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

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Torn Earlobe Repair Is Easier Than You Think

Earlobe repair by Dr PearlmanHow many of you have been walking around for years with torn or elongated earring holes? Are you avoiding wearing those expensive diamond studs you got for some special occasion?

The ears add to the overall aesthetics and balance of the face. A torn earlobe is unattractive and can draw attention away from other facial features. The biggest culprits causing torn earlobes are babies, sweaters, and hairbrushes. Additionally, earlobes may have stretched from years of wearing heavy earrings. Or maybe you have intentionally stretched your earlobes during the recent trend but have now decided you no longer want gauged earlobes. Whatever the reason, earlobe repair is a quick and easy fix.

Repairing Your Earlobes

Earlobe repair is a surgery intended to close any gaps and restore the earlobe to its original shape. The procedure to repair the earlobe is fairly quick, painless, and considered minimally invasive. The surgery is performed in an office-based facility under local anesthesia to numb the area, and it typically takes around 20 minutes per ear to complete. During the procedure, the side of the earlobe that is split or torn is removed and then sutured back together. We may use sophisticated surgical techniques such as z-plasty or a rotation flap.

After Surgery

There is no downtime following earlobe repair surgery, and dressings are unnecessary after the procedure. Patients typically return to work the very next day. Bruising is usually minimal at the suture site, though slight swelling and redness can be expected in the treatment area. These side effects are temporary and should subside within a few days. Though not expected, if pain medication is required, an over-the-counter oral medication, such as acetaminophen (TYLENOL®), should be sufficient.

Patients may be instructed to apply an antibiotic ointment two times daily for one week, depending on the physician’s preference. Patients will be advised to avoid strenuous activity to keep swelling to a minimum and ensure proper healing. Seven to 10 days after surgery, the sutures will be removed and the healing progress will be assessed. Scarring is minimal, and earlobes can usually be pierced again in approximately six weeks if desired.

Reducing Earlobes.

Sometimes we may even reduce the size of aging, pendulous earlobes as a single procedure or combined with facelift surgery.

Reshaping Ear Defects

Ear surgery, medically known as otoplasty is a more complex procedure and will be discussed in more detail in a future blog. Otoplasty includes surgical and non-surgical procedures to address congenital or cosmetic defects of the ears. In reshaping the outer ear, ear surgery can correct deformities and improve appearance, thus improving self-esteem and instilling confidence in the patient. Some of the issues that reconstructive ear surgery can address include:

  • Protruding ears
  • Lop ear
  • Constricted ear
  • Microtia

Many issues of the outer ear can be corrected with ear surgery. It’s worth it to see what ear surgery can do for you. If you are interested in earlobe repair or have misshapen ears, seek out the experts at Pearlman Aesthetic Surgery. Contact our office at 212-223-8300 to schedule your consultation today.

How Many Times Can I Get Revision Rhinoplasty?

Pearlman Revision Rhinoplasty Patient

Actual revision rhinoplasty performed by Dr. Pearlman (he did not perform the first surgery).

With the nose being the focal point of the face, it’s no wonder why rhinoplasty is a popular cosmetic procedure. Rhinoplasty is considered the most technically challenging cosmetic facial surgery because of the nose’s complex contours and intersecting concavities and convexities. Sometimes, a procedure does not go as planned. Whether it is a failed procedure or your dissatisfaction with the results, up to 15 percent of primary rhinoplasty patients seek a revision.

While there is no set number of how many revisions can safely be performed, with each revision rhinoplasty comes a new set of challenges. Revision surgery is more complex than the first surgery, and additional surgeries may have a higher rate of complications than the first unless performed by an expert in revision rhinoplasty and if a patient is not willing to accept less than 100 percent improvement.

The Complexity of Revision Surgery

After the initial or primary rhinoplasty, scar tissue begins to form because the skin is separated from the crucial infrastructure of the nose. This trauma to the soft tissue may cause the skin to weaken and thin. The skin may then become thinner and less forgiving of hiding any imperfections that may be present underneath. We call that shrink-wrapping.

Furthermore, primary rhinoplasty is typically a reduction of the tissue and structure of the nose. Special care must be taken to maintain structural support to the infrastructure of the nose every time a reduction is performed. Further reduction could lead to a weakening of the nose if support has been lost.

Also, when the primary rhinoplasty is performed, the surgeon will use the natural landmarks of the nose as a guide to navigate its anatomy and make safe, predictable changes. In a revision, the anatomy has changed, making it more difficult for the surgeon to navigate the aesthetics of a patient’s face. We now use grafts, most often from the patient’s own cartilage, to restore structure and strength in revision rhinoplasty and even in primary rhinoplasty to reduce the need for potential revision surgery the first time around.

