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

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Deep Plane Facelift New York City

Why you should consider a Deep Plane Facelift?

Facelift surgery is still the gold standard for rejuvenation of the aging face.  There are a few different techniques used for Deep plane facelift before and afterfacelifts ranging from mini-lifts to the deep plane facelift  A mini-lift raises the skin for a short distance and suspends the deeper muscle called the SMAS.  This procedure is good for younger patients who do not need a lit of lift.  Unfortunately, the results have also been shown not to last as long as a deep plan facelift.

As we age we also lose facial volume, especially in the cheeks.  To replenish the cheeks a lot of surgeons will perform simultaneous fat transfer with facelift surgery.  However, a deep plane facelift will re-suspend sagging cheeks along with the jowls and excess neck skin.  Patients will actually have fuller, more youthful cheeks after a deep plane facelift even without fat injections.  The deep plane facelift is also thought of as a more aggressive surgery than a simple skin or SMAS lift.  Yet, patients look more natural since the SMAS muscle is lifted and fixed in place securely.  The skin can then be gently sewn down without tension; thus avoiding the “swept” or “wind-tunnel” look.  The procedure may take longer but the results are superior and longer lasting.

facelift model

Total Facial Rejuvenation: Extreme Makeover

Not the show, but real life.

extrememakeover4 dr. pearlmanThere is no denying that we want to put our best foot forward when it comes to our physical appearance. Everyone desires to look good because when you are happy with your appearance, that happiness radiates to every other aspect of you. For many people, staying in shape to look good is what motivates them to eat right and exercise. And when you don’t feel like your appearance matches your inner vitality, perhaps it is time to consider making a change.

Your face is the opening statement about your appearance, and if a combination of aging, sun damage, and lifestyle choices has changed your look, or if you are displeased with the underlying facial features you were born with, extreme makeover surgery can help you achieve the facial rejuvenation you desire.

Combining Procedures for Total Rejuvenation

Much like the name suggests, an extreme makeover is just that: extreme. This surgery combines multiple procedures at once, allowing for a complete transformation. And while these can be performed at different times, you will find that it is most beneficial to you (both through recovery time and cost) to combine them, creating a stunning before and after reveal. Commonly, an extreme makeover procedure involves some combination of the following:

  • Facelift surgery to tighten the underlying muscles and remove excess skin from the mid and lower face as well as the neck.
  • Eyelid surgery to remove drooping skin on the upper eyelids and heavy bags below the eyes.
  • Forehead lift surgery to address sagging brows.
  • Chin Augmentation to bring out a sunken chin that can accompany aging.
  • Rhinoplasty to reshape the nose. This can include removing nasal humps, narrowing the nostrils, or repairing the nose after an injury.
  • Injections, such as BOTOX® Cosmetic or dermal fillers, to soften the appearance of wrinkles and fine lines, and to fill hollowed areas on the face.

Balanced Facial Features

While not everyone needs a combination of procedures to achieve their ideal-looking face, combining procedures allows for facial harmony and balance. If there are noticeable signs of aging in many different areas and not all of them are addressed, you run the risk of looking out of balance. This is a telling sign that cosmetic surgery has been performed, which is not ideal. While the goal of surgery is to achieve a youthful, refreshed appearance, you also want that appearance to look natural. Facial harmony means natural results.

Enhanced Confidence

Everyone has the ability and right to look as young as they feel. Deciding to improve your natural beauty can allow you to gain confidence that you may have lost or never had. It can allow for your true self to shine through. Visit us at Pearlman Aesthetic Surgery to discuss what the best procedure is to turn back the clock.

A Broken Nose: One of the Most Common Sports Injuries

Young man defeated in sports game suffered loss with broken noseParticipating in sports can be rewarding and exhilarating, but it is not without risks. Because of flying elbows and sticks in many sports, sports injuries are all too common. Nasal fractures are the most commonly injured facial bones. A broken nose is especially likely among participants in baseball, basketball, soccer, and boxing. Without attentive care, a nasal fracture can result in permanent disfigurement of the nose and even breathing issues. Fortunately, Dr. Pearlman can perform either what is called a closed reduction soon after trauma or, if delayed, a rhinoplasty to improve a nose that was damaged by a sports injury.

