - 310.657.4302! During a consultation, I will explain the best approach to surgery to give you the best outcome possible. For patients who do not live locally, I also offer Skype consultations.

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Lower Eyelid Fat Transfer – Does it really make sense?

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Fat transfer to the face has significantly grown in popularity in cosmetic surgery over the past 25 years. The techniques of harvesting, processing and injecting the fat have changed tremendously to yield better results, but, still, most of the information we can give patients regarding results is purely anecdotal and experiential in nature. In other words, there are few evidence-based studies that show us true percentages of success rates and complications. Recently, renowned oculoplastic surgeon, Dr. Guy Massry, reviewed a large series of patients who had eyelid fat grafting and found that the incidence of contour abnormalities (lumps and bumps) long term after surgery approached 8%. Presenting this information does not make Dr. Massry popular among aesthetic surgeons, but it is the first evidence-based information on lower eyelid fat transfer that will soon be published. Dr. Massry has presented this information at recent scientific meetings, including the 2017 Vegas Cosmetic Surgery Conference.

Avoiding Complications With Eyelid Fat Grafting

How do we avoid lumps and bumps from eyelid fat grafting? As stated above, the process of fat grafting involves harvesting the fat (collecting it), processing the fat (preparing it), then injecting the fat (grafting it). At this time, there is no data that shows harvesting fat from one area or another leads to fewer complications; this clearly needs further study. The processing or preparing of the fat can involve simple drainage or straining, spinning the fat (centrifugation), and sometimes putting chemicals on the fat that will hopefully allow it survive better. There are currently studies underway to determine whether or not these methods improve outcomes and decrease complications. Lastly, the injection technique of fat is also under study with different size cannulas; this may or may not make a difference long term.

The bottom line is that fat grafting is not a complication-free procedure. If you read reviews online, you will see that many patients are unhappy with their outcomes. So in that regard, Dr. Massry urges every patient to be responsible and do their homework when choosing a surgeon for this procedure.

Removing Lumps & Bumps From Prior Lower Eyelid Fat Transfer - Case Study

Eyelid fat transfer correction - Dr Guy MassryThis woman had fat grafting to lower lids several years ago with another surgeon. She was left with lumps, bumps and contour abnormalities and was incredibly self-conscious of her appearance. She came to Dr. Massry for correction. Dr. Massry developed a technique where he can remove these unwanted fat deposits from inside the lower lids to avoid any skin incisions and potential scarring. He has found that the fat is different that native eyelid fat and is almost always located in a particular layer of the eyelid. The procedure takes about an hour and a half and can be performed under sedation or general anesthesia. In the before

Dr. Massry developed a technique where he can remove these unwanted fat deposits from inside the lower lids to avoid any skin incisions and potential scarring. He has found that the fat that is transferred is different that native eyelid fat and is almost always located in a particular layer of the eyelid. The procedure takes about an hour and a half and can be performed under sedation or general anesthesia. In the before picture on the left you can see arrows pointing to lumps and bumps, and after surgery, these are gone and the under eye area is smooth.

Choosing The Best Oculoplastic Surgeon For Eyelid Fat Grafting

We would highly recommend you do your homework before choosing a surgeon to perform fat grafting under the eyes. And if you do unfortunately end up with lumps and bumps following fat grafting, it is even more important to find an expert to correct these issues without creating further damage.

If you are considering eyelid fat grafting or need to correct lumps and bumps from a prior surgery, please contact eyelid expert Dr. Massry today - 310.657.4302!

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Orbital Decompression For Eyelid Paralysis

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As an oculoplastic surgeon, Dr. Guy Massry has unparalleled expertise in orbital and eyelid surgery. He has dedicated his career to advancing and innovating surgical techniques to give patients the best results possible. One of his latest advancements in eyelid paralysis surgery is that he now performs customized orbital decompression (setting the eye back) for patients with eyelid paralysis.

What Is Orbital Decompression?

