The 411 On Eyelid Blepharoplasty With time, the muscles surrounding the eyes lose their strength. This can cause loose folds and sagging skin in the upper eyelids and bags under the eyes. Not only does this give the face a tired appearance, but it can also impair vision and make it difficult to wear contact lenses. In extreme cases, there can be muscle fatigue from trying hold the eyes open and irritation from the excess skin rubbing together. Eyelid blepharoplasty is the solution to the aging of the eyes. How Aging Affects the Eyes: Over time, the upper eyelids can develop extra fat, muscle, and wrinkles. This can make a person appear sleepy, lazy, or even angry. The skin under the eyes can lose its elasticity and fat can collect under the eye. This can make a person appear overly tired and much older than they are. What is Eyelid Blepharoplasty? Commonly known as lid surgery, blepharoplasty removes excess fat, skin, and tissue from the eyelids. The procedure can be performed on both the upper and lower eyelids to get rid of droopy skin and improve the field of vision. Lid surgery is an effective way for both men and women to reverse the signs of aging and make their face appear more youthful and rejuvenated. Common Types of Eyelid Blepharoplasty: To correct the upper eyelid droop, an incision is made along the crease of the eyelid in order to remove the excess tissue. The incision is then sutured to make the skin above the eye smoother and tighter. A lower eyelid blepharoplasty is most often done using an incision. The most common surgical technique uses a transconjunctival approach in which the incision is made along the lower eyelashes to minimize the visibility of scars. Laser resurfacing and hyaluronic acid fillers can also be used to remove wrinkles and tighten the skin around the eye. These non-invasive procedures are well-suited for treating hooded eyelids and bags under the eyes. Who Is a Candidate for Eyelid Blepharoplasty? Candidates for eyelid surgery must be above the age of 18. Most people who choose the procedure have loose or excess skin along the upper eyelids that interferes with their vision. The surgery is also appropriate for those with bags, dark circles, or puffiness around the eyes. REQUEST AN APPOINTMENT

Orbital Blowout Fracture Surgery Injuries to the eye socket and surrounding eye structures are a common occurrence. Blunt force trauma and sharp force trauma due to assaults, athletic activities and falls can lead to canalicular lacerations, eyelid lacerations, orbital fractures and orbital hemorrhages. An oculoplastic surgeon will examine and treat the eyeball in addition to the socket as the eyeball is an injury-prone area. During the consultation, New York oculoplastic surgeon Dr. Robert Schwarcz will examine the patient’s face and eyes and assess the patient’s orbital CT scan results to determine the injury’s severity. Orbital Blowout Fractures The fragile nature of the orbital bones and adjacent sinuses make it highly likely for eye and orbit trauma to result in an orbital blowout fracture. Often, the fracture occurs in the orbital floor or medial wall. While some orbital fractures do not require surgery, large fractures or fractures that cause enophthalmos or diplopia do necessitate a surgical procedure. Surgical Repair of an Orbital Blowout Fracture To prevent scarring and increase the procedure’s success rate, an orbital blowout fracture should be repaired no later than 2 weeks after the trauma occurred. In some cases, the surgeon may be unable to repair the site immediately. For example, a sunken eye may appear or become more severe over time; therefore, the patient will need enophthalmos surgery or a filler injection to improve the appearance of the sunken eye. Due to the small incisions that remain hidden inside of the eyelids, patients tend to recover quickly from orbital fracture surgery. Dr. Schwarcz performs this surgery while the patient is under general anesthesia. This outpatient procedure takes approximately 1 hour for the surgeon to complete, and the patient will have a follow-up appointment at Dr. Schwarcz’s New York office 1 week after the surgery. Select a Certified Oculofacial Plastic Surgeon Since the orbit and eyelid are complex structures, oculoplastic surgeons undergo specialized training to learn the nuances of eyelid and orbital treatments . Oculoplastic surgeons who are members of the American Society of Ophthalmic Plastic and Reconstructive Surgery are board-certified ophthalmologists who must complete a cosmetic and reconstructive surgery fellowship to receive training on treating issues that involve the eyelids, lacrimal system, orbits and nearby structures. Dr. Schwarcz is an oculoplastic cosmetic surgeon who is an American Board of Cosmetic Surgery diplomat and board certified by the ASOPRS as well as the American Academy of Ophthalmology. REQUEST AN APPOINTMENT

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

Lip Enhancement via Facial Fillers Many people opt for lip enhancements non-surgically via facial fillers. Restylane Silk is the facial filler of choice for the lips. To create more voluptuous, juicier, fuller lips , this non-surgical non-invasive treatment is done by injection by a cosmetic plastic surgeon. The amount of filler will be discussed prior to the treatment and your particular goals and preferences will be considered and taken into account. Facial fillers are also used to improve and enhance the texture and volume of other areas of the face. During lip augmentation, a topical anesthetic is applied before the injection. Some slight swelling or bruising may occur after but will subside. REQUEST AN APPOINTMENT

