Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
16Feb/170

Revision Lower Eyelid Surgery: Fixing Retracted or Pulled Down Lower Eyelids

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Lower eyelid retraction, or pulled down lower lids with a change in the shape and appearance of the lower eyelids, is a dreaded complication of lower eyelid blepharoplasty.  It occurs for a variety of reasons and is difficult to correct.  Little research has been put into lower eyelid retraction after blepharoplasty (ie. revision lower eyelid surgery), which is one of the reasons correcting the problem has been so challenging.  Recently, Guy Massry, MD, of Beverly Hills, California, a respected expert and frequent lecturer on post blepharoplasty lower eyelid retraction performed a scientific study to evaluate the current state of this condition. The study abstract can be viewed here.

From this work, Dr. Massry made modern and novel suggestions on why it happens, which allow better treatment options with surgery or fillers. You can watch his novel approach to fillers here:

Eyelid Fillers Explained

Non-Surgical Treatment for Retracted Eyelid

Lower eyelid retraction after blepharoplasty is a very complicated problem that only a very experienced eyelid surgeon such as Dr. Massry should evaluate and treat.  Please be careful with this problem and seek only the advice of specialist with years of experience.

Contact Dr. Massry Today!

If you have been left with unsatisfactory results from a primary blepharoplasty, please call Dr. Massry today so he can help restore your eyelid appearance and function - 310.657.4302.

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7Feb/170

Red Carpet Beauty Secrets Revealed

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February marks one of the most glamorous months of the year in Hollywood! From the Grammys to the Oscars and all the parties in between, celebrities hit the red carpet looking their absolute best. But how do they achieve that flawless beauty? Dr. Guy Massry, an oculoplastic surgeon to the stars in Beverly Hills, reveals some of the top red carpet beauty secrets!

“In the months leading up to awards season, actors, singers, producers, directors, agents, etc. all begin their red carpet preparation. On most of their prep-lists you will see excellent skin care routines, extra gym sessions, strict diets, non-surgical beauty treatments, and, for some, plastic surgery,” commented Dr. Massry.Red Carpet Beauty Secrets Revealed

What Are The Go-To Non-Surgical Beauty Treatments?

At his Beverly Hills practice, Dr. Massry helps his celebrity patients look their best with a conservative approach to injectables, including BOTOX and fillers.

BOTOX

The days of “bad BOTOX” are over as long as you go to an expert injector who knows precisely where to place the Botox so the results are natural and there is still movement around the brows and forehead. Botox is a great treatment to smooth out unwanted wrinkles and lines from the forehead, 11-lines, and crow’s feet. Additionally, Dr. Massry can strategically place the Botox to give his patients a “Botox Brow Lift.”

A conservative and natural approach to Botox is especially important for actors who need to be able to make distinct facial expressions to get their character’s emotions across. Dr. Massry knows and understands this need and therefore just uses Botox to subtly smooth and refresh his celebrity patients’ appearance for the red carpet.

Fillers

Filler treatments are one of Hollywood’s best-kept secrets when performed by a skilled injector! Today there are several filler products (such as Restylane, Juvederm, Restylane Silk, Belotero, etc) on the market that allow for very natural looking results. Some of the most common filler treatments include:

  • Under the eyes for dark circles, under eye bags or hollows
  • Fill sunken brows
  • Lift and revolumize sagging upper eyelids
  • Add volume to hollow temples
  • Restore and enhance volume to the cheeks
  • Increase the size of the lips
  • Replenish volume to nasolabial folds

As with his approach to Botox, when Dr. Massry treats his celebrity clients with filler, he takes a very natural and conservative approach. “My goal is to use fillers simply to restore lost volume to my patients’ faces. I can also use the filler to create subtle, yet powerful, facial contours. But ultimately we never want anyone to suspect any ‘work’ has been done,” said Dr. Massry.

