Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
12Feb/150

Upper Eyelid Hollows or Sunken Eyelids after Blepharoplasty Surgery – Eyelid Fillers Can Be The Answer

Posted by Chris Sullivan

Hello, I am Guy Massry, MD – an oculoplastic (ophthalmic plastic surgery specialist) in Beverly Hills, California. Over the years I have had extensive experience in performing secondary surgery (revision surgery or “redo” surgery) on patients unhappy with their initial blepharoplasty (cosmetic eyelid surgery). This has been a very taxing experience as I have seen so many unhappy and emotionally damaged patients who are in the depths of what is a form or variant of post-traumatic stress disorder (PTSD). The inciting event was surgery which “altered” the patient’s natural appearance. This does not mean there is anything wrong with the patient. It means the outcome of surgery negatively affected the patient’s confidence, well-being, and most importantly, their perception of themselves. The most common statement I hear from such patients is “when I look in the mirror I see someone else.” It is essential for all of us to understand this statement. Everyone would be bothered by “losing” a part of themselves – especially their appearance or how others see them. As I practice in Beverly Hills, a city where eyelid surgery is so commonplace, I tend to see a high volume of these issues.

With experience I have realized that while surgery can help in many of these cases, in some situations surgery is limited, and there are other, “better” options for certain patients. One such situation is upper eyelid hollows after poor outcome upper eyelid blepharoplasty. Hollows are depressions form over-excision of skin, muscle or fat. It leaves patients with a deep upper lid and often times skin on bone which is a very aged, or what we call “skeletonized” look. The primary goal of surgery is to recreate youth – this situation does the opposite. It surgically ages people.

I have developed some simple in-office techniques to address the issue of a hollowed or sunken upper lid after upper blepharoplasty surgery. The technique involves the placement of a specific filler to fill and expand the depleted tissue planes so that youth can be re-created. Physician injectors tend to take fillers lightly as they are not a “surgical procedure.” However, complications from fillers also occur and it is critical that you seek an eyelid filler expert when you get treatment, especially with revisions of poor outcome surgery. It is very important the physician injector know the biochemical makeup of the various fillers (all are different and all act differently) so that appropriate selection of filler material for each individual patient is performed.

Please don’t give up if you suffer from hollow upper lids after blepharoplasty surgery. I am happy to see you in consultation and discuss the various options of treatment. Do not get stuck on a permanent solution surgically. If surgery is not indicated or cannot meet your expectations – more surgery can, and often will, make things worse. Please contact my office, Guy G. Massry, MD, at 310-863-3488 or through my website if you would like information or a consultation upper eyelid hollows or sunken upper eyelids after blepharoplasty.

Below is an example of how the situation can be remedied with filler.

 

Blepharoplasty  remedied with filler - before & after.

Blepharoplasty remedied with filler.

 

A: Initial patient presentation to me after poor outcome upper blepharoplasty surgery
B: Immediately after filling left upper lid with filler in the office
C: Immediately after filling right upper lid with filler in the office
D: A month after filling procedure. A very natural result

 

25Sep/130

Dark Circles Under the Eyes – Why? And How to Fix

Posted by admin

Dark Circles under the lower eyelids are very troublesome, detract from appearance, and impart an aged look on people.  In fact dark circles under the lower eyelids may be the most common concerns patients present with to an eyelid specialist (oculoplastics or ophthalmic plastic surgeon’s).

Why do dark circles under the eyes develop?  Well, there are a variety of causes:

  • First-prominent, puffy eyelid bags above can allow a shadow to be created which can impart a dark appearance below.
  • Second-pigment cells in the skin (melanocytes) can be overly active causing darkening.
  • Finally-the muscle under the thin eyelid skin and blood vessels in the same area often appear dark.  When the skin is thin enough this darkness can become apparent.

