Revisional Surgery

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Revisional Cosmetic Eyelid Surgery


The eyes may be the most distinguishing feature of a person’s face. The goal of good cosmetic surgery, first and foremost, is to maintain health and function; and then to provide an improved and natural appearing outcome. Too many times cosmetic eyelid surgery results in an “operated look” or with visual problems.
Revisional cosmetic eyelid surgery (or revision blepharoplasty) can address poor results from primary surgery. However, this is one of the most difficult areas of oculoplastic surgery to master. Revision surgery is more complex than primary surgery because the surgeon has to operate on scarred planes with distorted anatomy. This means there are unknown factors, which can only be identified once in surgery. This makes surgery unpredictable. In addition, it is often hard to meet a patient’s expectations for the surgery, as the desire is to recreate what was present prior to the first “poor outcome” procedure.
The goal of revision eyelid surgery is to make the patient look as close to where they were before their initial procedure, but with the caveat that it must be done safely and with realistic expectations. Dr. Guy Massry is one of the most revered national and international surgeons in revision eyelid surgery, with patients flying in from around the world for his expertise.
Cosmetic surgery is rapidly evolving into a very specialized medical discipline. There are numerous sub-specialists within the field with varied backgrounds in training, ranging from specialists in general, facial, nasal, ophthalmic, and dermatologic plastic surgery. This evolution within cosmetic surgery reflects the general trend in medicine and surgery of the development of the super-specialist. Today, cosmetic eyelid surgery should be performed by ophthalmic plastic surgeons (board certified ophthalmologist with additional subspecialty training in cosmetic surgery of the eyelids), especially in the case of complex revision surgery, so that the patient receives the best outcome possible.

Revisions Surgery After Cosmetic Eyelid Surgery

The goal of primary cosmetic eyelid surgery is to reverse the signs of aging around your eyes. An appropriate blepharoplasty procedure will make you look refreshed, rested and more youthful. However, in some cases, primary surgery does not go as the patient had planned (due to poor technique by the surgeon, complications from the procedure, expectations for the surgery were not met, etc.) and the results can actually age the patient or change the shape of the patient’s eyes in an undesirable way. When this happens, revision eyelid surgery may be necessary to restore the aesthetics and/or function of the eyelids. As revision surgeries are always more complicated than primary surgeries, it is crucial for patients to find an oculoplstic surgeon who has extensive experience with revisional surgery, like Dr. Massry, to mitigate the risks and possible complications of additional surgery around the delicate eye area.

Reasons for Revision Eyelid Surgery 

Patients seek blepharoplasty to eliminate the appearance of aging and exhaustion around the eyes. However, over-correction or under-correction from a blepharoplasty (for issues such as under eye bags or hollows, sagging or loose upper eyelids, excess skin around the eyes, fine wrinkles, excess fatty deposits that appear as puffiness in the eyelids, or dropping lower eyelids) can lead to aesthetic and/or functional problems for the patient, requiring revisional surgery.

The most common reasons patients come to Dr. Massry for revision eyelid surgery include:

  1.  Lower Lid Retraction – the 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).
  4. Fat grafting results in lumps, bumps and contour issues.

In addition to revisional cosmetic eyelid surgery (or revisional blepharoplasty) Dr. Guy Massry (Beverly Hills ophthalmic plastic surgeon) also performs the following revisional surgeries:

  • Revisional browlifts
  • Revisional midface lifts
  • Revisional canthoplasty (surgery on the outer or inner corners of the eyelids)
  • Revision ptosis repair
  • Revision eyelid fat grafting

Lower Lid Retraction

The most unwanted complication of lower lid blepharoplasty is lower lid retraction, in which the lower eyelid is pulled down. The goal of fixing lower lid retraction is restore the natural lower eyelid shape so that your eyes appear more vibrant.

Fat Grafting Repair

Fat grafting under the eyes can, unfortunately, result in lumps, bumps and contour issues. This is a very complex complication to fix. Dr. Massry has pioneered a procedure that allows him to remove the lumps and bumps of fat through an incision inside of the lower eyelid so that there is no visible scarring.

Why Choose Dr. Massry for Your Revisional Eyelid Surgery?

During his career as a board certified oculoplastic surgeon, Dr. Massry has developed a reputation among his peers as the go-to surgeon for revisional eyelid surgery. He has authored countless peer-reviewed articles and textbooks and has lectured and trained other physicians around the world on his revisional surgery techniques. Additionally, other physicians routinely refer their patients to Dr. Massry for complicated revision surgeries. When it comes to choosing a surgeon for your revision eyelid surgery, rest assured that in the hands of Dr. Massry, you will receive the best care available.
In dealing with revision cases, first and foremost, Dr. Massry makes sure that the patient has an understanding of the realistic expectations for surgery. While Dr. Massry will do everything he can to help the patient achieve their desired results, the damage done to the anatomy in previous surgery (or surgeries) will determine to what degree the situation can be improved. It is not until Dr. Massry examines a patient in-person that he can truly tell if the tissue planes have been scarred 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 the actual surgery that the true extent of the problems present become completely known.

For answers to frequently asked questions, head over to our What to Expect page.

Interested in Revisional Cosmetic Surgery?