Blepharoplasty

For celebrities in their late 40s to late 60s, sagging upper eyelids and lower eyelid bags become a big concern and a dead giveaway for their age. As one of the best blepharoplasty surgeons, Dr. Massry offers his celebrity patients a very customized approach to eyelid rejuvenation. For eyelid rejuvenation surgery to provide the best outcome, Dr. Massry considers all aspects of the eyelids and adjacent areas. This includes assessing forehead and eyebrows to see if an eyebrow lift is needed, as well as looking at the cheeks or midface to see if fat repositioning, a midface lift, or fat grafting will be beneficial. Taking this more holistic approach ensures the patient’s results look natural and balanced.

Plastic Surgery Isn’t Just For Celebrities

Although we have discussed the top red carpet beauty secrets for celebrities, these treatments are available to everyone! If you want to refresh and rejuvenate your appearance, Dr. Massry can help you. Whether you are interested in Botox, fillers, blepharoplasty, or some combination of the three, you can rest assured that Dr. Massry will provide you with the same dedicated care and aesthetic expertise his celebrity patients receive.

To schedule your consultation with Dr. Massry, please call us at 310.657.4302.

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3Feb/170

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

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As eyelid filling has become commonplace, so too have eyelid filling complications.  The problems and complications seen range from less severe issues such as increased bruising and swelling, to more concerning problems such as lumps, bumps, persistent swelling, skin color changes, inflammation, and infection.  The best way to avoid these complications is to have an eyelid filler expert do your filler treatment.  This means someone who knows the various filler products – not just their names but more importantly their biochemical composition (their so-called recipe) and their clinical behavior (what they do when injected into living tissue).  While this seems very obvious, it unfortunately is a major problem.  The filler product market is always changing and it takes effort and dedication to keep up with it.  It is critical to keep up with the literature and research in this area, or problems will develop.

Expert filling also requires a detailed knowledge of eyelid anatomy and aging changes, and equally detailed experience with injecting these products into these very delicate areas.  These three points: (1) knowing filler products, (2) being an eyelid expert, and (3) knowing how to inject the eyelids are the KEY to successful eyelid filling and avoiding complications.

Choose Dr. Massry For Your Eyelid Filler Treatment

Dr. Guy Massry is a board certified oculoplastic surgeon with years of experience in eyelid fillers.  He teaches principals in this area nationally and internationally, and is sent the most complicated filler problems for correction by his colleagues.  Eyelid filling is one of Dr. Massry’s prime practice interests and he has developed techniques to inject fillers which have yielded the best of results.

Eyelid filler - Dr Guy Massry

Below you can watch Dr. Massry’s unique filling techniques for both the upper and lower eyelids.

Hyaluronic Acid Gel Filling of the Brow and Upper Eyelid Video 

Hyaluronic Acid Gel Filling of the Lower Eyelid and Associated Hollows

Schedule Your Eyelid Filler Treatment With Dr. Massry

If you are interested in filler treatments to improve your eyelid appearance ( get rid of bags, circles and hollows) please contact Dr. Massry's office in Beverly Hills today - 310.657.4302

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2Feb/170

MIOS – A Life Changing Procedure For Patients With Eyelid Paralysis

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As he is always striving to advance the field of oculoplastic surgery, Dr. Guy Massry in Beverly Hills has pioneered a surgery technique called the minimally invasive, orbicularis-sparing (MIOS) lower eyelid recession. Knowing that there was a lack of a minimally invasive surgical technique to address lower eyelid retraction (the lower lid is pulled down) in the presence of eyelid weakness (orbicularis deficit - eyelid paralysis), both in cosmetic and reconstructive cases, Dr. Massry and his colleagues set out to perfect a surgical technique to fill this absence.

The MIOS procedure involves a closed canthal suspension (lid tightening without cutting already weak muscle) with true transconjunctival lower eyelid retractor recession (lift lower lid from inside the eyelid - no skin cuts) to provide a means of lower eyelid elevation without lower eyelid muscle trauma. This procedure can be used safely and effectively in several types of cases including facial nerve injury (facial paralysis), trauma, surgical complication, etc.

MIOS for Eyelid Paralysis

The patient below suffered from eyelid paralysis and underwent MIOS surgery with Dr. Massry to help create eyelid symmetry and be able to close her eye. In the case of eyelid paralysis, MIOS offers patients a minimally invasive surgical option without the need for an eyelid weight implant.