Dr. Guy Massry, Beverly Hills Ophthalmic Plastic Surgery, is a blepharoplasty surgeon (eyelid surgery) expert, who has a particular interest in reducing dark circles around the eyes.  The best treatment depends on the primary cause and this can be identified upon evaluation in the office.   If eyelid dark circles concern you please contact Dr. Massry at his office (310) 657-4302, or through his web site.

dr-massry-beverly-hills-dark-circles

14May/130

When Are Eyes in Danger of Complications from Blepharoplasty Surgery

Posted by admin

guy-g-massry-md-oculoplastic-surgeon-beverly-hills-californiaBlepharoplasty or eyelid surgery is one of the most commonly performed cosmetic and functional facial surgical procedures in the United States today.  It is performed by all aesthetic facial specialties – but is best when in the hands of a cosmetic eyelid surgical specialist – or an oculoplastic surgeon.

The reason surgery is best performed by eyelid surgery specialists is to avoid complications to the eyes.  These complications include the true ocular problems such as the inability to close the eyes, dry eyes, reduced vision, chronically irritated or infected eyes, or constant pain in the eyes.  Complications can also affect appearance and include a “wide-eyed” look, a “cat-eyed” look, upper and lower lids that are hollow, a rounded eye (i.e. lost normal shape), lower lids that are pulled down, or an abnormal outer corner to the eyes.

These complications can be avoided by an appropriate preoperative evaluation and by having surgery performed by a “true” eyelid specialist.  Dr. Guy Massry (Beverly Hills ophthalmic Plastic surgery) is an oculoplastic surgeon with vast expertise in cosmetic blepharoplasty surgery.  Dr. Massry can be reached through his website or at his office at (310) 657-4302.  Dr. Massry would be happy to see you for your eyelid surgery needs.

 

 

 

24Feb/130

Blepharoplasty Surgery (Eyelid Lift) Before and After Photographs

Posted by admin

Blepharoplasty Surgery (Eyelid Lift) Before and After Photographs

25Jul/120

How to Fix Bad Blepharoplasty Surgery

Posted by admin

Blepharoplasty surgery – also referred to as eyelid surgery, eyelid lift surgery, eyelid bag surgery or simply cosmetic eyelid surgery – is one of the most common facial plastic surgical procedures performed today.  Numerous surgeons from varied subspecialties perform eyelid lift surgery.  The problem is that blepharoplasty surgery is a very specialized cosmetic surgery which can easily lead to a poor outcome if not performed by the appropriate surgeon.

So who performs eyelid lift surgery?

  1. Oculoplastic or ophthalmic plastic surgeons.  These specialists are first trained in eyes (ophthalmology) and then further trained is eye plastic surgery.
  2. Facial plastic surgeons.  These are ear nose and throat trained surgeons who do further training in facial cosmetic surgery.
  3. General plastic surgeons.  These are surgeons trained only in plastic surgery – but of the entire body (head to toe).
  4. A variety of other surgeons without any specific training in plastic surgery.

Clearly the best trained and most experienced surgeons for your eyelid bag surgery are oculoplastic surgeons http://drmassry.com/#/6-0 , http://drmassry.com/blog/?p=116 .  All other fields do not have the depth of training in surgery of this very complex area of the face.

Cosmetic oculoplastic surgeons specialize in blepharoplasty (eyelid or eyelid bag surgery) http://drmassry.com/blog/?p=754http://drmassry.com/blog/?p=603, http://drmassry.com/blog/?p=546 , http://drmassry.com/blog/?p=531 .  They also specialize in fixing surgery that has turned out poorly.  No other field in cosmetic surgery has this form of training.  If you have had a poor outcome to your eyelid bag surgery – please see only an oculoplastic surgeon to correct the problem.  This is the best way to ensure a good outcome to your redo (revisional ) procedure.

Common problems encountered after poor result eyelid lift surgery are inability to close the eyes, pulled down lower lids, problems with the canthus (outer corner of the eyelids), residual puffiness, and a slew of other issues.

These problems can be corrected in many cases.  However, to do so, only a specialist in the field should be seen.

 

 

 

 

15Jul/120

Bell’s palsy – Why can’t I close my eyes?

