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Board Certification: American Board of Facial Plastic and
Reconstructive Surgery American Board of Otolaryngology - ABO

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Eyelid Surgery NYC

As we age, the upper and lower eyes develop loose skin and excess fat that creates puffiness. Dr. Rizk favors minimally invasive techniques to remove excess skin and fat and rejuvenate the upper and lower lids. Most patients are able to return to normal activity within one week, looking more refreshed and youthful.

Dr. Rizk employs an advanced scarless technique using an incision inside the lower lid (transconjunctival) and reducing wrinkles with laser surfacing or skin excision as indicated. Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision. The procedure is usually performed in an office with local anesthesia in as little as 45 minutes. Blepharoplasty can be combined with a facelift or BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes.

Dr. Rizk is a double board certified facial plastic surgeon who specializes in plastic surgery of the eyes, brows, face and nose only. He is one of a handful of surgeons with this expertise. Dr. Rizk is not a general plastic surgeon and does not perform plastic surgery on the body. Dr. Rizk has presented his techniques at conferences and published his rapid recovery methods for a natural look in the most prestigious journals of plastic surgery.

Dr. Rizk published his techniques and algorithm for analysis and treatment of the lower lid in Plastic and Reconstructive Surgery Journal (2003). Dr. Rizk’s article on blepharoplasty speaks about making eyes look youthful and not hollow. He performs a scarless technique for lower lids with no external scar. He also performs a modified version of upper eyelift to address the sagging hooded eye.

What are the aging changes associated with the eyelids?

As we age, the upper and lower eyes develop loose skin and puffiness. The quality of the skin also changes and may become wrinkled, especially in thin-skinned people with sun exposure. Crow's feet develop on the sides of the eyes. The puffiness under the eyes is hereditary and may occur at an early age from weakening of the layer of tissue that holds the fat in the eye (orbital septum). As such, the fat may protrude through this weak layer and appear as puffiness under eyes.

What are the aging changes associated with the eyelids?

As we age, the upper and lower eyes develop loose skin and puffiness. The quality of the skin also changes and may become wrinkled, especially in thin-skinned people with sun exposure. Crow's feet develop on the sides of the eyes. The puffiness under the eyes is hereditary and may occur at an early age from weakening of the layer of tissue that holds the fat in the eye (orbital septum). As such, the fat may protrude through this weak layer and appear as puffiness under eyes.

What are some contradications to having eyelid surgery?

A history of thyroid disease, dry eye, or any ophthalmological disorder needs to be evaluated and may preclude a patient from having eyelid surgery. A medical clearance is always obtained to check the patient's medical condition and an ophthalmologic evaluation may sometimes be warranted if the patient has a history of eye diseases or dry eye.

What does a blepharoplasty do and how long does it last?

Basically, the procedure removes excessive drooping skin and sculpts/redrapes/removes bulging fat. The net outcome is younger appearing eyes that look brighter than before. As a rule, the results are most impressive and long-lasting (up to 15 years). Just think for a moment: When you talk to someone, she/he invariably looks at your eyes - the "window" of your soul - and judges your age according to how they appear. Of all the features of aging on the face and neck, the ones that respond best to surgery and last the longest, are the eyes and the double chin. Depending on your appearance and your age, the eyelid operation can reduce your visible age anywhere from 5-15 years, or even more.

Tatler Magazine Visits Dr. Rizk's Practice

Tatler Magazine Visits Dr. Rizk's Practice

Dr. Rizk discusses procedures for aging lower eyelids

Dr. Rizk discusses procedures for aging lower eyelids

How do I choose a surgeon?

Your best choice in selecting the right doctor is to look for a surgeon who specializes in facial plastic surgery; one who has an extensive background of experience to give you a safe and successful outcome; and preferably one who is an artist, since this operation requires skills for making surgical incisions precisely to remove redundant skin and fat. Realize also most eyes and brows are not symmetrical. Attempts are made to vary amount of skin removal to create more symmetry. Some incisions are placed in natural creases above the eyelids but some outside natural creases on the corner upper eyelid hooding to lift the corner upwards. Furthermore, the experienced doctor will not only rejuvenate your eyelids, but will also remove the droopy skin that many people have at outer edges of the eyelids in the areas of the smile lines. Selecting a board certified facial plastic surgeon is also important. The best recommendation is from a friend who has had work on his/her eyes.

How does Dr. Rizk's technique differ from the traditional approach to eyelid rejuvenation?

Dr. Rizk's technique for the upper and lower eyelids is based on the concept of a natural result which avoids the older "hollowed eye look" . To do this, Dr. Rizk conservatively removes some fat, while also sculpting fat with the laser and also repositioning it into deeper creases at border of eye/cheek regions. Additionally, his eyelid incisions in the upper eyelids curve upwards on the corners to lift the corner hoods up, rather than place the incision lower in a crow's feet, which may lower the eyebrow. Additionally, he uses the laser to sculpt the fat pads in the upper eyelids rather than remove them which avoids the hollowed appearance. In the lower eyelids, Dr Rizk favors the reduction of fat pads through the scarless transconjunctival approach (incision inside eyelid, rather on outside), and fat sculpting with the laser and repositioning, again to achieve a natural contour, rather than older fat removal techniques. For a smoother result the skin of the lower eyes and crow's feet is either lasered with the Fraxel co2 laser or a pinch of lower eyelid skin is removed if it is redundant. Dr. Rizk published a landmark article in Plastic and Reconstructive Surgery Journal and created an algorithm for the lower eyelids which combines newer treatments with the older techniques and discusses how to obtain an excellent result and avoid ectropion or malpositioning of the lower lid. This article is in "in the news" section of website.

What is laser blepharoplasty?

Laser blepharoplasty is one in which a laser is employed during procedure to change or cut some of tissue. Dr. Rizk utilizes the latest Fraxel-co2 laser technology both in cutting and sculpting the muscle and fat as well as to smooth the skin under the eyelids. The laser use results in less bruising and swelling and is part of Dr. Rizk's rapid recovery protocol. For more information on the fraxel-CO2 laser see the laser section of this website. The laser may not be used in some cases on the skin of darker skin individuals.

The upper blepharoplasty incision?

The upper lid operation should always have a fine line, hairline incision placed in the normal crease of the eyelid-the one you have had since birth-where it will be mostly out of sight. If you have drooping skin on the outer aspect of the eye in the region of smile wrinkles, this can also be included in the excision. This excision of lateral excess hooding has been modified by Dr. Rizk to lift the corner upwards and open the eye, rather than curve down and bring the eyebrow down. This will leave a fine line in this lateral hood region resembling a crow's feet. After removing the redundant droopy skin, the underlying bulging fat is sculpted, trimmed and repositioned as needed and the incision is meticulously closed with as little sutures as possible (the more sutures used it may leave pimples or milia which can be removed later). Dr. Rizk uses very fine, non-reactive removable sutures. Dr. Rizk does not use absorbable sutures as they leave a tiny skin reaction when they absorb.

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