In this patient’s pictures, you can see that prior to surgery (LEFT SET of pictures) her right eye does not close completely and is, therefore, red, dry and irritated. You can also see that her lower right eyelid is much lower than her left lower eyelid. Utilizing the MIOS procedure, Dr. Massry was able to help this patient more appropriately close her right eye, as well as create more symmetry between the two eyelids WITHOUT AN EYELID WEIGHT.

MIOS - Dr Guy Massry

Why Choose Dr. Massry For Your Eyelid Paralysis Surgery?

Dr. Massry is an international leading expert in orbital and eyelid surgery. As mentioned above, he is constantly advancing and improving the surgical techniques used by oculoplastic and facial plastic surgeons. In the case of eyelid paralysis, he has unparalleled experience in helping patients with eyelid closure and symmetry correction. Additionally, Dr. Massry pioneered and conducted the study on the success and safety of the MIOS procedure. Read Dr. Massry’s study entitled – “The Minimally Invasive, Orbicularis-Sparing, Lower Eyelid Recession for Mild to Moderate Lower Eyelid Retraction With Reduced Orbicularis Strength.”

Schedule Your Consultation With Dr. Massry Today!

If you are suffering from eyelid closure and aesthetic issues due to eyelid paralysis, schedule your consultation with Dr. Massry today to find out if you are a candidate for the MIOS procedure – 310.657.4302.

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24Jan/170

Moebius Syndrome Awareness Day 2017

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Moebius syndrome awareness day - MassryJanuary 24, 2017 marks this year’s Moebius Syndrome Awareness Day, hosted by the fantastic Moebius Syndrome Foundation.

Moebius syndrome is a rare congenital neurological disease that affects the muscles responsible for facial expressions and eye movement, causing facial paralysis. Symptoms of Moebius syndrome can include, but are not limited to:

  • Inability to smile or make complete or partial facial expressions
  • Difficulty swallowing and eating
  • Eye issues, including eye sensitivity, inability to blink, strabismus
  • Absence of ability to move eyes laterally
  • Dental hygiene problems
  • Impaired hearing
  • Tongue deformity
  • Hand and feet deformity

For patients with Moebius syndrome, there have been some great advancements in facial reanimation procedures in recent years. Dr. Guy Massry is able to help Moebius syndrome patients with bilateral eyelid paralysis reconstruction. Patients are unique and Dr. Massry will develop a customized surgical plan to give them the best results possible. Most commonly, Dr. Massry will perform eyelid paralysis surgery to create an epicanthal fold and/or place gold weights so that the cornea is protected.

For facial reanimation procedures for Moebius syndrome patients, Dr. Massry teams up with Dr. Babak Azizzadeh of the Facial Paralysis Institute. Dr. Azizzadeh offers some of the most cutting-edge facial reanimation surgery options to help patients smile and make facial expressions. To learn more about Moebius syndrome surgical treatments, please visit the Facial Paralysis Institute.

If you would like to learn more about eyelid paralysis surgery with Dr. Massry, please call us at 310-657-4302.

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18Jan/170

Eye Bag Surgery – What You Need To Know

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Under eye bags are one of the most common aging issues an oculoplastic surgeon treats. While many eye creams and skin care products claim to get rid of under eye bags, they will never give you the complete results that surgery will.

Under eye bags

What causes eye bags?

Everyone ages in a unique way. The most common reasons we see under eye bags include:

  • As you age structures around the eyes become weaker and the fat begins to sag
  • Fluid retention creates the baggy, puffy appearance
  • Lack of sleep
  • Excessive stress
  • Allergies
  • Genetics

How do you remove under eye bags?

The surgical correction of under eye bags is called blepharoplasty. When choosing a surgeon to perform your blepharoplasty it is imperative you select a specialized oculoplastic surgeon with great expertise in this surgery, as the under eye is a very delicate and complex area. Dr. Guy Massry is a board certified ophthalmic plastic surgeon in Beverly Hills who helps patients from around the world remove their under eye bags. When Dr. Massry performs blepharoplasty procedures, he customizes the surgery to the specific needs of the patient so that they receive the best results possible.