Posted by admin

Bell’s palsy is a form of facial paralysis which can lead to the loss of the ability to close your eyes.  The Upper eyelid has muscles which open the eyes (levator muscle and Muller’s muscle) and a muscle which closes the eyes (orbicularis oculi muscle).  When the elevator muscles become weak or mal-functions what results is a droopy lid referred to as ptosis.  The orbicularis muscle is supplied by the 7th Cranial nerve also called the facial nerve.  In Bell’s palsy and other forms of facial paralysis this nerve is damaged and leads to weakness of eyelid closure.  As the closing of the lids is reduced, the patient experiences dry eyes, red eyes, eye irritation, possible infections and potentially loss of vision.  For this reason it is critical to see an eyelid specialist who performs eyelid reconstructive surgery – or an oculoplastic surgeon.

The eyes are one of our most important organs as they control vision our most important sensory function.  In addition the appearance of the eyes and eyelids is vital to how we present ourselves to society and for our self-esteem.  We must do all we can to attain the best visual function and appearance after suffering from Bell’s palsy or other forms of facial paralysis.

For more information on the subject of Bell’s Palsy, inability to close the eyes and how to correct these issues please open the following links: http://drmassry.com/blog/?tag=eyelid-paralysis, http://drmassry.com/blog/?p=488 , http://drmassry.com/blog/?p=521

 

 

14Jul/120

The Browpexy – A Minimally Invasive Brow lift

Posted by admin

outer brow lift and blepharoplastyToday cosmetic eyelid surgery (blepharoplasty) is one of the commonest facial aesthetic procedures performed in the world.  Often times to perform appropriate eyelid lifts (blepharoplasty) it is necessary to also address the brow.  There are numerous forms of formal brow lifts such as the endoscopic brow lift, which are very powerful, but also expensive and very involved surgical procedures.

For those patients who are concerned with costs, recovery from surgery and invasiveness of the procedure, there is an alternative.  This other form of brow surgery is called a browpexy.  A browpexy is a procedure which minimally elevates or stabilizes the brow so that it will not be lowered even further when eyelid surgery is performed.  In many cases when the brow is low (or borderline low) and eyelid lift is performed the brow will be pulled even lower.  This has negative consequences on appearance and function after surgery.

What Is A Browpexy?

A browpexy is a suture suspension of the brow to the underlying bone.  It can be performed from within the eyelid (internal browpexy) or from a small incision above the brow.  The later procedure is called the external browpexy (developed by Dr. Guy Massry – Ophthalmic Plastic Surgeon -  Beverly Hills, California). Below are a few of Dr. Massry's published articles on the procedure:

Now a browpexy is not for everyone.  Appropriate patient selection is critical to attain the best results.  However, in the right patient and with the right doctor performing the procedure, high patient satisfaction and excellent results are obtained.  Below are examples of patients who underwent the external variant of the browpexy as described by Dr. Massry.  When viewing these photos (before surgery - left/after surgery - right) only pay attention to the correction of brow asymmetry - which was the purpose in each case.

Before and After Browpexy

Contact Dr. Massry Today!

For more information on this novel and non-invasive form of brow lifting, please schedule a consult with Dr. Massry by calling us at 310.657.4302.

Meet Dr Guy Massry

9Apr/120

Fixing Eyelids in Bell ’s Palsy

Posted by admin

When Bell’s palsy occurs the eyelids become weakened or paralyzed – this is called eyelid paresis or paralysis.  This is a difficult condition for the patient as the eye does not close which leads to discomfort, disfigurement and loss of function.

Dr. Guy Massry ( Beverly Hills Ophthalmic Plastic Surgery) http://drmassry.com is an expert in eyelid paralysis surgery.  Dr. Massry performs surgery in minimally invasive ways so as to preserve function and appearance, as is evidenced by his most recent novel surgical description http://www.widepr.com/press_release/36561/novel_approach_to_correcting_lower_lid_droop_minimally_invasive_orbicularis_sparing_mios.html

Please refer to the following links for more information on eyelid paralysis surgery by Dr. Massry http://drmassry.com/blog/?p=488 , http://drmassry.com/blog/?p=527 .

Only doctors with much experience with eyelids and with eyelid paralysis should perform surgery in these circumstances.  Dr. Massry is a nationally recognized eyelid surgery specialist.  He has written two textbooks in the field: view links to these books -  http://www.springer.com/medicine/ophthalmology/book/978-1-4614-0066-0 and  http://www.springer.com/medicine/ophthalmology/book/978-0-387-25389-3 .  Dr. Massry takes great care in not only correcting the eyelid problem, but also doing surgery in a very aesthetic way.

