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  • Revisional Eyelid Surgery

    In some cases, facial and eyelid surgeries like blepharoplasty, a brow lift, canthoplasty and ptosis surgery result in functional or cosmetic problems. Revisional eyelid surgery addresses these issues. The best doctor for revision eyelid surgery and blepharoplasty is experienced and trained in facial, revisional and original eyelid surgery.

    Dr. Robert Schwarcz is a member of the American Board of Ophthalmology as well as the American Board of Cosmetic Surgery. Utilizing the knowledge gained from his specialized oculofacial plastic surgery fellowship with the Jules Stein Eye Institute, Dr. Schwarcz focuses on revisional, reconstructive and cosmetic surgery in his New York practices, using a minimally invasive approach for revision canthoplasty. As an oculoplastic surgeon expert of NYC, Dr. Schwarcz has written multiple articles about revisional eyelid surgery, such as fat graft usage in reconstructive surgery and lower eyelid reconstruction.

    Revisional Eyelid Retraction Surgery

    Eye rounding and lower eyelid retraction with scleral can result from a poorly performed lower blepharoplasty or canthoplasty procedure. This is a common problem among the patients who seek Dr. Schwarcz’s help- specifically revision and correction of eyelid surgery. As a reconstructive surgeon, he is the person to see for these types of corrective procedures. When scar tissue forms on layers of the lower eyelid, the lower eyelid can retract. Eye closure muscle damage and an excessive removal of lower eyelid skin may also contribute to this problem.

    The eye’s appearance is not the only issue for a patient’s face. Some people may have serious ocular discomfort along with blurry vision, dry eyes, redness and tearing, resulting from the inability to blink or close the eyes in a normal manner. To correct this significant issue, an oculoplastic surgeon needs to raise the lower eyelid and repair the canthus via the outer eye corner tightening, hidden lower eyelid incisions and a lower eyelid lift.

    Sometimes, the surgeon grafts the patient’s skin to replace the fast-healing skin that is missing from the lower eyelid. However, outer eye corner tightening, or canthoplasty, is usually not an adequate approach by itself because of lower eyelid scarring. Therefore, the Madame Butterfly procedure is used to restore the eye’s natural almond shape. During this procedure, the surgeon releases scar tissue, lifts the midface and revises the lateral canthus through a non-visible incision.

  • Cosmetic Treatments for a Sagging Neck & Face

    Sagging skin around the face and neck is typically one of the first signs of aging. Over time, the skin becomes less elastic, and the underlying fat that supports the skin of the face and neck can shift or disappear. Heredity, stress, sun exposure, and smoking can also affect the skin and contour of the face and neck. A trained and experienced oculoplastic facial surgeon like Dr. Robert Schwarcz can use a variety of cosmetic surgery techniques to tighten the skin of the face and neck to create a more youthful and aesthetically pleasing profile.

    Facelift:

    A rhytidectomy, commonly referred to as a facelift, is typically used to reverse signs of aging involving the face and neck. Facelifts can be used to remove excess fat and tighten the skin of the neck to eliminate a “turkey neck” or double chin. The procedure can also reduce the appearance of jowls and nasolabial fold lines between the nose and mouth.

    Neck Lift:

    A neck lift is often used in combination with a facelift to improve the contour of the neck. The procedure involves removing excess fat in the neck through excision or liposuction and tightening the muscles of the neck. In some cases, excess skin may also be excised. Since a neck lift requires a detailed restoration of the musculature, patients considering the procedure should consult Dr. Schwarcz, a board-certified cosmetic and reconstructive surgeon to achieve the best possible results.

    Mini Facelift:

    A mini facelift is a more conservative cosmetic surgery than a traditional facelift. The procedure is focused on reversing signs of aging around the eyes, mouth, and forehead without altering the rest of the face. Although the results are subtle, a mini facelift is often enough to correct minor sagging along the cheeks, neck, and jaw. This procedure is ideal for men and women who want a more refreshed look with less visible scarring and downtime.