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. REQUEST AN APPOINTMENT

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 . REQUEST AN APPOINTMENT

Tear Trough Treatment and Sunken Eye Treatment Tear trough deformities often occur in those who have certain genes or thin faces. This hollow area under the eyes gives the appearance of dark circles, making the eyes look tired or sunken. Some people may also have bags under the eyes, which worsens the appearance of dark circles. People who have mild tear trough hollowness can cover the area with makeup or temporary plumping moisturizer, but these approaches do not provide an effective, long-lasting solution. Luckily, patients in New York have other options. Dr. Schwarcz, a board-certified oculoplastic surgeon, can treat sunken eyes and tear trough hollowness with surgery and cosmetic treatments of the eyes, such as hyaluronic acid gel filler injections, fat transfer injections, tear trough implants and lower blepharoplasty procedures. Hyaluronic Acid Fillers A cosmetic surgeon can safely inject hyaluronic acid fillers to treat sunken eyes and tear troughs . This non-invasive, reliable procedure only takes several minutes. To prevent discoloration and maintain a natural look, the surgeon will inject a conservative amount of filler into the area below the patient’s lower eyelid. The pain is minimal, and the results can last up to two years. After receiving a hyaluronic acid gel injection, swelling and bruising may last for a couple of days. Fat Transfer Injections Another sunken eye and tear trough treatment approach is a fat transfer injection. By manually suctioning a minimal amount of fat from the medial thighs or stomach and transferring the fat to the eyelid via an injection, the surgeon can fill the hollow under-eye area. Bruising and swelling may last up to 10 days; however, the recovery process is painless. The effects of a fat transfer injection are often permanent. Residual hollowness may occur; however, the surgeon can inject a touch-up filler if necessary. Tear Trough Implants A tear trough implant is a safe, effective, permanent way to correct tear trough deformities and sunken eyes. While under conscious sedation, the surgeon makes an incision inside the patient’s lower eyelid. Then, the surgeon places the silicone implant. Although tear trough implant procedures are more invasive than other surgery and cosmetic treatments of the eyes, the results create a natural appearance. Lower Blepharoplasty Procedures Patients who have excess fat bags may benefit from a lower blepharoplasty with fat repositioning . This procedure involves redistributing the fat bags to make the under-eye area look smooth. To reposition the prolapsed fat without causing a scar, the surgeon will make a transconjunctival incision. REQUEST AN APPOINTMENT

Facts About Cosmetic Lip Enhancement Full, lush, and shapely lips have come into style these days. Lips like Angeline Jolie’s have become desirable to many women, although the possibility of “duck lips,” those extremely large and grotesque results of poorly done cosmetic procedures are a possibility. The patient and her cosmetic plastic surgeon must work together to plan and execute the most flattering results. The Procedure The filler used is usually performed with Restylane Silk to create volume . During the first session, a very small amount, approximately 1cc of the filler, is injected into the edge of the lip, also known as the wet-dry junction or where the pink meets the facial skin tone. The patient should be actively involved in the procedure. The lip begins to inflate immediately as the filler is injected. The patient should hold a mirror and watch closely along with the surgeon, to determine when enough filler has been injected. Any leftover filler may be discarded or used to fill in laugh lines or another facial area where it is needed. Pain and Side Effects Pain should be minimized by the cosmetic plastic surgeon. Lidocaine, a topical pain treatment, is applied to ease the pain at the injection site. As the filler enters the lip, it spreads through the tissue and may cause pain. The surgeon should administer a dental block to eliminate discomfort. A patient should know in advance what pain relief is provided and can ask when making the appointment. Two injections are made into the upper lip, and two to the lower. Bruising and bleeding may occur if the injections are inserted into the pink area of the lip itself, because the lip has many blood vessels. The least damaging and safest area to inject is at the lip edge. The result should be attractive, well-defined lips. Depending on the extent of the results you seek, multiple treatment can be utilized. To discuss your treatment options for lip augmentation, contact our office today. REQUEST AN APPOINTMENT

Lip Augmentation: The Path to Plumper Lips with Dermal Fillers Lip augmentation using dermal fillers is a non-surgical treatment for creating full, voluminous lips . In the past, lip augmentation typically involved collagen injections. Today, the most popular dermal fillers contain hyaluronic acid, which is safer than collagen and produces longer-lasting results. Hyaluronic acid occurs in the body naturally and adds volume to the area where it is injected. Other cosmetic procedures to increase lip volume, including implants or fat injections, are rarely used today because of the risk of inconsistent results and side effects. Common Hyaluronic Acid Fillers The most frequently used dermal fillers for plumping of the lips include Juvederm , Restylane , and Restylane Silk . They work by adding structure, shape, and volume to the lips. Each of these fillers involves a similar procedure and produces comparable results. Some fillers also contain the local anesthetic lidocaine to help make the injections more comfortable. The effects of the injection typically start to lessen after approximately six months. Repeat injections are required to keep the lips plump. Benefits of Non-Surgical Lip Augmentation Hyaluronic fillers immediately start to support and reshape the lips. Fillers offer a number of benefits over other methods of lip augmentation. The doctor can control the amount of lip volume that is created by adjusting the amount of filler used. The treatments can be spread over multiple appointments in order to achieve the desired results. Bumps or lumps created by normal lip movement dissolve easily. Hyaluronic acid fillers tend to create less swelling and bruising than other types of fillers. Hyaluronic acid is a natural substance that is unlikely to result in an allergic reaction. What to Expect During Lip Augmentation A cosmetic surgeon can perform injectable lip augmentation using dermal fillers during a quick in-office procedure. The doctor will numb the area with a topical numbing agent or by injecting a local anesthetic. Dr. Schwarcz, a cosmetic and oculofacial reconstructive surgeon, will mark the areas to be treated before injecting the filler using a fine needle. The results of the cosmetic procedure should be noticeable right away. Potential Risks and Side Effects Complications following lip augmentation injections are rare and typically include: tenderness and redness at the injection site, bleeding at the injection site, and minor bruising and swelling It is normal to experience some minor discomfort and swelling, but these symptoms can usually be alleviated with ice. 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