Dr. Rizk's technique for the upper and lower eyelids is based on achieving natural results, which avoids the 'hollow eye look'. To do this, Dr. Rizk conservatively removes some fat, while also sculpting remaining tissue with a laser and repositioning it to fill increases at the border of the eye and cheek regions.
Additionally, his eyelid incisions in the upper eyelids curve upwards on the edges to lift the corner hoods rather than place the incision lower in the crow's feet area, which may lower the eyebrow. Furthermore, he uses a laser to sculpt the fat pads in the upper eyelids rather than remove them, which avoids a hollowed appearance.
In the lower eyelids, Dr. Rizk favors the reduction of fat pads through the scarless transconjunctival approach (incision inside the eyelid, rather than on the outside), and fat sculpting with a laser and repositioning, again to achieve a natural contour, rather than older fat removal techniques.
For smoother results, the skin of the lower eyes and crow's feet is either lasered through a Fraxel CO2 laser or a pinch of excess lower eyelid skin is removed. Dr. Rizk published a landmark article in the Plastic and Reconstructive Surgery Journal and created an algorithm for the lower eyelids which combines newer treatments with older techniques. The article also discusses how to obtain excellent results and avoid ectropion or malpositioning of the lower lid.