  • The Facial Implants Procedure

    Facial implants are a popular facial rejuvenation treatment among patients in NYC. Board-certified cosmetic surgeon Dr. Schwarcz can use a variety of different implants to augment specific parts of the face to create a younger and more aesthetically pleasing profile. The implants are constructed from solid materials that are compatible with the patient’s own tissue.

    Cheek Implants:

    Cheek implants can increase the projection of recessed or flat cheekbones. They are typically inserted through incisions hidden within the mouth and positioned along the portion of the cheekbone to be augmented. Cheek implants may be combined with other cosmetic procedures. In these cases, the incisions may be made within the hairline or lower eyelid.

    Chin Implants:

    Chin implants are used to increase the projection and size of a chin that is out of proportion with the rest of the face. These implants are normally inserted through an incision inside the mouth situated along the crease between the gums and lower lip. An alternative technique uses an incision made underneath the chin.

    Jaw Implants:

    Jaw implants are used to augment the width of the lower third of the face in order to create a jawline that is well-defined and angled appropriately from the ear to the chin. Jaw implant surgery involves an incision along the jawline toward the back of the inside of the mouth at the crease between the cheek and gums.

    What to Expect During Implant Surgery:

    The procedure is performed using intravenous sedation or general anesthesia. The incisions are closed using sutures that are either absorbable or that will be removed within a week or two following surgery. The initial results of implant surgery are almost immediately apparent; however, it is normal to experience noticeable swelling following the procedure. The swelling may take some time to completely resolve in order to see the final results.

  • Popular Cosmetic Procedures for Men

    Cosmetic surgery is becoming increasingly popular among men in New York City. Treatment by a facial oculoplastic and cosmetic surgeon can be used to address both aesthetic and functional concerns involving the various features of the face.

    Cosmetic Procedures Most Requested by Men

    Eyelid Rejuvenation

    As a person ages, it is normal for the muscles that support the eyelid to weaken and stretch and for fat to collect around the eyelids. The result is eyelids that droop and bags under the eyes that give the person the appearance of being tired, haggard, and older than their age. Eyelid rejuvenation also known as blepharoplasty removes the excess skin and fat deposits to create a younger, more refreshed appearance.

    Neck Lift

    The skin of the neck is thin and elastic, which makes it prone to sagging and wrinkling with age. This results in a double chin, jowls, and the dreaded “turkey neck.” A neck lift creates a firmer, more defined neck and chin by eliminating excess skin and fat and tightening the underlying muscles.

    Rhinoplasty

    Commonly referred to as a nose job, rhinoplasty reshapes the bone and cartilage of the nose to make it more proportional to the size and shape of the face. Depending on the desired appearance, rhinoplasty can be combined with a chin augmentation to achieve a balanced facial aesthetic.

    Chin Augmentation

    A strong, chiseled jawline is considered ideal by most men. For men who do not come by this naturally, chin augmentation using implants can provide the desired projection and definition and bring the features of the face into proportion. The implant is made from materials that are compatible with natural human tissue and is designed to feel like a natural chin. The procedure involves inserting the implant through an incision made inside the mouth or underneath the chin.
    Combining chin augmentation with neck liposuction creates even more dramatic results.

  • What is Thyroid Eye Disease (TED) or Thyroid Orbitopathy

    Thyroid eye disease, also known as TED, is an orbital disease closely linked to Hashimoto’s thyroiditis, Graves’ disease, and other immune disorders affecting the thyroid. Although the condition affects all races and ages, it most often occurs in individuals in their 20s to 60s. Women are far more likely to develop TED than men. TED affects approximately 14 out of every 100,000 females. The incidence among males is roughly one-fifth that of females.

    Approximately 25 to 50 percent of individuals with an immune disease of the thyroid develop TED that involves the orbit of the eye. This thyroid orbitopathy can lead to optic neuropathy, impaired motility, congestion, and severe inflammation. Although an estimated 90 percent of patients with orbitopathy have a history of thyroid hormone abnormalities, the condition is not caused by the abnormal hormone levels, and the orbital disease does not automatically resolve once hormone levels are normalized.

