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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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SmartLipo NYC

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What is SmartLipo?

Doctors constantly seek better and less invasive techniques for patients. It used to be that once patients with full necks and jowls reached their 50′s and sometimes even younger, the only “cure” for them was a facelift. Today, using SmartLipo laser technique, we now have a less invasive measure that takes liposuction to a whole new level. This laser directly heats collagen under the skin to tighten overlying skin. SmartLipo laser technique was first applied to the area under the neck but now can also be used in the lower face and jowls for Laser Facial Sculpting.

Over the past decade there have been numerous devices created by the laser companies that include either laser or radiofrequency that tout skin tightening without surgery, seeking a true “non-surgical facelift.” This is an attractive idea for both doctors and patients: Run a device over the skin to penetrate without damaging the skin and directly heat the collagen so that it thickens and tightens. Unfortunately, treatments with these tightening devices were painful and expensive and yielded minimal results. To take this concept to a new level with long-standing results, the SmartLipo device does what these devices promised but didn’t deliver: direct heating of the collagen.

SmartLipo and Laser Facial Sculpting can be performed under light sedation up to general anesthesia according to the patient’s needs. Following tumescent anesthesia, a very tiny (2mm) incision under the chin and behind each earlobe, a 1064 nm Nd:YAG laser fiber is used to heat the undersurface of the skin to a set temperature to denature collagen but not damage the overlying skin. The laser also coagulates the neck fat making subsequent liposuction more consistent. As patients heal, the skin continues to contract and results improve up to 6 months or longer after treatment. Neck fullness and jowls both diminish significantly. The first two patients I treated are a couple in their 50′s, and their photos are in our photo gallery. The photos shown are 8 months post treatment. They didn’t believe it until we compared photos, but they look better at 8 months post treatment than they did even at 4 months.

Laser SmartLift

After the first time I used SmartLipo laser for a facelift I was convinced that it is a great tool for enhancing the facelift technique. After the tumescent anesthetic is instilled, the SmartLipo laser fiber is used under the skin flap. The laser does three things: coagulates blood vessels, separates the skin from the underlying muscle in the correct plane, and heats the collagen on the undersurface of the skin. These three advantages are what separate the Laser SmartLift from an ordinary facelift.

Since the blood vessels are coagulated before skin flap elevation with scissors, there is little to no bleeding when the skin is being separated from the underlying muscle. This is revolutionary! It means less black-and-blue after surgery and maybe even faster back-to-work for patients. My first Laser SmartLift patient, is a lawyer and was back in her office one week after surgery. I don’t usually recommend that, two weeks is better, but she looked great with a scarf at one week.

The SmartLipo laser fiber is advanced with little pressure and finds the path of least resistance, which is exactly where the skin flap should be raised. This means less trauma to the muscle underneath. This is also an advantage in revision facelifts; the plane of separation is sometimes less defined. The laser helps make this procedure almost as easy as a primary facelift. The third area of improvement is skin tightening from collagen contraction during the procedure as discussed above.

Is SmartLipo, Laser Facial Sculpting or Laser SmartLift for you? There is a spectrum of patients who we can now treat with this great new laser. A young patient up to their early 50′s looking for better neck contour. A patient in their late 40′s to mid 50′s with neck fullness and early onset jowls.


Answers to frequently asked questions about the procedure

Q: Can Plastic Surgery Help my Eyes Look Less Tired?

Eyelids can look "tired" from a number of reasons. The more common ones are bags under the lower eyelids, excess skin of the upper and/or lower eyelids and drooping of the eyebrows. You don't have any of these.

Your eyelids slant downward towards the sides; the corner where the upper and lower eyelids meet (called the canthus) is lower towards your ears than near your nose. There are a number of surgical techniques that can be used to raise the lateral canthus. Sometimes, there may be some hollowness of the bone of the eye socket as well. This is also treatable. Seek out a surgeon who is versed in this procedure for a more definitive discussion.

Q: How long does a rhinoplasty last and at what point will you need to do additional maintenance?

A: A rhinoplasty will last for the rest of your life. However, even a nose that has undergone a rhinoplasty ages like the rest of your face and body. As we age, the nose begins to droop. After a rhinoplasty they will age from where they were after the procedure. The procedures we do for an aging nose is often more subtler than a formal rhinoplasty.

Q: What is a "mini lift"?

A mini-facelift of today was the maxi-facelift of 2 decades ago. Mini or maxi, best to discuss with your doctor.  There are many definitions of what a mini-facelift is. For some it's a shorter incision, for other doctors its less work on the muscle called the SMAS. The technique depends more on the doctor's skill and your anatomy. For a patient in their early 40's, you often don't need the same deep plane facelift that someone in their 50's or above might need. Most of these procedures address your jowls.

Q: If I were to have a rhinoplasty and septoplasty, would I go to a facial plastic surgeon, ENT or Plastic surgeon?

A: Performing both a quality septoplasty and rhinoplasty is dependent on the individual's training and experience. Generally, facial plastic surgeons start with ENT training before they move on to facial plastic surgery. Although they are not formally trained, many plastic surgeons can also be experience and qualified to perform septoplasty procedures. The main focal point should be how much training they have received and how much experience do they have performing the procedures together and separately. There are subtle signs that could indicate if the proposed surgeon is right for you:

  • Did the surgeon look inside my nose? (As surprising as it sounds, in a number of my revision consults, patients often say that their original surgeon never looked inside their nose.)
  • Do they have specialized instruments to tackle the procedure? (A special headlight, nasal instruments, etc.)
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