What to Do After a Sports Injury to the Nose

A sports injury to the nose can occur when an athlete is hit in the face by an opponent, ball, stick, or another piece of sporting equipment. The first thing to do is check whether a serious head injury took place. While monitoring the condition of the nose, it should be determined whether a concussion, neck injury, or brain injury may have occurred. If so, emergency medical services should be contacted immediately. If emergency medical services are not needed, initial steps should include stopping the bleeding with pressure on the nostrils and applying ice to minimize swelling in the nose and eye area.

The athlete should visually inspect his or her nose to determine if there is any sign of misalignment that was not previously there, such as a crooked bridge, flattened bridge, or asymmetry. Increased difficulty breathing through the nose can also indicate a fracture, which may obstruct the nasal airways. A fractured nose will likely begin to swell and bruise, and the athlete should go to a local hospital or walk-in clinic for an evaluation and X-rays. If the swelling is not yet severe, a facial plastic surgeon or ENT specialist may reset the fracture immediately after the injury. It is very important that someone evaluates the inside of your nose to make sure you don’t have a collection of blood inside, called a hematoma. Hematoma is the only true urgent reason to see a specialist right away.

When Is Nose Surgery Recommended?

Dr. Pearlman Broken Nose Repair Rhinoplasty PatientIf a broken nose is not reset immediately after the injury, swelling will ensue. Unfortunately, this is the likely situation. Sometimes, it is prudent to wait several days for the swelling to reduce to actually be able to tell how crooked the nose really is. However, if you wait more than two weeks, the bones start to set and can no longer be manipulated with a simple closed reduction. So, the sweet spot is between a few days and a week and a half.

A fractured nose that is very badly displaced, was never reset, or heals poorly despite being reset can be corrected with rhinoplasty. Rhinoplasty can reshape the nose to reverse the effects of the break on the outward appearance and nasal breathing. Under the hands of a skilled rhinoplasty surgeon, the athlete can expect natural-looking results that mask the evidence of there ever having been a sports injury to the nose. If there is a concurrent deviated septum from the trauma, cartilage heals differently than bones. We recommend waiting at least six to eight weeks for the cartilage to fully heal before performing septoplasty after trauma. If desired, athletes can make the most of the experience by asking the surgeon to correct other nasal defects, such as a bulbous tip, large nostrils, or a bump along the bridge. After rhinoplasty, instead of being permanently crooked or deformed by the injury, the nose will be able to heal properly and retain a natural, aesthetically pleasing appearance.

When Can I Play Sports Again?

Because the nose will be especially sensitive and vulnerable after being broken and undergoing surgery, it is usually best to take six to eight weeks off from contact sports and three weeks off from strenuous physical activity. Athletes should be careful not to return to sports too early, or they risk damaging their nose further and compromising their surgical results. If an early return to physical activity is requisite, most physicians will require a face guard or protective splint for at least six weeks to protect the nose as it heals. As athletes comply with this directive, they can expect full healing of a broken nose and look forward to having an entirely natural nasal appearance after a sports injury.

Dr. Pearlman is a recognized expert in rhinoplasty, revision rhinoplasty, and septoplasty. For nasal surgery and correction of a broken nose, you should trust your face to a facial plastic surgeon.

Improve Facelift Results With Facial Implants

Defined, angular facial features not only distinguish facial beauty but also point to youth and vitality. Age-induced skin laxity produces sagging cheeks and jowls, and the cheeks, jawbone, and neckline often lose their youthful definition. Patients who would like to reap the greatest benefits from their facelift should consider combining their facelift with facial implants or fat injections to enhance their facial structure. Alternatively, a deep plane facelift may accomplish both, without implants.

Cheek Surgery GraphicFacial Structure and Aging

New scientific research has shown that facial structure can be adversely affected by the aging process. The bones of the body, formerly perceived as relatively static once we reach adulthood, are now known to be constantly changing. This is why individuals tend to lose stature and become shorter as they age. In several studies of men and women ranging in age from 20 to 65+, researchers discovered that the older individuals had comparatively shorter jaws, receded chins, sinking cheekbones, and lower rims of the eye sockets. This research suggests that aging leads to a loss of bone support and structure in the face, specifically in the jaws, cheeks, and eye-socket bones. This reduction in structural support demonstrates that skin and soft tissue laxity are not the only cause of sagging cheeks, jowls, and drooping brows.