    Patients with thyroid eye disease typically experience an active disease phase in which the inflammatory symptoms are progressive. This is followed by a post-inflammatory phase in which the symptoms stabilize and become inactive. The active phase of the disease can last up to 18 months. During this time, the patient may experience symptoms that include:

    • orbital pain and discomfort,
    • swelling and redness around the eye and conjunctiva,
    • abnormal protrusion of the eye,
    • strabismus, and
    • optic neuropathy.

    A small number of patients with thyroid dysfunction and severe orbitopathy go on to develop a skin condition known as Graves’ dermopathy in which the skin of the lower limbs becomes red and swollen and develops an orange peel-like texture. Some of these patients also go on to develop a thickening or clubbing of the nail beds and fingertips.

    Treatment for Thyroid Eye Disease:

    Once the condition becomes dormant, the patient can consult an oculoplastic surgeon like Dr. Robert Schwarcz to correct the damage caused by the active phase of the disease. This typically involves surgery to realign the eye muscles, reduce pockets of fat in the eyelids, narrow the opening of the eyelid, and lessen the protrusion of the eye. Click here to learn more about thyroid orbitopathy.

  • The Best Techniques to Shape and Plump Your Lips

    For individuals looking for a simple enhancement treatment for the size and shape of your lips, hyaluronic acid fillers such as Juvederm®, Restylane®, and Restylane Silk® are effective methods to achieve full, natural-looking lips.  Hyaluronic acid is a protein that occurs naturally in the skin. When injected into the lips, these fillers add volume and definition while not altering the soft, natural feel of the lips.

    Non-Surgical Lip Plumping and Shaping

    If the lips are over injected with filler, it can result in overly plump “duck lips.” When considering a non-surgical procedure to add shape and definition to the lips, it is important to consult a cosmetic plastic surgeon with a specialty in lip augmentation. To achieve the most natural-looking results, the doctor must take the proportions of the entire face into consideration to determine the most aesthetically pleasing lip volume and shape. This is something Dr. Robert Schwarcz is keen on doing before performing even the simplest of cosmetic procedures. Hyaluronic acid fillers can be used to lift the mouth at the corners to reduce the appearance of frowning and create a more defined “cupid’s bow” in the center of the top lip. Restylane Silk is increasingly popular for lip augmentation and is especially effective, with patients reporting noticeable improvement within two weeks of treatment.

    To determine the amount of filler to be used and the placement of the injections, Dr. Schwarcz, a board-certified cosmetic surgeon, will consider the current shape and size of the lips as well as other facial features, including the angle of the tip of the nose, the space between the nose and upper lip, the size and shape of the philtrum, and the angles of the corners of the mouth.

    The injections are performed on an out-patient basis. It is natural to expect some swelling and bruising immediately after the procedure, but this typically subsides quickly. The effects of the injections normally last up to a year. It is recommended that patients begin with a small amount of filler since additional injections can always be performed once the swelling subsides if the desired fullness is not achieved.

    Contact our practices in New York, both in NYC and Scarsdale to learn more or schedule your first consultation!

  • Dermal Fillers, Lower Blepharoplasty, & Fat Grafting for Dark Circles and Under-Eye Bags

    The area around the eyes is one of the first places to reflect the tell-tale signs of aging. Bags, hollows, or dark circles under the eyes can make a person’s overall appearance look tired, haggard, and even unwell. Fortunately, various cosmetic treatments, including eyelid blepharoplasty and dermal fillers, can correct these issues to provide a younger and more rejuvenated appearance.

    What Causes Bags and Dark Circles Around the Eyes?

    The delicate skin around the eyes can change because of lifestyle, diet, the amount and quality of sleep, and overall health. Some people are even genetically predisposed to having excess skin and dark circles under their eyes. Age and drastic changes in weight can stretch and weaken the muscles around the eyes to create hollows or bags of excess fat.