Orbital decompression is traditionally a procedure to treat bulging eyes for patients with Thyroid Eye Disease or Graves' Disease. However, Dr. Massry realized the benefits of orbital decompression could be applied to help eyelid paralysis patients. When performed by an expert, like Dr. Massry, orbital decompression surgery will successfully set the patient's eye(s) back.

Setting the eye back allows the eyelids to work better in a bio-mechanic fashion. In other words, the eyelid does not have to go over such a great slope or arc of the eye so it is easier for them to close. Typically, patients say their eyes close better and they blink better and it is less difficult to function on a daily basis.

In cases of eyelid paralysis, the eyelid muscles are already weak and operating on them further damages them to a greater extent. Orbital decompression is a great alternative to further surgery on eyelids that have already been damaged by previous surgeries. Although the risks to orbital decompression can be significant, they do not exist in the cases of eyelid paralysis. In these cases, the decompression does not involve entering the sinuses and thus the risk of double vision and vision loss is significantly decreased.

Orbital Decompression For Eyelid Paralysis Case Study

The woman below had numerous eyelid surgeries in the past with other surgeons. These numerous surgeries, unfortunately, disfigured her appearance and limited her life. Upon finding Dr. Massry, he recommended using his novel approach to orbital decompression for eyelid paralysis.  Along with his colleague, Dr. Raymond Douglas, who specializes in orbital decompression for thyroid eye disease patients, they proceed with orbital decompression for her. She is a fantastic example of how great the results of orbital decompression can be for eyelid paralysis patients!

Orbital decompression for eyelid paralysis - Dr Guy Massry

Read Her Review Of Her Experience with Dr. Massry

"Simply the best! I cannot say enough positive things about my surgical experience with Dr Massry and his staff! I live in Nebraska. I was born with a seventh nerve facial paralysis and very poor eyelid closure. I have struggled with corneal exposure all my life and have had at least 11 procedures including gold weights and tarsorrhaphies to deal with keratitis and breakdown. I have daily discomfort. I tell others most of the time it's like skinning your knee when you fall off your bike but it's my eyeball.

I decided it was time to look outside of NE for a surgeon who could think outside the box and that is exactly what I found in Dr Massry. After a Skype consult and then flying to CA to meet in person, he explained that he wanted to try an Orbital Decompression for the problem. He would recess my eye back and down in the socket a few millimeters. I happen to be a scrub nurse in ophthalmology so this really sounded wild considering I don't have Graves disease. But after listening to his reasoning it was clear I needed to try something else because I had exhausted anything else that could be done with my eyelids.

I had the surgery in July 2016 and life has been great for me since then :) I used to use non-preserved artificial tears every 15 min, ointment or goggles at night, humidifier, etc. Now I am much more comfortable, use tears far less, hardly any times of having to be treated for horrible keratitis, and actually, have days that "I don't think about my eye." It sounds crazy but that is huge for me!

And the bonus was how much of a self-esteem boost I have from a change in my appearance cosmetically! I had someone ask me weekly, if not daily, if I had a stroke or if I had a glass eye. It really bothered me but now that rarely happens. All of those involved in my treatment and care from Dr. Massry's wonderful staff to the care I received at their outpatient surgery center were first class. The pic of myself and Dr. Massry was taken July 2016 the day prior to surgery and the other pic was taken Nov 2016 on my 40th birthday with my wonderful husband. Big difference! This is long and personal but I wanted to give details so if you feel like your situation is hopeless, it is not. Contact Dr. Massry!" -Ginger

Schedule A Consultation With Dr. Massry

If you or a loved one is suffering from eyelid paralysis, contact Dr. Massry's office today to find out if you are a candidate for Orbital Decompression. This innovative surgery technique may be able to greatly improve not only your eyelid aesthetics and function but also your overall quality of life. Call us at 310-675-4302 to learn more.

We also offer Skype consultations for our out of town patients to make it as easy as possible to meet with Dr. Massry.

You may also enjoy reading Dr, Massry's blog entitled Eyelid Paralysis - A Minimally Invasive Procedure to Improve Function & Aesthetics.

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