Eyelid Skin Cancer Surgery and Eyelid Reconstruction Cancerous and benign skin lesions commonly develop on eyelid skin because the skin is thin, and it receives a substantial amount of long-term sunlight exposure. However, many eye-fold lesions are not cancerous. Dr. Robert Schwarcz, a board-certified oculoplastic cosmetic surgeon, can easily remove these lesions. Common Eyelid Cancers Squamous cell carcinoma and basal cell carcinoma are the two most common types of eyelid cancers. Basal cell cancer grows slowly, but it does not metastasize. Contrastingly, squamous cell cancer is more likely to spread. Any patient in New York City who has an ulcerated or bleeding lesion or nodule that will not heal should be examined and biopsied by a board-certified oculoplastic cosmetic surgeon. While rare, eye-fold melanoma calls for an aggressive treatment approach. Basal Cell Tumors Approximately 90 percent of tumors on the eyelid are basal cell tumors. Basal cell tumors may present as pearly nodules that eventually ulcerate. While basal cell tumors do not spread, they can grow into the surrounding tissue. An oculoplastic reconstructive surgeon can remove these tumors and reconstruct the affected area. Squamous Cell Tumors and Melanoma Squamous cell tumors are more aggressive than basal cell tumors, so they require a more complex skin cancer surgery technique than basal cell carcinomas to ensure the tumors have not spread. The surgeon will coordinate any further treatment with the patient. The severity and size of the tumor will dictate the next step in treatment. Mohs Surgery for Eyelid Skin Cancer A board-certified cosmetic surgeon has to meet three goals to achieve a successful eyelid skin cancer surgery outcome. The first goal is to remove all tumors. The second goal is to restore the eyelid’s functionality. Lastly, the third goal is to make the area look aesthetically pleasing. To reach these three goals, the surgeon will utilize the Mohs surgery technique . Mohs surgery is designed to carefully excise the cancerous tumor one skin layer at a time without removing a large amount of healthy tissue. Depending on the complexity of the patient’s condition, the surgeon may need to either graft skin from another area of the patient’s body or simply suture the area. If the patient requires a skin graft, the treated area may need to be reconstructed in stages. Staged reconstruction is usually reserved for the most severe eyelid skin cancer cases. REQUEST AN APPOINTMENT

How Rhinoplasty is Performed Rhinoplasty is a type of cosmetic procedure used to reshape the nose to improve its structure . Patients often have this procedure done to correct a deformity. For example, a person can have a nose job done to eliminate a bump on his or her nose, alter the size or shape, or to correct a birth defect. During a rhinoplasty procedure, a board-certified cosmetic surgeon can also alter a patient’s nasal shape so that he or she can breathe easier. Who are the Best Candidates for Nose Surgery? Those who are under the age of 16 should wait until their nose becomes more fully developed. In addition, this cosmetic surgery option is not ideal for those who smoke or drink. Both smoking and drinking reduces blood flow, which means that less oxygen reaches the skin. Necrosis can occur if the skin does not get enough oxygen during the wound-healing process. Open Rhinoplasty Technique vs. Closed Technique Board-certified cosmetic surgeons can choose from two different procedures. If the patient’s nose only needs minor alterations, then the surgeon can make incisions within the nose to reshape it. Patients who need more drastic reshaping will undergo open rhinoplasty. During this procedure, the surgeon must create a vertical strip between the nostrils so that he or she can see the entire nasal structure. During a Rhinoplasty Procedure The surgeon will start by placing incisions around the nose based on the alterations requested before the procedure. The surgeon will dissect the nasal skin, create a new structure and then drape the skin back over the area. During most rhinoplasties, the surgeon must use a nasal splint to help stabilize the nose’s anatomy. The purpose of rhinoplasty is to change facial features in a subtle way that blends in with the rest of the face both symmetrically and proportionally. After the procedure, patients must take care of their nose so that it can heal properly. The healing process occurs gradually, so patients may experience inflammation and minor bleeding after surgery. It can take up to one year for the healing process to finish. Those who plan to undergo additional facial procedures should ask their surgeon about having them done all at once. For example, a board-certified cosmetic surgeon can conduct a chin augmentation in conjunction with a nose procedure. Having multiple cosmetic surgeries done at once can help the surgeon maintain facial balance. REQUEST AN APPOINTMENT