For more mild eyelid bags, it is possible to improve the appearance without surgery by using dermal fillers, such as Restylane. When injected by a true expert, like Dr. Massry, the Restylane re-contours the under eye area so that it appears smooth and bag-free.

Contact Dr. Massry Today!

If you are bothered by the appearance of eye bags, contact Dr. Massry today to see if you are a candidate for eye bag surgery – 310.657.4302!

Next, read Lower Lid Blepharoplasty - Maximizing Results

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17Jan/170

Can Botched Eyelid Surgery Be Fixed?

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Although eyelid surgery is a common cosmetic procedure, the eyelids are very delicate and should only be treated by an expert oculoplastic surgeon to avoid any surgical complications or unsatisfactory results. If you unfortunately end up with botched eyelid surgery, Dr. Guy Massry in Beverly Hills can help.Revision eyelid surgery - eyelid lengthening - front - Dr Guy Massry - Beverly Hills

The reason patients choose to have blepharoplasty is to eliminate the appearance of aging around the eyes. The most common aging issues patients want to improve with surgery include:

  • Sagging or loose upper eyelids
  • Under eye bags or hollows
  • Excess skin around the eyes
  • Fine wrinkles
  • Excess fatty deposits that appear as puffiness in the eyelids
  • Dropping lower eyelids

However, if a surgeon over-corrects or under-corrects the patient’s appearance with blepharoplasty it can lead to aesthetic and/or functional problems for the patient, requiring revisional surgery.

Botched eyelid surgery can leave you with the following unwanted outcomes:

  • Over operated appearance
  • Under correction
  • Visual problems
  • Retraction – the lower eyelid is pulled down and the shape of the eye has changed
  • Eyes can’t close completely – too much tissue was removed from the upper eyelid
  • The lateral canthus (outer corner of the eye) was cut during surgery and the eye looks and feels different

While these conditions are very difficult to correct, Dr. Massry has dedicated his career to helping patients who need complicated revision surgeries. First and foremost, when dealing with botched eyelid surgery cases Dr. Massry makes sure that the patient has a realistic expectation for the results of their revision surgery. Dr. Massry will do everything he can to help his patients achieve their desired results. However, the damage done to the anatomy in previous surgery (or surgeries) will determine the degree to which Dr. Massry can improve the eyelid form and function. During a consultation with Dr. Massry, he will examine the patient for scarred tissue planes, if there is good blood supply and tissue movement, etc., all of which affect the outcome of revision surgery. Finally even with a complete examination, it is not until surgery takes place that the true extent of the problems present become completely known.

Let Dr. Massry Fix Your Botched Eyelid Surgery

If you experienced a poor outcome from a previous blepharoplasty with another surgeon, please contact Dr. Massry today – 310.657.4302.

Dr. Massry is a world-renowned oculoplastic surgeon who specializes in revision eyelid surgery. When other surgeons encounter patients who need complex revision surgery, they refer out to Dr. Massry for his unparalleled expertise. You can rest assured that your eyes are in the best hands possible with Dr. Massry.

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20Dec/160

Top 5 Reasons People Want Eyelid Surgery

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top-5-reasons-people-want-eyelid-surgery-dr-massryBlepharoplasty, or cosmetic eyelid surgery, is a fantastic treatment option to rejuvenate your eyes, and therefore your overall facial appearance. Although blepharoplasty is a common cosmetic procedure, it should only be performed by a board-certified oculoplastic surgeon who specializes in treatments around the eyes. The structures around the eyes are very delicate and complex and require the skills of an experienced oculoplastic surgeon, like Dr. Guy Massry, to avoid complications.

At Dr. Massry’s oculoplastic practice in Beverly Hills, the top 5 most common reasons people want eyelid surgery include:

  1. “I want to look well-rested.”
  2. “I want to look younger."
  3. “I want to feel refreshed.”
  4. “I want to remove my under eye bags.”
  5. “I want a boost in my self-confidence.”

