Blepharoplasty (cosmetic eyelid surgery) is one of the most frequently performed aesthetic surgical procedures performed in the United States today. General plastic surgeons, ear nose and throat trained facial plastic surgeons, general non-cosmetic surgeons and dermatologists all perform blepharoplasty surgery. While all of these specialists can attain good results to surgery, none of them have specific specialized training in eyelid surgery. Only ophthalmic plastic or oculoplastic surgeons have this background. Dr. Guy Massry, a well-respected Beverly Hills...

Lower eyelid paralysis (weakness) can occur from a variety of causes – most commonly in association with facial paralysis such as Bell’s palsy.       One of the major problems which occur in eyelid paralysis patients is a lower lid droop also referred to as paralytic lower lid retraction.  In addition to a droop, the lower lid can also turn out, which is medically referred to as a paralytic lower lid ectropion.  Traditional surgery to correct paralytic lower lid retraction or ectropion has involved a variety of aggressive surgical procedures which often cut...

The term canthal suspension is a general description of procedures used to tighten or suspend the lower lid.  These procedures are needed during initial lower blepharoplasty (cosmetic eyelid surgery) to prevent complications (eyelid droop), and are also used for patients who have developed complications from previous cosmetic eyelid surgery (eyelid retraction or pulled down lower lids).  There are a variety of canthal suspension techniques which can be used.  A canthoplasty  is the most aggressive and powerful procedure.  In this procedure the outer attachment...

Blepharoplasty (eyelid) surgery is a unique kind of facial cosmetic or functional (to improve field of vision) surgery in which variable amounts of skin, muscle and fat are excised from the eyelids (both upper and lower eyelids).  More modern advances have emphasized the need to preserve (rather than remove) one’s own eyelid fat (fat repositioning), or augment eyelid fat with transfer from another area of the body (fat grafting). Blepharoplasty surgery, more than other kinds of plastic surgery, really requires an expert in this field.  The eyes are our most...

Blepharoplasty surgery (cosmetic eyelid surgery) is a specialized form of facial surgery which is performed by general plastic, facial plastic and oculoplastic surgeons.  While all specialists are qualified to perform such surgery only oculoplastic surgeons have specific and specialized training in blepharoplasty surgery. Oculoplastic surgeons are certified by the American Board of Ophthalmology or AAO (eye surgery) and by the American Society of Ophthalmic Plastic and Reconstructive Surgery or ASOPRS.  In other words they are dual certified in both surgery of...

Fillers are materials injected to the face to treat fine lines, fill depressions (hollows) and improve the contour of the face.  Injecting filler around the eyes is a specialized treatment to help dark circles, or the depressions between the eyebrows and the upper lid and between the lower lid and the cheek (midface). Eyelid filler treatment is more complex than similar injections to the face as the eyelid skin is thin.  As a result of this, the filler can at times be more easily seen through the skin (as a bluish hue – called the Tyndall effect) and can lead to...

Dr. Guy Massry, Beverly Hills Blepharoplasty Specialist Named Section Editor for “Aesthetic Abstracts and Citations” for the Journal Ophthalmic Plastic and Reconstructive Surgery Dr. Guy Massry, Beverly Hills Oculoplastic Surgeon, and editorial board member of the journal “Ophthalmic Plastic and Reconstructive Surgery” (the scientific journal of the American Society of Ophthalmic Plastic and Reconstructive Surgery) has been named section editor for the “Aesthetic Abstracts and Citations” section of the journal. This section reviews all relevant per...

Brow lifting is a cosmetic procedure which can be performed in a standalone fashion or in conjunction with eyelid surgery.  The goal of surgery is to elevate the ptotic (droopy) brow so that the eyelid is less full.  When a blepharoplasty is added the result is more substantial.  It is incumbent upon the aesthetic surgeon to assess whether a brow lift is all that is needed or if blepharoplasty should also be performed.  The surgeon best trained to make this decision is the oculoplastic surgeon – a specialist in surgery of the eyelids and surrounding areas. Dr....

Today, lower blepharoplasty (cosmetic eyelid) surgery is more than removing skin/muscle and fat from the eyelids (remove eyelid bags).  In fact, this older form of surgery (what we refer to as subtractive lower blepharoplasty) often leads to a sullen, guant, aged and altered appearance.  Cosmetic eyelid specialists (oculoplastic surgeons) have come to learn that preserving, augmenting and redistributing what is considered excess eyelid tissue is a more effective means of cosmetic rejuvenation (so called “additive blepharoplasty”) of the eyelids than removing...

Blepharoplasty (cosmetic eyelid surgery) is one of the most frequently performed aesthetic facial procedures in the world.  Blepharoplasty (upper lids, lower lids or both) is a very specialized surgery which many cosmetic surgeons perform which unfortunately leads to many difficult complications to address.  Just view the common blepharoplasty surgery complication chat rooms or the various cosmetic surgery review sites in the Internet to see how big this problem has become.  This is not because surgeons are not good, but rather because eyelid surgery...

In his first talk, Dr. Massry presented data on three new surgical techniques he has developed and published over the last 3 years. The title of the talk was “Modern Adjuncts to Upper Blepharoplasty Surgery.” The three procedures elaborated on (and their publication citing) are as follows: 1. Massry GG. The External Browpexy. Ophthal Plast Recontr Surg 2012;28:90–95 2. Massry GG. Nasal Fat Preservation in Upper Eyelid Blepharoplasty. Opth Plat Reconstr Surg 2011;27: 352-55 3. Massry GG. Effacing the Orbitoglabellar Groove with Transposed Upper Eyelid Fat. ASOPRS...

Educate Yourself Before Proceeding The term fat transfer and fat grafting are synonymous; they both refer to taking fat from one area of the body (abdomen, thighs, etc.) and injecting it to the eyelids and hollows around the eyes.  Eyelid fat transfer can be a standalone procedure or can be performed with other facial or eyelid surgeries such as brow lift, blepharoplasty, canthoplasty, ptosis or cheek (mid face) lift surgery. Eyelid fat grafting can be a very rewarding procedure as the fat will fill hollows and depressions around the eyes and provide a more...

Today, lower blepharoplasty (cosmetic eyelid) surgery is more than removing skin/muscle and fat from the eyelids (remove eyelid bags).  In fact, this older form of surgery (what we refer to as subtractive lower blepharoplasty) often leads to a sullen, guant, aged and altered appearance.  Cosmetic eyelid specialists (oculoplastic surgeons) have come to learn that preserving, augmenting and redistributing what is considered excess eyelid tissue is a more effective means of cosmetic rejuvenation (so called “additive blepharoplasty”) of the eyelids than removing...

Blepharoplasty is a cosmetic or functional (to improve vision) eyelid surgery whose goal is to improve appearance or field of vision.  Blepharoplasty surgery can involve the upper or lower lids and can be performed under local anesthesia (patient awake with numbing shots), under twilight anesthesia (sedated) or under general anesthesia (patient completely out).  The key to successful surgery is not knowing when to do surgery, but rather when not to do surgery. In the next series of blogs Dr. Guy Massry will review when it is not appropriate to perform...