Almond Eye Surgery Almond eyes are characterized by a slightly raised outer corner or canthus and a lower eyelid that sits at the lower edge of the iris. While all eye shapes can be beautiful, almond eyes create an attractive, youthful, and somewhat exotic appearance. Some individuals have almond eyes naturally because of genetics or their ethnicity. For those with a rounded outer canthus or a lower eyelid that is rounded or low allowing the sclera to show, surgery may help improve the shape and appearance of the eye. Who Is a Candidate for Almond Eye Surgery? Patients considering almond eye surgery should consult a board-certified oculoplastic surgeon to ensure that they have a clear understanding of the type of outcome that they can expect based on their current eye shape and anatomy. In some cases, a lateral canthoplasty is performed to tighten or reposition the outer canthus of the eye. In patients with a lower eyelid that is too low or that is retracted to expose part of the sclera, additional procedures may be necessary to adjust the position and tension of the lower eyelids. It is common for patients to combine almond eye surgery with a brow lift, blepharoplasty surgery , and other cosmetic procedures to achieve their desired result. Almond eye surgery is a very delicate procedure that can be even more complicated in patients who have had prior eyelid surgery or who have protruding eyes, so consulting a specialist in oculoplastic surgery is essential. Dr. Robert Schwarcz of New York is an oculoplastic surgeon and specialist in surgeries involving the eyes. His practices offer surgical services at both the Scarsdale and New York City locations. What to Expect The procedure is performed under local anesthesia, and patients are released the same day. While conscious sedation may be used, the patient still needs to be able to open their eyes during the surgery. Mild discomfort is to be expected for the first day following surgery; however, this is normally easily managed with medication. Some bruising and swelling are normal for the first week to 10 days. While most patients return to their normal activities within a week, complete healing can take several weeks to months. REQUEST AN APPOINTMENT

Reconstructive Surgery for Orbital Tumors and Fractures When trauma or injury to the orbital socket or area near or around the eyes occurs , the consequences can be significant. If left untreated, one can inevitably lose or tarnish their eyesight as a result. Dr. Schwarcz recommends repair and/or reconstructive surgery depending on the circumstances and nature of the condition. If an orbital tumor metastasizes, it can be one of the following: Optic Gliomas Osteomas Hemangiomas and Lymphangiomas Sarcomas Fibrous Histiocytomas Retinoblastoma Meningiomas Schwannomas/Neurofibroma If an orbital tumor is present, cosmetic plastic surgeon Dr. Schwarcz will surgically remove the tumor by small incisions near the eye. Contact our practice to schedule your appointment to learn more about orbital tumor and fracture removal . REQUEST AN APPOINTMENT

Complications of a Facial Fracture Just like all bones throughout your body, bones in your face are vulnerable to fractures. While a broken nose is the most common , you can also break your forehead, cheekbones, jaw, and eye sockets. And once you have one or more facial fractures, you run the risk of complications that can affect your appearance and physical function. Board-certified oculofacial plastic surgeon Robert M. Schwarcz, MD , provides orbital and facial reconstructive surgery to help minimize the effects of facial fractures . In this post, we take a closer look at facial fractures, including potential complications and repair procedures. Facial fracture causes and complications Most any impact that affects your face can lead to a facial fracture. Especially common causes include: Car accidents Falls Physical fights Domestic violence Sports injuries Workplace accidents At most any point, even after a broken facial bone has healed, you can end up with various complications. Some complications are on the milder side, such as bruising or swelling, and they resolve on their own with healing. For more serious injuries, severe complications can occur. Depending on the location and severity of your facial fracture, you could experience: Facial disfigurement, such as sunken-in eyes or flat cheeks Limited function, such as having a hard time fully opening or closing your jaw Eye damage or vision problems, such as blurriness, double vision, or blindness Brain damage Recurrent nosebleeds from a broken nose You also may suffer from lingering pain or altered sensation, such as numbness. Facial fracture treatment Treatment for facial fractures aims to restore normal function and appearance that you lost with the injury. Oftentimes, initial treatment for a facial fracture involves medications to minimize pain and swelling. If you have a high risk of infection, you’ll also need antibiotics. Some facial fractures can be treated with a closed reduction, which resets the break without exposing the bone. If needed, open reduction is a surgical procedure that accesses the bones to reposition them so they’re properly aligned. Complex facial fractures that involve multiple bones require reconstructive surgery . When considering surgical repair for the effects of a facial fracture, it’s important to consult with a qualified expert promptly. Rather than wait for full healing, aim to talk to a specialist as close to the injury date as possible. To learn more about facial fracture corrective surgery, call one of our offices — in the Upper East Side of Manhattan and in Scarsdale, New York — to book an appointment with Dr. Schwarcz. You can also request a consultation using our online scheduling tool. REQUEST AN APPOINTMENT