Blepharoplasty is the perfect surgery to address and improve these concerns! With age, the upper eyelids begin to droop and sag, creating that hooded, tired appearance. Additionally, the under eye area can develop fat pockets and bags that make you appear exhausted or older than you really are. Whether you have just one or both of these concerns, Dr. Massry knows that the appearance of tired eyes can lead to a decrease in self-confidence. Luckily, a customized blepharoplasty with Dr. Massry will restore a refreshed and youthful eyelid appearance so you can regain your confidence!

Why Choose Dr. Massry For Your Blepharoplasty?

As a world-renowned oculoplastic surgeon, Dr. Massry has dedicated his career to specializing in cosmetic and reconstructive eyelid procedures. He has an unparalleled knowledge of the underlying orbital anatomy and a keen eye for eyelid aesthetics. When you have surgery with Dr. Massry, you can rest assured that you are in the best hands possible.

When Dr. Massry performs blepharoplasty procedures, he takes a very customized approach. He knows that every patient is unique (both in their orbital anatomy and aesthetic goals) and tailors the surgical techniques and outcomes to meet the needs of the patient. During your consultation with Dr. Massry, you can explain your eyelid concerns and discuss your goals for your surgical results. Once Dr. Massry has all of this information and has examined your eyelids, he will give you his recommendations for the best and most natural blepharoplasty results.

Schedule Your Eyelid Surgery Consultation Today!

Regardless of your reasons for wanting cosmetic eyelid surgery, Dr. Massry is here to help! Please call us today to schedule your consultation with expert eyelid surgeon Dr. Massry – 310.657.4302!

For our out of town patient, Dr. Massry offers Skype consultations so you can meet him from the comfort of your own home. Call us to find out more!

Other Blepharoplasty Blogs You May Enjoy:

Lower Lid Blepharoplasty - Maximizing Results

Dr. Massry's Dos and Dont's After Eyelid Surgery

Cosmetic Eyelid Surgery FAQs

Top 10 Questions Patients Ask Before Eyelid Surgery

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29Nov/160

How To Look Stunning At This Year’s Holiday Parties

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holiday-party-beauty-prep-massry

It is already that time of the year again – holiday party season! So dust off your sparkly holiday dress, pull out your ugly Christmas sweater, and glam up your beauty routine. To help you look your best, Dr. Guy Massry, a Beverly Hills oculoplastic surgeon, recommends Botox and/or filler treatments to refresh your facial appearance.

Botox is a fantastic non-surgical treatment that erases wrinkles on your forehead, 11-lines, and crow’s feet. The treatment temporarily prevents the wrinkles from forming and therefore your skin appears softer and smoother. When performing Botox injections, Dr. Massry’s goal is not to “freeze” your face, but to soften it while still allowing for muscle movements that display your expressions. Additionally, Dr. Massry can strategically place the Botox injections to give you a “Botox Browlift.” Botox takes 7 – 14 days to take full effect, so make sure you book your treatment at least a week and a half before your holiday party!

Facial fillers are a fantastic way to instantly restore volume to the face. A voluminous face with contours is a mark of youth and beauty. Unfortunately, as we age, we lose our youthful volume. When Dr. Massry examines his patients, he determines which areas of the face have lost volume and uses fillers such as Juvederm, Belotero, and Restylane to restore volume. The most common areas that Dr. Massry treats with fillers include, the mid-face, under eye area, and temples.

  • Mid-Face – When the mid-face (cheeks) loses volume, the skin begins to droop and sag and the face appears older. Using an injectable filler, such as Restylane Lyft, Dr. Massry is able to lift and augment cheek volume to restore a more youthful appearance.
  • Under Eyes – The stress of the holidays often times reveals itself in the form of unwanted dark circles under the eyes. If you are beginning to notice you look more tired than usual or if your under eye area has been bothering you for a while, now is the perfect time to try Restylane, Restylane Silk or Belotero under the eyes! The treatment will make your dark circle disappear instantly and you will look like you are the most well-rested person in the room.
  • Temples – Many people don’t realize it, but a common area that we lose volume is in the temples. Hollow temples create an unflattering shadow effect that darkens the face and eyes. Filling in hollow temples with Juvederm provides stunning results!

