Blepharoplasty and Eyelid Scar Correction Lower Blepharoplasty Revision Dr. Robert Schwarcz in New York City frequently sees patients who suffer from problems such as prolonged chemosis, scarring, missing skin, wrinkled skin, lumps, bumps and an overabundance or lack of eye bags. Revisional lower blepharoplasty can correct these issues. Due to the eyelids’ delicate nature, a careful approach must be used to not exacerbate these problematic conditions. Therefore, Dr. Schwarcz restores the eyelids and overall shape of the eyes with minimally invasive surgical techniques. When Revision Surgery is Warranted In the case of one patient, it was determined that she had residual filler and an under-eye fat prolapse. To correct these problems, Dr. Schwarcz performed a transconjunctival lower blepharoplasty , which requires no stitches and leaves no scars, and fat repositioning while the patient was under local anesthesia. After surgery, the lower eyelid was smoother and improved in appearance. Hollow Eye Revision Another cosmetic complication from a lower or upper blepharoplasty occurs when an excessive amount of fat is taken from the eyelid. This complication creates an undesirable sunken, hollow look to the eyes. In order to restore the eyes’ fullness and youthfulness, Dr. Schwarcz injects filler or fat around the eyes. As an alternative to a fat transfer, acid gel filler can be used. After the surgeon injects filler into the upper eyelids or under eyes, the results are instant. The patient can expect these results to last approximately two years. To produce a natural appearance, the surgeon must be knowledgeable in the eyelids’ normal and previous surgical anatomy. When a hollow eye is corrected by performing a fat transfer with stem cells, fat is taken from the patient’s thighs or stomach and injected into the hollow area. Fat is an excellent, long-term option for hollow eye correction. However, synthetic fillers are more predictable. Eyelid Scar Correction As an elite oculoplastic surgeon in NYC, Dr. Schwarcz regularly performs eyelid scar correction . Scarring is commonly seen in the lateral canthus and medial canthus. When scarring occurs in these areas, the patient’s appearance is negatively altered, potentially causing the patient a great deal of emotional pain. To hide and revise the scars, the surgeon utilizes minimally invasive techniques like epicanthoplasty with Z-plasty. REQUEST AN APPOINTMENT

The Mid-Face Lift and Cheek Augmentation Age, gravity and sun damage can eventually cause fat deflation and facial descent. In the mid-face from the nasolabial folds to the lower eyelids, these issues are particularly noticeable. As a person grows older, the mid-face may deflate, flatten and fall, causing the face to prematurely age. To reverse these signs of aging, a cosmetic surgeon can lift the mid-face. In comparison, the surgeon can perform a full face-lift as well.The surgeon may also give the patient malar implants or fat injections during a mid-face lift procedure to make the area more convex and increase the mid-face’s fat volume, creating a more youthful appearance. As a board-certified oculoplastic surgeon, Dr. Schwarcz specializes in reconstructive and cosmetic procedures with a focus on the eyes and face. Dr. Schwarcz often performs cheek augmentations, face lifts and mid-face lifts for his patients in NYC and Scarsdale. Mid-Face Lift Techniques The patient may be an excellent candidate for one or more mid-face lift techniques, including a transconjunctival mid-face lift, transtemporal mid-face lift and endoscopic subperiosteal mid-face lift . Several factors will determine the ideal surgical approach, such as the patient’s aesthetic goals, facial structure and facial surgery history. Malar Augmentation Malar, or cheek, augmentation involves the surgical insertion of implants that create a fuller mid-face . These implants are constructed from solid materials that are designed to be permanent. An implant’s size and shape depend on the area the surgeon augments. To insert malar implants, the surgeon makes hidden incisions in the mouth, on the lower eyelid and along the temple . Once the area heals, the patient will typically feel like the implants are a natural part of their cheekbones. Mid-Face Lift and Malar Augmentation Benefits Two signs of beauty and youth in the face are round contours and cheek projection. With a mid-face lift, the patient can obtain a three-dimensional projection and youthful contour to the mid-face. The surgeon can also give the patient fat injections with or without malar implants to enhance the patient’s facial volume, projection and contour. REQUEST AN APPOINTMENT