    Dermal Fillers to Correct Under-Eye Bags:

    Injectable dermal fillers use synthetic or natural substances, such as hyaluronic acid, to restore lost volume and stimulate collagen production under the eye. A cosmetic surgeon strategically injects the filler under the eye to plump the skin, which eliminates hollows and reduces the appearance of under-eye circles. The results of dermal filler injections typically last about one year.

    Fat Grafting:

    Fat grafting is another minimally-invasive method of rejuvenating the area under the eyes. A small amount of fat is harvested from the patient, typically around the flank or hips. The fat is then processed and injected into the area under the eye. The results of a fat graft last longer than injectable dermal fillers.

    Blepharoplasty Surgery:

    Blepharoplasty, commonly known as eyelid surgery, provides a long-lasting solution to dark circles and sagging under the eyes. The procedure involves removing or repositioning excess skin and fat under the eyes. The redistribution of the fatty tissue keeps the eyes from appearing too hollow. The result is a smooth, youthful appearance. The incision is made along the inside of the eyelid, so the scar is completely hidden.

    Choosing the Right Under-Eye Treatment:

    Individuals who wish to undergo cosmetic treatment to correct dark circles or bags under their eyes should consult a board-certified oculoplastic surgeon like Dr. Robert Schwarcz to discuss their options. Dermal fillers, fat grafts, and blepharoplasty are all safe, effective procedures that can be performed in his offices in New York using a local anesthetic. The most appropriate treatment depends on the patient’s goals, the type of issue to be corrected, and how long the patient would like the results to last.

    Contact Dr. Schwarcz’s Scarsdale or New York City practice today to learn more information regarding these cosmetic procedures.

  • 5 Signs You Need Revision Eyelid Surgery

    Most patients undergoing eyelid surgery, also known as blepharoplasty, do so for aesthetic or medical reasons. Blepharoplasty surgery is an effective way to remove loose skin and excess fat around the eyes that can add years to the overall appearance and even interfere with the proper function of the eyelid. If the cosmetic surgeon is not skilled in the procedure, the patient may experience complications and require a revision surgery to correct the issue.

    Reasons to Undergo a Revisional Eyelid Blepharoplasty:

    Eyelid surgery is not a forgiving procedure. Even the slightest mistake can create undesirable results. The following are a few of the most common reasons why a patient may opt for corrective surgery.

    Drooping Eyelids

    The most common reasons that the eyelids may continue to droop following the original surgery are that too little skin was removed or that the levator muscle responsible for lifting the eyelid was not tightened. This can be corrected with a revisional surgery that tightens the muscle to create a more refreshed and vibrant appearance.

    Distorted Eye Shape or Contour

    An example of this type of issue is a sagging lower eyelid that reveals more of the white than normal. The problem typically occurs when too little or too much skin is removed. A revision blepharoplasty can help restore the natural shape of the eye.

    Inability to Blink or Shut the Eyes

    This issue can occur if too much skin is removed during an upper eyelid surgery. The skin is then so tight that the eyes cannot completely close, which is referred to as lagophthalmos. This is not only uncomfortable, but it also increases the risk of injury to the eye by dust and other debris. A revision blepharoplasty that uses skin grafts can make it possible to blink and close the eyes properly.

    Undereye Hollowness

    This issue can occur if the surgeon removed too much fat from the lower eyelids. The result is that the eyes appear sunken, which makes the individual look ill or tired. Revision blepharoplasty surgery can be used to add volume to the hollow areas to create a younger, rested, and alert appearance.

    Asymmetry

    While no one has perfectly symmetrical eyes, a poorly executed eyelid surgery can make the eyes appear noticeably unbalanced. This can occur if too much fat is removed from around one eye, if more skin is removed from one side than the other, or if the levator muscle of one eye is tightened too much. Revisional surgery can restore the normal symmetry of the eyes.

    When considering eyelid revision surgery, it is best to seek out a board-certified oculoplastic surgeon like Dr. Robert Schwarcz with specific expertise in performing these types of procedures. Click here to learn about what is involved in an eyelid blepharoplasty procedure.

