A retracted lower lid is one that is pulled down. When the lower lid is retracted it causes cosmetic disfigurement and potentially dry eye symptoms (irritation, scratchy feeling and redness). This can occur after cosmetic lower lid surgery and lead to very unhappy patients. This problem can be corrected by an eyelid specialist. The best way to avoid it is to have surgery performed by a surgeon with significant experience with eyelid surgery. Below is an example of a case sent to Dr. Massry for the repair of a retracted lower lid. Note the improvement in lid...

An ectropic lower lid is one that is turned out.  When the lower lid is ectropic it causes cosmetic disfigurement and potentially dry eye symptoms (irritation, scratchy feeling and redness).  This can occur after cosmetic lower lid surgery and lead to very unhappy patients.  This problem can be corrected by an eyelid specialist.  The best way to avoid it is to have surgery performed by a surgeon with significant experience with eyelid surgery.  Below is an example of a case sent to Dr. Massry for the repair of an ectropic lower lid. Note the improvement in lid...

Cosmetic eyelid surgery (blepharoplasty) can be performed on the upper lids only, lower lids only, or on all four lids (four lid blepharoplasty).  The goal of surgery is to create a natural and youthful surgical result.  This can only be accomplished with a meticulous preoperative examination of the patient and an equally detailed discussion of patient desires and expectations.  When this is done appropriately, the process is satisfying to patient and physician, and the results are excellent. Below is an example of a before (left) and after (right) surgery...

Hollowing of the eyelids is a major problem for many patients presenting for eyelid rejuvenation today.  This can occur from aging alone, or also from previous eyelid surgery.  Contemporary thought is that fat around the eyelids is precious and must be preserved when possible.  In the areas of the lids which are prominent (puffy) where there is excess fat; the fat can be moved (repositioned) to areas of hollows or depressions.  It is important to remember that depressions and hollows around the eyes are as common and important to address as is fat prominence. ...

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 or body plastic surgery.  This trend within cosmetic surgery reflects the general trend in medicine and surgery of the super-specialist.  It stands to reason that nose jobs (rhinoplasty) should be performed by those trained in nasal surgery, or that breast augmentation should be performed by plastic surgeons with...

I am often asked about the use of LATISSE for eyelash growth. LATISSE solution is a prescription treatment used to grow eyelashes, making them longer, thicker and darker. If you are using, or have used, prescription products for any eye pressure problems, only use LATISSE under close doctor supervision. Using LATISSE may cause increased brown pigmentation of the colored part of the eye (iris) which can be permanent. So if you have light colored eyes be careful with its use. Eyelid skin darkening may also occur which may be reversible. Only apply LATISSE at the...

Blepharoplasty (cosmetic eyelid surgery) can be performed on the upper lids, lower lids, or both.  The eyelid skin and muscle are always either excised (removed) or left in place if they are not in excess.  The last component of the eyelid which must be addressed is the fat compartments.  The upper lid has two fat pads (the middle and central).  There is no outer fat pad but rather a tear gland (lacimal gland) in its place.  The tear gland must not be confused for fat, as if it is excised it can lead to permanent dry eye and other complications. The lower...

If cosmetic upper lid surgery (upper blepharoplasty) is performed alone, many patients desire surgery under local anesthesia only.  That means only numbing the lid with small injections.  This may scare some, but in reality is a great way to go as no drugs are given systemically (to the whole body) by IV injection.  This makes immediate recovery much easier.  The procedure can be very comfortable if performed by a surgeon experienced with eyelid surgery (oculoplastic surgeon). What I do is apply a numbing cream to the eyelids for 20 minutes before proceeding...

Upper eyelid blepharoplasty is a procedure whereby skin, muscle and fat are removed from the upper lid to imprve appearance and/or field of vision.  Tissue removal is performed by direct excision.  After the lid is appropriately de-bulked of tissue excess, the wound is closed with sutures.  Marking of the amount of skin to be excised is critical.  This is one of the  major factors in determining final eyelid appearance and function (ie. the ability to close the eye).  As I have stated before, having an eyelid specialist (ophthalmic plastic surgeon) perform this...