What Is Asian Blepharoplasty? The crease, shape and eye-fold corners of Asian people’s eyelids differ from those of Caucasian people’s eyelids. In those who are of Asian descent, the orbital fat of the upper eyelids is more prominent, and the upper lids have either lower or non-existent creases. Approximately one-half of Asians have single eyelids, which are eyelids without a crease. The other one-half of Asians do have upper eyelid creases, or double eyelids. These creases may be broken, continuous, complete, parallel, partial or tapered. In contrast, Caucasians usually have semi-lunar creases. Many Asian patients also have an epicanthic fold, which is a term used to describe upper eyelid skin that covers the eye’s inner corner. To alter the appearance of the patient’s eyelids, a board-certified oculoplastic surgeon like Dr. Robert Schwarcz who specializes in eyelid blepharoplasty can perform double eyelid surgery to alter the eyelids’ appearance. During the double eyelid surgery, the surgeon may also perform an epicanthoplasty, which is designed to change the appearance of an epicanthic fold. The Eyelid Blepharoplasty Procedure Dr. Schwarcz is a New York oculoplastic surgeon who specializes in blepharoplasty and is skilled in creating the appearance of double eyelids in patients who have asymmetric creases or non-defined creases by using a non-incisional procedure or incisional surgical technique. The incisional surgical technique produces more long-lasting and predictable results than the non-incisional technique. However, those who undergo the non-incisional surgical procedure recover faster. Regardless of the type of surgery performed, the surgeon gives the patient local anesthesia. In some cases, the patient will need to be sedated. Most patients experience bruising and swelling during the 10-day recovery period. The ideal goal of blepharoplasty is to give the patient’s eyes a symmetrical look while preserving the characteristics of their top eye skin, so the patient’s eye creases still appear naturally Asian. Our practices are located in New York City and Scarsdale, New York. To schedule a blepharoplasty consultation with Dr. Schwarcz, contact one of our offices today. REQUEST AN APPOINTMENT

Cosmetic Orbital Decompression Surgery Proptosis is a condition that causes the eyes to appear large and disproportionate to the rest of the face. Bulging eyes receive too much air exposure and are susceptible to harm from foreign objects. Some people are born with proptosis, but people can also develop it later in life. This condition can affect one or both eyes and is more prevalent among certain ethnicities. What Causes Bulging Eyes? An orbital tumor Thyroid eye disease Sunken cheekbones Shallow eye sockets Genetics How Do Doctors Treat Bulging Eyes? Most patients need to visit a board-certified oculofacial cosmetic surgeon to undergo orbital decompression surgery. Bulging eyes often cause irritation, redness and tearing. In addition, some patients are unable to close their eyes fully. To treat the problem, the surgeon must perform orbital eye socket surgery to set the eyeballs in a better position . The surgeon makes tiny incisions to remove bone or fat from behind the eyeballs during this outpatient procedure. Orbital decompression surgery can also improve a person’s cosmetic appearance. For example, the surgery can make the eyes look more proportional to the rest of the face. If a patient only has one bulging eye, the surgery can make his or her eyes appear more symmetrical. Orbital decompression surgery is especially beneficial for those who are unable to close their eyes fully. The Surgical and Recovery Process for Bulging Eyes Patients can visit Dr. Schwarcz, a reconstructive facial surgeon in the New York area to undergo an orbital CT scan. This scan will allow the surgeon to analyze if the patient is a good candidate for orbital decompression surgery. The surgery takes anywhere from 45 to 90 minutes to complete per eye. Surgeons perform the procedure while patients are under general anesthesia. To hide the incisions, the surgeon places them in discrete areas. For example, surgeons often place the incisions inside the eyelid. After surgery, patients can resume normal activities within 7 to 10 days. Any bruising and swelling that the patient experiences should subside within two weeks. Patients may experience some moderate pain after surgery, but they can manage the pain by taking oral pain medication. If the surgeon used non-absorbable sutures, then the patient can have the sutures removed after one week. Those who wear contact lenses may need to wait 7 to 10 days before using them again. REQUEST AN APPOINTMENT