  • Types and Benefits of Facial Fillers

    As you age, your skin will naturally lose volume and sag as the pads of fat and connective tissues beneath it shrink. Facial fillers help reverse this change by adding support beneath the skin, stretching it out to erase wrinkles. When administered by a skilled cosmetic plastic surgeon, fillers can give quick, long-lasting results with no surgery or recovery time necessary.

    Temporary, Semi-Permanent and Permanent Facial Fillers

    Fillers are classified as one of three types: temporary, semi-permanent, and permanent.

    Temporary fillers are based on natural compounds. All temporary fillers eventually break down and are absorbed by the body, so they must periodically be renewed to maintain their benefits.

    Originally, collagen fillers such as Cosmoplast, Cosmoderm, and Evolence were the most popular injectable treatments. However, they have been overtaken in popularity by hyaluronic acid-based fillers, such as Restylane, Juvederm, Restylane Silk, and Perlane. Hyaluronic acid’s advantage is that it provides a softer, more natural look.

    Another type of temporary filler is calcium hydroxylapatite, which is stronger and heavier than hyaluronic acid and is typically injected deeper in the skin. Radiesse is a filler composed of calcium hydroxylapatite and is used to treat moderate to deep creases and folds.

    The only facial filler composed of poly-L-lactic acid that is FDA approved is Sculptra. This is heavier than temporary facial fillers, and is usually used to treat especially deep facial lines and indentations to create volume, when other fillers aren’t strong enough. While their results are long-lasting, they may still require occasional maintenance with your cosmetic plastic surgeon.

    Permanent fillers such as ArteFill are made with microspheres of polymethylmtethacrylate (PMMA). They are too heavy to be used in delicate areas, but work well in places where the skin is thick and lines form deeply, such as the nasolabial folds.

    One permanent injectable treatment to beware is silicone. Silicone injections are not approved by the FDA and are dangerous and unsafe, especially since many practitioners offering silicone injections are not licensed. Patients have suffered severe reactions and side effects from silicone. Silicone can also shift within the body, producing an uneven, lumpy appearance.

    Which filler is best for you is a matter best determined in consultation with a licensed cosmetic plastic surgeon. Your doctor can help you determine what’s best for your case and work out a treatment plan. The right filler can produce a remarkable renewal in your look, with no surgery involved.

  • Treat Your Excessive Sweating with Botox

    An estimated 2.8 percent of the American population, or about 8 million people, suffer from a condition called hyperhidrosis. These people sweat heavily from their armpits, soles of the feet, or palms of their hands. This sweating occurs regardless of the weather or the person’s emotional state. Hyperhidrosis or excessive sweating can be embarrassing by producing visible dampness and sweat odors through clothing. It can also damage clothes, and when present in the feet it can produce an environment conducive to athlete’s foot and other infections.

    Treatment for hyperhidrosis usually involves antiperspirants and medication, with surgery as a last resort. However, there’s a non-surgical treatment your cosmetic surgeon can help you with. Botox has recently been approved by the FDA as a treatment for hyperhidrosis in the armpits, and many doctors use it to treat Blepharospasm and any involuntary twitching as well. In addition, Botox is commonly used on the neck and face.

    How Botox Controls Hyperhidrosis

    Botox is primarily known as an anti-wrinkle treatment. It works by temporarily paralyzing the nerves in the affected area. In the case of hyperhidrosis, Botox is injected to block the nerves that send signals to the sweat glands.

    Botox injections in areas commonly affected by hyperhidrosis, such as the hands, armpits, and groin, is a relatively simple procedure that should not be painful. The injections do not need to penetrate deeply, so a small needle is all that is needed, minimizing discomfort. Using Botox on the feet is somewhat more difficult because the skin of the feet is thicker than the armpits or hands. A larger needle and some form of anesthesia, such as a nerve block, may be required.

    Effects of Botox Injections for Hyperhidrosis

    You should see immediate results from your Botox injections. There should be no recovery or downtime necessary. The effects of the injection should last approximately eight months. However, that may vary depending on your own body chemistry and the area to be treated. Your cosmetic plastic surgeon will help you assess how well the injections are working for you and create a schedule of injections to keep you sweat-free.