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. REQUEST AN APPOINTMENT

Understanding the Different Types of Skin Cancer Your skin is your largest organ and the organ most vulnerable to cancer, especially if you spend time in the sun without protection, if you have light skin and eyes, or if skin cancer runs in your family. Every day in the United States alone, 9,500 people are diagnosed with a type of skin cancer , meaning that if you have it, you’re far from alone. Thankfully, even the most aggressive form is typically curable with early detection and treatment. Board-certified cosmetic surgeon Robert M. Schwarcz, MD , is pleased to provide such treatment, including Mohs surgery . Read on to learn about the three most common skin cancer types and how Dr. Schwarcz and his team can help. Basal cell carcinoma More people are diagnosed with basal cell carcinoma than any other form of skin cancer. In fact, 3.6 million people in the U.S. learn they have it each year. It derives from uncontrolled, abnormal growth of basal cells within your skin and tends to grow slowly without spreading to other tissues in your body. During this growth, it destroys skin tissue in its path, leading to raised red or pink bumps that are often flaky. These symptoms typically appear on areas of your skin that have been repeatedly exposed to UV rays, such as your arms, ears, face, and legs. Squamous cell carcinoma Rays from the sun also play a role in squamous cell carcinoma, but typically only in people who have a compromised immune system. Unlike basal cell skin cancer, this form is highly aggressive and more likely to spread to your lymph nodes or organs without treatment. The most common sign is a rough growth on your skin, known as actinic keratosis, which progresses into a crusty-edged, inflamed ulcer. Melanoma Melanoma only accounts for about 1% of skin cancer cases , but it results in the most skin cancer-related deaths. Highly invasive and aggressive, melanoma starts out as a mole caused by sun exposure and can rapidly spread to your blood and lymphatic system. Genetics may also play a role in whether you develop it. The melanoma mole may appear asymmetrical, have an irregular border, and change colors. It can also appear anywhere on your body, even under your fingernails or in your eye. Treatment for skin cancer Early diagnosis is important when you have skin cancer, particularly when you have melanoma. The sooner you receive needed treatment, the better your outcome will be. Treatment usually involves removal of cancerous cells. Dr. Schwarcz can also remove precancerous lesions , preventing the disease on that area of skin. Dr. Schwarcz has extensive experience in Mohs surgery. This specialized way of removing skin cancer cells — guided with detailed mapping and a microscopic exam of your skin — best protects surrounding tissue and leads to minimal scarring. Mohs surgery is considered the most effective and precise skin cancer treatment, resulting in a 99% success rate . For more advanced and serious skin cancers, such as later stage melanoma, you may also need radiation therapy, chemotherapy, targeted therapy, or immunotherapy. If you’re concerned about skin cancer or precancer, call our office or request a consultation using our online scheduling tool to book an appointment with Dr. Schwarcz. REQUEST AN APPOINTMENT

Tear Duct Reconstruction Tear duct surgery may be warranted when the tear ducts are blocked causing peripheral vision or issues with the eye such as excessive tearing. Tear duct reconstuction surgery may be required at that point to remove the blockage in the ducts. Various techniques exist to allow for alternative drainage. Oculoplastic facial surgeon Dr. Schwarcz performs dacryocystorhinostomy or DCR via surgical incisions to create a new route for drainage to occur. If you or a loved one is struggling with tear duct issues and want to explore your options and solutions, contact our offices to schedule your consultation. Tear duct repair can bring the necessary comfort back to your eyes. REQUEST AN APPOINTMENT