ClearLift: A Breakthrough in Cosmetic Laser Treatment ClearLift is a non-invasive skin resurfacing procedure that can lift and tighten sagging skin , reduce the appearance of wrinkles, fine lines, vascular redness, and small spider veins. The procedure is gentle enough that it can be used on the neck and chest as well as around the eyes and mouth. This form of laser cosmetic treatment is gaining popularity because it produces dramatic results with no discomfort, pain, or downtime. Uses for ClearLift Treatment ClearLift is gentle and appropriate for all types of skin. Most patients opting for the procedure want to improve the appearance of fine lines and wrinkles around the mouth and eyes. Others want to tighten sagging skin on their neck, chest, or face. The ClearLift laser uses Q-Switched technology that is also effective in eliminating pigmented skin imperfections, vascular lesions and even tattoos. How Do the Treatments Work? The energy from the ClearLift laser strengthens the collagen structure that supports the skin. The laser heats the underlying layers of skin while leaving the outer epidermis untouched. This stimulates the development of new collagen, which helps to lift and tighten the skin and plump out lines and wrinkles. When the dermal layer of the skin is heated, the body’s natural healing reaction is stimulated. The body treats the heating as a wound and builds collagen in the area as a way of “repairing” the damage. The heating occurs several millimeters under the surface of the skin, so there is no visible damage to the skin. Since the upper layer of skin is not affected, a local anesthetic is not required. The procedure does not cause the swelling or redness associated with other laser therapies. The fact that the surface of the skin is not damaged also reduces the risk of infection. New York board-certified cosmetic oculoplastic surgeon Dr. Schwarcz can perform the ClearLift procedure in approximately 20 minutes. Some patients achieve visible results after just one treatment. The appearance of the skin continues to improve as the body builds new skin cells and collagen. In most cases, three to five treatments are performed several weeks apart. The ClearLift Difference While ablative laser treatments that vaporize the outer-most layer of skin produce results, they can be uncomfortable and require several weeks of downtime. ClearLift skin resurfacing works under the surface of the skin, which makes it possible to return to normal activities right away. REQUEST AN APPOINTMENT

How to Remove Unsightly Scars and Keloids Part of the aftermath of having an invasive surgical procedure is the resulting scar. Scar tissue is made of myofibroblasts and collagen fibers, which are the same tissues of the skin it has replaced, but with a different fiber composition. The new alignment of collagen scar tissue is typically inferior, making it appear worse. The body may over-produce collagen to try to repair the damage of an injury, which may result in a scar that is raised above the normal skin level. These adverse scar conditions can happen at any time following an incision during a reconstructive surgical procedure. The most undesirable scars are keloids and hypertrophic scars . Keloids occur less often than hypertrophic scars and are more difficult to treat. Knowing what kind of scar has occurred is vital in its proper treatment. Keloids These irregular looking scars grow to be larger than their original borders, becoming raised and bubbling up outside the original incision. This makes them harder to remove than hypertrophic scars. Sometimes having a cauliflower-like appearance, keloids can either form right after a procedure or take several months to form. Dark-skinned people are more susceptible to this type of scar, and the probability of getting this type of scar is hereditary. Hypertrophic Scars These scars develop in wound closures that are tightly stretched. This happens in places that have a lot of movement, expanding the wound. These scars typically form within 4-8 weeks. The scar is raised, but its borders are not extended. These scars are typically linear and can be removed with surgery. There are varying degrees of this type of scar, but it occurs in 40%-70% of people. Commonalities Either type of scar can develop after an incision in the skin. Two two types of scars have an equal distribution between sexes and are most common when one is in their teens or 20s. Prevention and Treatment It is important to reduce the tension of an incision while it is being closed. To reduce tension at an incision, a surgeon can distribute the tension by closing the wound deeper in the skin. Wearing compression garments following a procedure also helps reduce post-operative swelling. Additionally, steroid injections, radiotherapy, silicon gel sheeting, laser therapy, and Madera can relieve scars. Hypertrophic scars are more prone to success from these treatments than keloids. Scarring is a common concern following a cosmetic procedure. Look at your family history to determine if you may be at risk. If scarring complications do occur, there are treatment options available. Contact our office today to learn more about scar and keloid removal techniques. REQUEST AN APPOINTMENT