Facelift Surgery and Facial Implants

Beautiful long curly blond hairstyle female portraitWhile facelift surgery has advanced far beyond the “cut and pull” techniques of the 20th century, it still focuses on the soft tissue rather than the bones. Experienced facial surgeons can skillfully tighten and lift the muscles, tissues, and skin of the face to rejuvenate the appearance. Surgeons may also use fat injections or dermal fillers to reverse facial volume loss. With these techniques, a facial surgeon can noticeably rejuvenate the face with natural-looking results. But to adequately address age-related bone loss and achieve the most dramatic results, it may be advisable to incorporate facial implants with facelift surgery.

Facial implants are used to augment the facial skeleton in the following ways:

  • Chin implants are used to enhance a receded chin and improve the balance and definition of the profile and neckline.
  • Cheek implants, cheek fillers (such as JUVÉDERM VOLUMA® XC), or fat transfer are used to create a more angular face shape and counteract sagging cheeks.
  • Sub-malar implants or fat transfer are used to restore youthful fullness to the midface by elevating the area below the cheekbones and above the nasolabial folds.
  • Jaw angle implants or facial fillers are used to enhance a small jaw and restore jaw definition loss from sagging jowls.

Since research shows that bone loss occurs as we age, bone implants can be just as important for facial rejuvenation as skin and muscle tightening. Facial implants are long lasting and can enhance the results of facelift surgery. When placed on the facial bones, implants serve as part of your facial skeleton and can support the soft tissues in their newly tightened and lifted positions. Strengthening the facial structure with implants can counteract the loss of bone definition due to aging and restore a youthful, natural-looking appearance.

Do I Need a Brow Lift or Blepharoplasty?

Many plastic surgery procedures and treatments have been devised to rejuvenate the upper face. The forehead and eye area are prone to developing wrinkles and sagging skin that can contribute to an aging, tired, and sad appearance. If it is time for you to take the plunge for facial rejuvenation, you may be wondering whether you would benefit from a brow lift or blepharoplasty. For a quick summary, if you feel you look “tired,” you are more likely a candidate for upper blepharoplasty. If you are asked if you are “angry,” you may be more of a candidate for a brow lift. The following indicators will help you understand which procedure you need (or whether you may need both) to achieve the most desirable aesthetic outcome.

eyelid patient by dr. pearlman

Brow Lift Surgery

Brow lift surgery is a procedure that rejuvenates the upper face by addressing forehead wrinkles and sagging brows. Using either an endoscopic approach or a modification of the traditional coronal lift technique, Dr. Pearlman elevates the forehead and the brows to rejuvenate their appearance. Dr. Pearlman recognizes the general differences in male and female eyebrows and is careful to raise them appropriately when performing brow lift surgery. As a result of this surgery, the forehead will lie smoother and the brows will appear more lifted and natural. Brow lift surgery often eliminates upper face wrinkles and can correct upper eyelid hooding that was caused by sagging brows.

Candidates for Brow Lift Surgery

If the overhang or hooding of your upper eyelids extends beyond the corner of your eyes, then you are certainly more of a candidate for a brow lift. Another indicator is the shape of your eyebrows; if they are flat or the tail is even lower than the central part of the brow, a brow lift will help restore a youthful arch. A candidate for a brow lift will have experienced a distinct drop in the forehead over time and flattening of the arch that has led to sagging brows. If sagging brows have also led to upper eyelid hooding, a brow lift will be able to reverse it. If you look back at an old photograph of yourself and see that the position of your eyebrows has changed over time, you may be a good candidate for this procedure. You may also be a candidate if you have severe wrinkles on your forehead and brow area.


Blepharoplasty (eyelid surgery) is a procedure that rejuvenates the upper face by addressing excess skin and fat in the upper and lower eyelids. The procedure is often separated into upper or lower blepharoplasty, though many patients undergo both at the same time. The surgeon surgically removes excess skin and fat and adjusts the muscle tissue to restore a more youthful appearance to the eyes. Blepharoplasty can restore full sightlines by removing excess upper eyelid skin in severe cases and can reduce fine lines and puffiness in the upper and lower eyelids.

Candidates for Blepharoplasty

A candidate for blepharoplasty will have sagging, excess skin in the upper and/or lower eyelids, usually accompanied by excess fat. Candidates may have prominent upper eyelid hooding that partially blocks their visual field. Bags beneath the eyes, typically caused by pockets of fat, may also be a symptom of aging experienced by blepharoplasty candidates. An old photograph of yourself will reveal whether the position of your eyebrows has changed over time; if it has not but you still have upper eyelid hooding, you may be a good candidate for blepharoplasty.

