Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
9Apr/150

Revision Eyelid Surgery | Fixing Results From Prior Eyelid Surgery

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Revisional eyelid surgery is one of the most difficult areas of oculoplastic surgery, as it is hard to meet patient expectations. Revision surgery becomes more difficult than primary surgery because you are operating on scarred planes that have been distorted completely in anatomy; it's not like first time surgery.

Before undergoing revisional eyelid surgery, first and foremost, there has to be an understanding between the physician and the patient about realistic expectations for revision surgery. The primary reason patients are unhappy with revisions is that they have an expectation that they will be exactly as they were before the primary surgery that caused the problem, and unfortunately that is not always possible. So what patients need to expect is a 50% improvement, and anything above that is a gift. Now, when Dr. Massry says a 50% improvement, he is undershooting expectations. The reason he sets the expectations at a 50% improvement is because he truly will not know how the final results will turn out until he is in surgery. Once he is in surgery he will see how bad the anatomy is distorted, how the blood vessels and blood supply have been effected, maybe they have had 1 surgery before, maybe they have had 10 surgeries before, all of these things play a factor in what kind of results can be achieved with revisional surgery.

Everything is done to make the patient as close to where they were before surgery as possible, within the realm of what the reality is. It really requires an in-person evaluation with Dr. Massry for him to give you an idea of what results revisional eyelid surgery can give you. If on his examination of a patient he finds that the tissue planes are not overly scarred, there is a good blood supply and tissues move around nicely, he can get them very close to where they were before the initial surgery. On the other hand, if a patient has already had 7 or 8 surgeries, the tissue isn't quite the same and surgery becomes more difficult.
Dr. Massry believes the key is the evaluation - coming into the office. The ability to give a patient realistic expectations requires that personal interaction so that Dr. Massry can appropriately examine the patient, feel the tissue, etc.
There are often times that revision surgery is not the answer. Revisions can have the domino effect - there have been a number of surgeries performed, and the problem really can't be improved much with surgery at this point. At this point fillers may be the best option then because if you keep operating things can keep getting worse, like the dominos falling.
The most common reasons for revision eyelid surgery include:
(1) Retraction - lower eyelid is pulled down so the lower lid is lower and the shape of the eye has changed.
(2) The outer corner of the eye (lateral canthus) has been cut during primary surgery so the eye looks different and feels different.
(3) Can't close the eyes (too much tissue was removed from the upper lid).
Often times Dr. Massry will first recommend fillers to fix eye issues to delay surgery and help things improve and then move to surgery. If patients can do something without surgery again, that is a nice way to show them there is a nice improvement, things can get better and delay surgery as long as possible.
Dr. Guy Massry is a board certified oculoplastic surgeon in Beverly Hills, CA and is internationally renowned for his expertise in revision eyelid surgery. If you are unhappy with the results from a prior cosmetic eyelid surgery, call us at 310-657-4302 to schedule your consultation with revision eyelid surgery expert, Dr. Guy Massry!

Posted by Chris Sullivan

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