Revisional Cosmetic Eye Surgery

This patient underwent revision surgery with Dr. Massry to remove fat grafting (from another surgeon) under the eyes. As well as brow lift and upper and lower blepharoplasty. 

What Is Revisional 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.
 

Dr. Massry – World Renowned For 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.
 

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.

Lower Lid Retraction Repair 

The most unwanted complication of lower lid blepharoplasty is lower lid retraction, in which the lower eyelid is pulled down. Fixing lower lid retraction is very complex and requires the skills of an expert. Upon evaluation, Dr. Massry will determine the best surgical technique to give you optimal results. Below are some examples of patients before and after lower lid retraction
repair with Dr. Massry.


Patient 1 - Lower Lid Retraction Repair

 

Patient 2 - Lower Lid Retraction Repair​

 

Patient 3 - Lower Lid Retraction Repair​

 

Patient 4 - Lower Lid Retraction Repair​


 See more patients before and after eyelid retraction repair. 


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. Below are some examples of patients before and after fat grafting repair.
 

Patient 1 - Fat Grafting Repair​

 

Patient 2 - Fat Grafting Repair​​

 
See more fat grafting repair before and after pictures. 


What To Expect From Revision Eyelid Surgery

After examining a patient in-person, Dr. Massry will be able to give the patient a realistic idea of what sort of results they can expect from revision surgery. In some cases, he will determine that surgery is not the answer. Revisions can have the domino effect - there have been a number of surgeries performed, and the problem really can't be improved much with surgery. If more surgery is performed in this instance the dominos will fall one on the other without end and things get worse – not better. Once this cascade starts there may be no further solution. Knowing who not to operate on, is as, or more important, than knowing who to operate on. At this point, fillers may be the best option because. Dr. Massry can use fillers to delay or avoid surgery and help things improve. While fillers are temporary they certainly are a better option than a bad outcome to further surgery.
 
As a wide spectrum of unexpected results can occur from eyelid surgery, Dr. Massry has seen and operated on almost all combinations of eyelid problems. This is a very specific patient population with unique and distinct needs. They are often unhappy, emotionally drained, and at their "wit's end." Dr. Massry and his staff know how difficult going through a revision surgery can be and are here to support you every step of the way.
 
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

Talk to Dr. Massry Today! 

Dr. Massry is happy to discuss your specific situation related to this area of specialized cosmetic surgery. These are not problems that should be taken lightly, or handled by individuals without significant training and experience in revisional ophthalmic plastic surgery. Having a surgeon with expertise in revision eyelid surgery evaluate you and recommend appropriate treatment, should be your first, and is your best, option. If you are in need of revision cosmetic eyelid surgery, please call us at 310.657.4302 to schedule your consultation with Dr. Massry.
 

Learn More About Revision Eyelid Surgery in Dr. Massry’s Blog

7 Tips For The Best Lower Lid Retraction Repair Results
Lower lid retraction can be a devastating complication after blepharoplasty. It is often psychologically, emotionally, and functionally traumatic for patients. When you experience eyelid retraction and look in the mirror and no longer recognize yourself, it is very sad and overwhelming.
 
An expert oculoplastic surgeon should repair post-blepharoplasty lower eyelid retraction. With over 20 years of experience in this surgery, Dr. Massry is a true specialist at repairing lower eyelid retraction. Dr. Massry has 7 tips for giving his patients the best lower lid retraction repair results. Read his full blog here
 
Revisional Lower Lid Surgery: Lower Eyelid Retraction – Don’t Settle For Less Than The Best
One of the worst complications of lower eyelid blepharoplasty is lower lid retraction – pulled down lower eyelids. This complication is a very difficult one to fix and often times requires several surgeries to restore a normal appearance and proper function.  
 
Revisional lower eyelid surgery is complicated and requires the skills of an oculoplastic surgeon. Dr. Guy Massry is internationally recognized for his expertise in this procedure. Learn more about how Dr. Massry will give you the best lower lid retraction repair results
 
The Massry Method – Fixing Pulled Down Lower Lids, Rounded Eyes and Canthal Webs
Unfortunately, lower blephraoplasty can result in lower lid retraction and canthal webs. Not only are these results functionally disabling, but they are disfiguring. These issues are incredibly hard to repair. As a leader in the field, Dr. Guy Massry has found that patients with these issues always require a customized “surgical recipe. ”Upon evaluation, he will determine which surgical techniques will restore their normal eyelid appearance. Read his blog to find out how he generally fixes lower lid retraction and canthal webs
 
Lower Eyelid Fat Grafting
Fat grafting (or fat transfer) to the lower eyelids has become a very popular treatment in recent years. While it can provide a great option for restoring lost volume to hollow under eyes, it is also prone to complications. With this in mind, it is very important to have an expert perform this procedure in the first place. Dr. Massry shares 8 facts about fat grafting for patients to consider before undergoing this procedure. He also, explains what to do if complications occur after fat grafting to the lower eyes. Read his 8 fat grafting tips here.