Droopy Eyelids and Revisional Eyelid Ptosis Surgery When droopy eyelids are caused by unsatisfactory results from a previous surgery, the patient can opt to undergo revisional ptosis reconstructive surgery . To tighten or move the levator muscle of the orbit, an oculoplastic surgeon can lift the upper eyelid. Depending on the condition’s severity and patient’s surgical history, the success rate of this procedure varies. However, if an experienced oculofacial plastic surgeon conducts a revisional ptosis surgery, the surgeon’s extensive background can improve the patient’s chances of a favorable outcome even with the presence of scar tissue. Dr. Robert Schwarcz is a board-certified oculoplastic surgeon who has performed numerous eyelid surgeries. He is a facial surgeon who has the ability to correct droopy eyelids caused by a brow lift, previous blepharoplasty , or canthoplasty. During the consultation, Dr. Schwarcz will recommend the best treatment option depending on the patient’s facial structure, concerns and goals. Revisional Eyelid Ptosis Candidates Scar tissue or other complications from a prior eyelid surgery can contribute to the complexity of a revisional ptosis procedure. However, patients with these issues may still be candidates for corrective surgery. Additionally, the surgical area after an eyelid surgery often takes 3 months to 6 months. As the healing progresses, some problems may resolve themselves. Therefore, patients should wait until they have fully recovered before consulting with an oculoplastic surgeon. Revisional Ptosis Surgery In order to repair the flaws created by a previous procedure, cosmetic surgeons utilizes a specialized revisional technique for the eyelids. This type of surgery is performed as an outpatient procedure in Dr. Schwarcz’s New York offices. Before starting the surgery, the patient is given local anesthesia. When the operation is finished, the patient can look forward to symmetrical, youthful eyelids. Revisional Ptosis Recovery Period After the procedure is completed, the patient may experience bruising, mild discomfort and swelling. The patient must keep the incision site clean at all times per the surgeon’s instructions. For the first few weeks, superficial healing will occur. However, the total recovery time takes up to several months. An Eyelid Specialist The results of a cosmetic eyelid surgery should look natural and preserve the eyelids’ function. Individuals who have an eyelid procedure performed by an inexperienced surgeon are at a higher risk of experiencing unwanted results such as an unnatural appearance, dry eyes. eyelid damage, visual problems and other issues. As a board-certified oculoplastic surgeon with a strong background in ophthalmology, reconstructive facial surgery and revisional eyelid surgery, Dr. Schwarcz has the experience to produce optimal results for his patients who suffer from droopy eyelids . REQUEST AN APPOINTMENT

When to Consider a Chemical Peel If you’re bothered by wrinkles or discolored skin, you may want to consider a chemical peel . This nonsurgical treatment takes about an hour and brings visible results in about a week. While the procedure is only minimally invasive, it’s not ideal for everyone. And if you’re a good candidate, you’ll want to time yours well. Board-certified oculofacial plastic surgeon Robert M. Schwarcz, MD , and his team offer chemical peels for clients seeking a more vibrant complexion. Here, we explain more about this procedure, including reasons to consider it. How chemical peels work Chemical peels remove the top layers of your skin to minimize common complaints, such as fine lines and pigmentation problems like scars and spots from sun damage. In many cases, they’re performed with topical anesthetics to ensure your comfort. During the procedure, the top skin cells are removed with a combination of acids, such as trichloroacetic or glycolic acid. The intensity of this process varies from light to deep, depending on which type of peel you choose. Afterward, as new skin is revealed, you can also benefit from boosted collagen and elastin production from natural healing processes triggered within your skin. This is important from an aging perspective, as you naturally produce less of these skin-enhancing substances over time. Are you a good candidate for a chemical peel? If you’re bothered by an uneven skin tone, signs of aging, or scarring on your skin, you may be a good candidate for a chemical peel. Ideal candidates also do NOT have: A history of abnormal or highly pigmented scarring Especially sensitive skin, due to a condition or skin medication Naturally dark skin In addition, if you’ve had certain acne treatments within the last year, your provider may recommend waiting before scheduling a chemical peel. If you’re pregnant, you’ll need to wait as well. Timing your chemical peel After your chemical peel, it may take a while for your skin to fully heal. If you have a medium or deep peel, your skin may show some redness for up to a few months . While you’ll still be able to go about your daily life normally, you may want to avoid scheduling your treatment shortly before a major event, such as a wedding. You should also time any deeper chemical peel in a way that allows you to take good care of your skin. You’ll need to avoid sun exposure while your complexion heals, so shortly before a beach vacation isn’t wise. For that reason, some people prefer to schedule chemical peels during winter months. You’ll also need to avoid makeup initially, until your provider gives you the go-ahead. To learn more about chemical peels or to inquire about giving one a try, call one of our offices — in the Upper East Side of Manhattan and in Scarsdale, New York — to book an appointment with Dr. Schwarcz. You can also request a consultation using our online scheduling tool. REQUEST AN APPOINTMENT