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