How To Treat Post-Pregnancy Skin Discoloration and Pigmentation Skin discoloration is a common consequence of hormonal changes that may come from pregnancy. It can come in the form of hyperpigmentation, freckles, brown spots, age spots and more. At Dr. Schwarcz’s practice, we utilize laser treatment to treat such skin discoloration for our patients. Mothers after delivery and labor often find this treatment helpful in regaining their pre-pregnancy cosmetic skin tone without the discoloration and freckles. Uneven skin tone and pigmentation can be treated by the intense pulsed light laser which targets and heats up the discolored cells to decrease their pigment. Contact our practice today to learn more about your options. You can have the skin you used to love prior to pregnancy and hormonal changes. The laser treatment is simple, painless and easy. We do not recommend undergoing this treatment during pregnancy for obvious safety reasons. It would be better to wait until after birth and delivery is complete to undergo cosmetic laser treatment. REQUEST AN APPOINTMENT

Reasons for Getting a Brow Lift As a person ages, their eyebrows often begin to sag, becoming flat and droopy. This creates a tired look, which can affect how a person sees themselves, as well as how other people interact with them. A brow lift is a simple cosmetic surgical procedure which works to correct this progressive condition, restoring confidence and self-esteem through a more youthful appearance. Why Get a Brow Lift Brow lifts help reduce visible signs of aging in the upper portion of the face . Where they are needed, they may stand alone, or they may be combined with other cosmetic procedures (such as a facelift) to rejuvenate more of an individual’s appearance at one time. Brow lifts are popular due to their longevity. Depending upon aging factors, lifestyle, and sun exposure, the effects of a brow lift typically last for many years. Botox injections, one of the major alternatives to this cosmetic surgical procedure, have a much shorter lifespan by comparison. Risk Factors This is a relatively simple cosmetic procedure , which can be performed by an oculoplastic cosmetic surgeon. A patient who smokes will most likely be advised against having the surgery, as will an individual who is in overall poorhealth. Types of Brow Lifts The brow lift is a form of cosmetic enhancement, which takes different forms depending upon the needs of the patient. Endoscopic Forehead Lift: Five small incisions are made above the hairline, allowing the entire forehead and brow region to be lifted. Pretrichial Eyebrow Lift: This procedure involves the removal of a strip of skin along the area of incision. The eyebrows are lifted, and the hairline is pulled down, reducing the appearance of a high forehead. Direct Brow Lift: A section of tissue is removed adjacent to the eyebrows, raising the brow region without affecting the hairline. This procedure tightens the forehead without changing its overall dimensions. Recovery Time Most patients are able to resume light activity 3-5 days after a brow lift. Provided that one avoids strenuous or stressful activities, it is usually possible to return to work in a little more than a week (7-10 days). Comparatively rigorous activity, such as an exercise regimen, should be abstained from for at least 2-3 weeks following the surgery. Activities requiring alertness and high reaction time, like driving, may need to be postponed for two weeks or more. Your surgeon can better advise you on the particulars, based upon the specifics of your procedure. Side Effects Common side effects include bruising and swelling along any incisions, as well as across the affected area. This swelling often worsens gradually, then subsides, over the first 3-4 days following the procedure. Some patients experience bruising under the eyes as well. This should also fade after 3-4 days following the surgery. REQUEST AN APPOINTMENT