Candidates for a Combined Brow Lift With Blepharoplasty

Some people identify as candidates for both brow lift surgery and eyelid surgery. When appropriate, it can be beneficial to undergo both procedures. Most often, candidates will get a brow lift with an upper blepharoplasty. For example, a candidate who has pronounced upper eyelid hooding due to a combination of excess upper eyelid skin and sagging brows will benefit most from undergoing both surgeries. Candidates for both procedures may have “tired eyes” as well as an angry appearance due to drooping eyebrows. If you have notably sagging brows, forehead wrinkles, sagging upper and/or lower eyelids, and puffiness or bulging around your eyes, a combined brow lift with blepharoplasty can give you a more youthful and rested appearance.

Non-surgical Brow Lift

There are a number of ways to non-surgically raise the eyebrow. BOTOX® Cosmetic can relax the muscles that pull the corner of the brow down. This loss of resting tone can lead to a nice elevation of the brow. Since it is an indirect effect, we cannot tell in advance who will get the best results from this treatment. Some patients look like they have had surgical brow lifts, and others only subtle changes. We can also use Ultherapy® to raise the brows in some patients.

To find out if you are a good candidate for brow lift, blepharoplasty, or both, please come in for a personal evaluation. Our phone number is 212-223- 8300.

Popular Facial Surgeries for Men

In an industry that has historically attracted women, for the most part, men have recently been getting plastic surgery in ever-increasing numbers. Statistically, surveys from the AAFPRS, ASPS, and ASAPS all show that numerous members of the male population are pursuing minimally invasive or surgical treatments to enhance their appearances. These numbers have been climbing as men become more and more concerned about their appearances and how they are affected by aging. The following facial surgeries are becoming increasingly popular among males, as men learn how they can uniquely benefit from facial plastic surgery.

Male Facial Plastic Surgery patient by Dr. Pearlman

Actual patient of Dr. Pearlman’s


Nearly 26,205 male rhinoplasties in 2016 made it one of the top five male plastic surgeries of the year, according to national statistics provided by the American Society for Aesthetic Plastic Surgery. It used to be that men shied away from nose surgery out of fear of having a feminized or overdone nose. Now, with modern techniques and Dr. Pearlman’s expertise as a facial plastic surgeon, men who are self-conscious about their overly large or unbalanced nose can achieve a more natural, yet still masculine, attractive-looking nose. Dr. Pearlman uses male rhinoplasty to improve the appearance of the nose with an often subtle approach, which can have profound effects. Instead of being “stuck” with a big nose, a man can get rhinoplasty to subtly refine the nasal tissues and restore balance among the facial features.


Perhaps surprisingly, blepharoplasty (eyelid surgery) was even more popular than rhinoplasty among men in 2016, with 28,025 procedures performed according to national ASAPS statistics. Men tend to develop bags under the eyes, which can be corrected through lower eyelid surgery to remove excess fat. The incisions for lower blepharoplasty are hidden inside the eyelid, so there is no visible scarring. For those desiring upper eyelid rejuvenation to correct signs of aging, the technique differs slightly for male blepharoplasty versus female blepharoplasty. Dr. Pearlman avoids feminizing the eyes by moving the upper eyelid incision lower toward the edge and leaving a little extra skin in the upper lids. Eyelid surgery can help men recapture an attractively youthful and masculine appearance.

Facelift Surgery

In a society where a young, strong, and masculine appearance is highly valued, men who have signs of aging and sagging in the face are progressively more likely to choose facelift surgery. A male facelift uses incisions that preserve the natural contour of the hairline. Dr. Pearlman focuses on lifting the skin without creating a pulled appearance. Often, he will place more emphasis on the lower face as part of the procedure, addressing any sagging skin and muscles with a sub-mentoplasty, which are most often the biggest concern for men. A facelift allows men to maintain a natural yet youthful facial appearance as they age.

Brow Lift Surgery

Because of unique facial structure characteristics, men tend to be especially vulnerable to forehead wrinkles and sagging brows as they age. This makes brow lift surgery a desirable procedure to correct a drooping brow and wrinkled forehead. Dr. Pearlman uses small, hidden incisions to raise the brows and soften the forehead. Depending on the patient’s hairline, these incisions may be placed behind the hairline or even hidden in the upper eyelid area. Brow lift surgery smooths away forehead wrinkles and lifts sagging brows to create a more approachable and attractive male face.

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