Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
25Sep/130

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

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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

14Jul/120

The Browpexy – A Minimally Invasive Brow lift

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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

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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

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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

 

 

 

26Feb/120

Eyelid Filler Injections with the Microcannula

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Eyelid bags and depressions can be treated non-surgically with filler.  Around the eyelids Dr. Massry (Beverly Hills Ophthalmic Plastic Surgery) prefers to use Restylane as his filler of choice. Traditionally, eyelid filler (Restylane) has been injected around the eyes with needles.  While the results have been good, there is often significant bruising and swelling associated with the treatment.

Recently, blunt-tipped microcannulas have been developed for injection of filler to any area of the face.  While these have taken hold, few injectors have been comfortable with injections around the eyes.  Dr. Guy Massry, an experienced eyelid filler injector has transitioned almost all his eyelid filler injections to the use of the microcannula.  Dr. Massry prefers this method, as it is safer (no chance of injecting into a blood vessel), more comfortable (not painful), easier to perform, and yields minimal to no bruising and swelling.

Below is an example of a woman who had Restylane eyelid filler injected to the hollows under the lower lids to improve appearance.  On the right are her immediate post-injection photos.  Note that there is slight redness (gone in 30 minutes) and no bruising and swelling

1Jun/110

Blepharoplasty – Blepharoplasty in Men

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Blepharoplasty (cosmetic eyelid surgery) is becoming more and more common in men.  Male blepharoplasty is different from the same surgery in women in that surgery is more conservative as not to feminize their appearance.  Over-aggressive male blepharoplasty is a common problem as many surgeons do not modify their technique when switching genders.  This has led to many unhappy patients who desire revision of their initial procedure.  The best way to avoid this is to see a well-trained blepharoplasty surgeon who has significant experience with surgery in men.

Below are two examples of before (left) and after (right) photos of male patients of mine who had upper and lower blepharoplasty.  The top patient was in his early 60’s and the bottom patient in his mid-70’s.  Note the natural and youthful improvement in appearance in both men after surgery. For more examples please open the link to my website http://drmassry.com/#/1-3

 

31May/110

Canthoplasty Surgery Part 3 – The Surgical Procedure

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In my first two blogs on canthoplasty surgery I discussed canthal anatomy http://drmassry.com/blog/?p=190 and why canthoplasty surgery is important http://drmassry.com/blog/?p=194

Please refer to these links for review.

Today I will describe with surgical photos and accompanying illustrations the traditional canthoplasty surgery or “lateral tarsal strip procedure.”

In the series below the top photos show the opening of the canthus (canhotomy), the middle photos the surgical cutting of the lid from the oribt bone (cantholysis), and the bottom photos how the lid is dynamically free after its release from bone.  This is how canthoplasty surgery begins

In the next series the photos demonstrate how a tarsal tongue (what we use to re-anchor lid to bone) is formed.  Top: tarsus (skeleton of lower lid) is released, middle and bottom: surrounding skin is cut away from tarsus.  This is how canthoplasty surgery progresses

In the next series on canthoplasty surgery the tarsus is prepared for suturing to bone.  Top: residual skin istrimmed from the tarsus, middle: tarsus is shortened, bottom: suture placed through tarsus in preparation for anchoring to bone.  The canthoplasty surgery is almost complete

In the final series below the canthoplasty surgery is completed. Top: suture placed through lining of the bone (periosteum), middle: lid tightened, bottom: skin closed.

As you can se there are many critical steps in canthoplasty surgery.  All the steps are important in order to get a good result.  For examples of before and after pictures of patients having canthoplasty surgery open the following link from my website http://drmassry.com/#/1-1

If you are interested in information on canthoplasty surgery you can contact Dr. Guy Massry (Beverly Hills Ophthalmic Plastic Surgery) at his office (310) 453-8474 or through his website http://drmassry.com

9May/110

New Surgical Technique to Improve Outcomes of Upper Blepharoplasty Surgery

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Dr Guy Massry, MD (Ophthalmic Plastic Surgery) of Beverly Hills, California has introduced a new surgical technique to improve outcomes in upper eyelid blepharoplasty surgery.

The novel technique demonstrates how to preserve eyelid fat during upper blepharoplasty surgery to prevent postoperative hollowing of the eyelids.  This is an important addition to our evolving understanding of maintaining eyelid fat during surgery to prevent a sunken appearance after surgery.  This concept has gained wide acceptance with lower lid surgery, but until now has not been elaborated well in upper lid surgery.

Traditional upper blepharoplasty is a subtractive form of surgery that involves the excision of variable amounts of skin, muscle, and fat from the eyelid. The goal of surgery is to improve field of vision and/or appearance. While surgical debulking of the eyelid may improve appearance early on, the removal of tissue inherent to this process (especially fat excision) can contribute to a hollowed appearance with an associated deep and sunken appearance of the upper eyelid. This skeletonized look may be eliminated or reduced by preserving and repositioning a prominent nasal (inner) fat pad, if present, to the central upper eyelid.

The article is featured in the peer reviewed journal Ophthalmic Plastic & Reconstructive Surgery - the primary periodical of the society.

Link:

http://journals.lww.com/op-rs/Abstract/publishahead/Nasal_Fat_Preservation_in_Upper_Eyelid.99710.aspx - the full article can be viewed by opening the article PDF under article tools

This recent innovation, which Dr. Massry has also presented at scientific medical meetings, is born out of a continuing effort by Dr Massry to improve the field of Ophthalmic Plastic & Reconstructive Surgery. Dr. Massry is also active making comprehensive information available to anyone considering ophthalmic plastic surgery through his website and social network pages. Please visit www.drmassry.com .