24Mar/120

Ophthalmic Plastic Surgery: Correcting Eyelid Paralysis/Paresis in a Minimally Invasive Way

Posted by admin

Eyelid Paralysis (paresis) can result from Bell’s palsy or a variety of other causes of facial nerve injury (facial/eyelid paralysis/paresis).  This typically results in an eye that cannot close, ocular irritation, dry eye, a red eye and tearing.  In addition the lower lid tends to droop (retract).  This adds to eye symptoms and is cosmetically a problem.

The difficulty in correcting the lower lid retraction (droop) is that most procedures require surgical manipulation (cutting) of the lower lid muscle which closes the eye (orbicularis oculi muscle) and the outer corner of the upper and lower lids – the lateral canthus.  These steps can weaken the lids further, cause scarring, and alter appearance in a negative way.

Dr. Massry has devised a better solution for eyelid paralysis patients whether from Bell’s palsy or any other cause of facial or eyelid paralysis (paresis).  Dr. Massry has called this procedure the Minimally Invasive Orbicularis Sparing (MIOS) technique of lower lid elevation (recession) for eyelid paralysis/paresis.

In this procedure the lower lid is elevated (recessed) by releasing the lower lid depressing muscle (to allow unopposed elevation) from the inside of the lid (transconjunctivally).  The lower lid is then tightened (suspended) from an outer upper lid incision typically used in standard cosmetic lid surgery (blepharoplasty).  In this way the lid tightening, or canthoplasty, and lid elevating, or lid recession, procedures are both performed with hidden incisions, no scarring, and most importantly no trauma to the lid closing muscle: the orbicularis muscle.

Below is an example of a young man who had this procedure on the right eye.  On the left are his before pictures.  You can see the lower lid droops and the eye is wider in opening.  On the right are the 6 month postoperative results.  Along with the picture are the patient’s own comments regarding his experience with surgery

Two years ago I had a doctor accidentally sever my 5 and 7 facial nerve during a jaw surgery... He told me it would come back but it never did. So for 2 years I had to battle with the depression of living with the right side of my face completely paralyzed. I was unable to blink or smile or protect my eye at all. It took me two very hard lessons of going to general surgeons to learn you can't think of not seeing a specialist when it comes to your health and safety... So I consulted the offices of Dr. Guy Massry, a specialist in eyelid paralysis surgery. Immediately I was blown away with the high standards of professionalism there, it was like night and day. They are very prompt, cordial, informed, and dedicated to their patients... Dr. Massry didn't just perform a surgery on my eye... He performed a miracle! I am SOO much happier now that he fixed my eye. You would barely even notice a difference between the two! It has made me much more comfortable to be in public and it's like he has given me my life back again! Plus he was always just a phone call away if I needed anything at all which if you know IS NOT the case with a lot of other medical practices. Overall, I'm glad I found out about Dr. Massry and I would fully recommend him to anyone else who suffered with facial palsy/paralysis like I did.

PhillipAmaro

 

 

 

6Mar/120

Eyelid Fillers Explained

Posted by admin

Lower eyelid filler is an important option for cosmetic lower lid rejuvenation in patients who do not desire lower blepharoplasty, or those who are not candidates for lower blepharoplasty.  There are a variety of lower lid fillers which can be used to improve lower lid bags and hollows.  The safest of these is Restylane.  Restylane is a hyaluronic acid (a normal part of our bodies) filler which is injected to the lower lid hollows to smooth the lid.  It can be injected with a needle, or with a microcannula (a blunt tipper cannula).

Dr. Massry prefers the microcannula technique for eyelid filling with Restylane as it is generally painless, complication free and leads to minimal bruising and swelling

Dr. Massry performs many eyelid filling procedures weekly.  He is a well-respected national lecturer and has authored two textbooks on cosmetic eyelid surgery.  The following link is to his latest text http://www.springer.com/medicine/ophthalmology/book/978-1-4614-0066-0 .

Bellow is an example of an immediate postoperative result of lower eyelid filling with Restylane filler with the microcannula.  As you can see there is a significant improvement in lower lid bags and hollows (see photos on right for after treatment).