Dr. Massry recommends you schedule all filler treatments 7 to 10 days before your holiday party so if you experience any bruising or swelling, it has enough time to dissipate.

Schedule Your Pre-Holiday Party Treatments Today!

If you want to look your best this holiday season, schedule your non-surgical beauty-boosting treatments with Dr. Massry today - 310.657.4302!

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11Oct/160

The Lessons I Have Learned With Endoscopic Brow Lifting

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Endoscopic brow lifting is my preferred method of aesthetic brow reshaping. I use the word reshaping because the primary lesson I have learned from 20 years of brow lifting is that the procedure should focus on brow shape and contour more than height. This is the single most important caveat of brow lifting and will allow better results and happier patients.

upper-and-lower-blepharoplasty-with-browlift-001

Over the last 4 years I have primarily utilized a temporal endoscopic plane approach (between the superficial and deep temporalis fascia) with or without the use of the endoscope to reshape the brow contour. My focus has been a temporal lift only. In my experience, in most cases, lifting the medial brow is an error which changes normal eyelid and periorbital, and ultimately, facial proportions. Most who need medial brow elevation also have bunching of glabellar tissue, and I have found benefit most from a central pretrichial approach (with tissue excision) combined with the temporal lift described below.

The procedure proceeds with standard temporal approach sub-superficial temporal fascia access to the canthus. This plane is made continuous with the central subperiosteal space by dividing the conjoint tendon. Dissection continues to the arcus marginalis periosteum at the superior orbital rim. The periosteum is released from the supraorbital neurovascular bundle laterally to the canthus. It is critical to release the lateral orbital thickening. The temporal brow is fixated with 2 sutures (2-0 PDS) from superficial to deep fascia. The lift is superior and nasal to avoid brow splaying and provide the best temporal elevation. No cautery is used for bleeding (vascular tourniquet is created with dilute anesthetic and added pure saline as needed – bleeding is controlled with mechanical pressure from volume of injection). Only staples close the wound and no scalp is excised. These are critical steps to avoid alopecia. Post-op regional supraorbital and lacrimal nerve blocks are given as is local anesthetic infiltration of staple sites – all to control pain. Preoperative Emend (substance P receptor antagonist) is a reliable way to control post-op nausea (I highly recommend this – look it up). Post-op pain control is with your narcotic of choice prn.

I have recently reviewed 162 such cases with the following findings.

94% of patients stated a high satisfaction with the brow lift.

The remaining patients were satisfied except for 2 who desired a revision for more temporal lift. Keep, in mind – all patients knew the procedure performed this way would not address glabellar or forehead rhytids. This was not their expectation. Most received post-op neuromodulation for this purpose. This avoids the numerous issues with selective myotomy/myectomy (another topic of discussion).

More than temporary motor nerve injury (first week or so) occurred in 2 patients (1.2%), which is slightly less than the reported 1.5% previously reported. Both these patients had previous coronal lifts (ie both revisions).

Sensory issues beyond 4 weeks (numbness, tingling, itching, etc) occurred in 3.8% of patients – far less than the previously reported 7%-8%. To achieve this, it is critical to stay subperiosteal when making the temporal sub-superficial temporal fascia plane continuous with the central subperiosteal plane (when dividing conjoint tendon). This protects the distal segment of the deep (lateral) branch of the supraorbital nerve. Also as the periosteal release is lateral to the supraorbital nerve egress, the proximal superficial (medial) branch of the nerve is less prone to damage.

We have paid more attention to motor injury than to sensory injury because morbidity is worse. However, always remember that sensory injury is more common.

It has been reported that post-op pain is present in up to 75% of traditional endolift surgery patients. In this technique, with injections described, I have noted its presence in approximately 30% of cases.

Alopecia at the incision site is a tough parameter to judge. Approximately 10% have made mention of it – close inspection most likely shows it is more common. However, at 1 year after surgery it is rarely suggested by patients.

It is important to share such knowledge as we continue to evolve our surgical procedures. I welcome other’s experiences so we can grow and learn together and deliver the best of care.

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