Tips for the Blepharoplasty Procedure Once you’ve decided to have undergo the eyelid blepharoplasty procedure to reconstruct your eyelids and tighten sagging skin around your eyes , it’s important to prepare yourself properly. Your cosmetic oculoplastic surgeon will tell you more about how to get ready, but here are some simple tips on what you can do: Stop smoking, at least a month and a half before the surgery. While of course quitting smoking is a good idea anytime, it’s especially important before a surgery. Smoking can depress your immune system, putting you at greater risk for infections and complications after the surgery. And after the surgery, smoke will irritate your eyes, causing you greater discomfort and making it harder to heal. This includes secondhand smoke! Likewise, drinking alcohol can make it harder to recover from surgery. Stop drinking two weeks before the surgery for best results. Keep yourself well hydrated and eat a healthy diet to speed your healing after the surgery. On the day of the surgery, do not wear makeup, skin cream, or any other cosmetics. Do not wear contact lenses, false eyelashes, or jewelry. Be sure you’re ready to recover at home after the procedure. You won’t be in a condition to go out shopping until your eyelids have healed. Make sure you’re stocked with all the groceries and supplies you’ll need, and if possible arrange for someone you can trust to take care of cooking, at least until you’ve recovered a bit. You should not eat any solid food until 24 hours after the blepharoplasty. Tylenol or another acetaminophen pain medication, as needed for pain. Do not use aspirin, ibuprofen (Motrin), or naproxen sodium (Aleve), as they can cause bleeding. If your ocuplastic surgeon prescribes a pain medication, use that instead — don’t mix pain medications! Some useful supplies to have on hand include: ice cubes, which can be applied to the eyes (wrapped in a cloth or towel) to reduce swelling and ease pain gauze pads to help protect the eyes and absorb any discharge lots of pillows or a bed wedge so you can sleep with your head elevated Be sure to talk to your surgeon before the surgery. He or she should be happy to answer any questions you have about the procedure and what results you should expect. Blepharoplasty is a relatively simple outpatient procedure. But there are risks associated with any surgery, no matter how simple. That’s why it’s best to arm yourself with knowledge and make proper preparations. This way, your recovery can be easy as possible and you can get on with enjoying your new and improved eyelids! For more dramatic effect, you can also consider undergoing blepharoplasty in conjunction with a brow lift which will raise your eyebrows and tighten the skin on your forehead . Contact our office to schedule your initial consultation with Dr. Robert Schwarcz , board- certified ophthalmologist and oculoplastic surgeon. REQUEST AN APPOINTMENT

Tips for a Successful Blepharoplasty Recovery Cosmetic surgery requires the patient to adhere closely to certain guidelines in order to recover quickly and healthily from the procedure. Blepharoplasty, or eyelid surgery , calls for the same guidelines as any other surgery, but due to the nature of the surgery, the patient will need to take additional precautions. The procedure itself is relatively simple and if both eyes and all four eyelids are operated on, the procedure lasts approximately an hour and a half without complications. Immediately After Surgery The first task that a surgeon will perform after the procedure, is applying a protective ointment and dressing to the eye of the patient. This will cause blurred vision that will last for approximately a day. Some pain and discomfort may be present as the anesthesia wears off. As your full use of your eyes will be temporarily weak during the healing process, patients who undergo blepharoplasty are advised not to drive and are actually prevented from doing so. Therefore, make sure to arrange for a designated driver ahead of time. Seven to Ten Days After the Procedure The first week or so after recovery is the most important period of recovery time. In order to prevent infection, the doctor will prescribe antibiotics to the patient. The patient must also monitor their temperature to detect any rise or fever, which may indicate infection. The patient must be sure to take the pain medication that the doctor has prescribed in case of discomfort. Many common painkillers like aspirin, naproxen and ibuprofen will worsen any bleeding, and should be avoided. Dr. Schwarcz will prescribe you appropriate pain medications that minimize bleeding. The patient should get lots of rest and not engage in excessive activity during this period of recovery. Keep the head elevated to prevent swelling. Dr. Schwarcz will advise you how to clean around the eyes while the incisions heal. Later Stage Recovery Vision will continue to be blurred during the healing process. Eyeglasses may be worn immediately, but contact lenses must wait until two weeks after surgery. Eye makeup can start being worn at this time as well. Any swelling or bruising should clear up as well. The patient may start to engage in heavier activity after the first 10 days, but strenuous activity or sports with risk of physical impact, especially to the face, must wait until the doctor gives their approval. Schedule an appointment to receive a consultation with oculoplastic cosmetic surgeon Dr. Robert Schwarcz who is also a board-certified ophthalmologist. REQUEST AN APPOINTMENT