Realistic Expectations

With an initial rhinoplasty, a patient is excited and hopeful of the outcome. After a patient has had nose surgery that did not come out favorably or had dissatisfying results, that patient may be more skeptical and anxious about the revision. An individual will pay more attention to minor imperfections that may have been overlooked in the primary surgery. It is important for any individual considering revision surgery to keep realistic expectations and communicate effectively with their surgeon about possible outcomes.

Picking the Right Surgeon

It is always advised to choose a board-certified facial plastic surgeon. Due to the complexity of revision rhinoplasty, it is beneficial to look for a specialist who has performed a high volume of revisions. Dr. Pearlman has performed revision successful surgery on patients who have had even four or more prior surgeries on their nose. As long as you respect the skin and restore support, noses can be operated on with predictable success. Despite all the challenges mentioned, a great outcome can be achieved when you choose a surgeon with specialized experience.

If you are unhappy with the appearance of your nose, schedule your consultation with Dr. Pearlman to discuss revision rhinoplasty options. Call our office today at 212-223-8300.

What Is the Cupid’s Bow Technique?

Beautiful young woman face fragment with natural smileLip enhancement has rapidly become one of the most requested cosmetic procedures, and it is primarily due to the rising trend of large, luscious lips seen on social media. Younger women are interested in achieving ideal, popular lip fullness, while older women want to restore the lip contour they once had. Whatever the reason, the desire for full lips is in full swing.

Unfortunately, while the number of requests for lip enhancement is rising, it doesn’t always mean that the quality is following suit, and a poorly done lip enhancement can be spotted even from a distance. True lip enhancement is intended to do just that: naturally and beautifully enhance the lips, not triple their size by creating the less than natural “fish-like” look. This is where experience and attention to detail come into play. When enhancing lips through the Cupid’s Bow technique, voluptuous, natural-looking lips are possible, without the “trout pout.”

Say Goodbye to Lip Liner

Lip enhancement is usually performed with hyaluronic acid fillers (such as Restylane® or JUVÉDERM®) to add subtle fullness to the lips. While this can provide ideal results on its own, the Cupid’s Bow technique can raise your lip enhancement up a notch, giving you your best lips ever. The Cupid’s Bow technique involves using small amounts of hyaluronic fillers along the border of your lip (the area you would apply lip liner) to sculpt and define the “cupid’s bow.” Then a small to moderate amount of filler is added to the body of the lips to enhance fullness. This is just like applying makeup to your lips. First is the lip liner followed by the lipstick. The small ridges from the upper lip to the nose, called philtral ridges, can even be enhanced if desired. BOTOX® Cosmetic can even be used around the lips to soften any lines.

Attain Natural-Looking Lips

The Cupid’s Bow technique allows for subtle, natural-looking improvement, upholding the belief that sometimes less is more when it comes to cosmetic beauty. The amount of fillers used in each area of the lips can be individualized to your needs and desires. The best results are the ones that others cannot identify—the ones that promote youthful, luscious lips. Cupid’s Bow lip enhancement brings definition and sultriness to the lips of women of any age without going overboard.

If you are interested in full, luscious, yet natural lips, seek out the lip experts at Pearlman Aesthetic Surgery. Please call Dr. Pearlman to schedule your consultation today.

Thread Lift vs. Facelift: Which Is for You?

Portrait of beautiful healthy happy smiling mature woman with curly hair When it comes down to correcting facial aging, you have many options ranging from non-invasive to minimally invasive to an actual surgical procedure. While all of these techniques aim to restore youthfulness and rejuvenate the face, the results they offer are not equal, and therefore the procedures should not be considered interchangeable. This is especially important between thread lift surgery and facelift surgery.

Both the thread lift procedure and facelift surgery improve sagging skin on the jowls, cheeks, and neck. However, while these may treat similar signs of aging, they are not substitutes for each other, and the difference between these go far beyond the fact that one is minimally invasive and the other is surgery. While both of these procedures can leave you feeling younger and revitalized, each is distinctively designed for specific candidates. The hard part is determining which may be right for your level of facial aging.

What Is a Thread Lift?

The Silhouette InstaLift™, also called a thread lift, improves the appearance of facial sagging and visible signs of aging with the use of dissolvable surgical threads. These threads work to “lift” the underlying tissues of facial structures that have been impacted by gravity and the loss of collagen. Once these threads are inserted and anchored, collagen production is stimulated, which allows for lasting results. The Silhouette InstaLift™ is non-surgical, minimally invasive, and provides natural-looking rejuvenation of your cheeks, jawline, and neck. We like to tell patients that you will get about 25 percent of the result of a surgical facelift with a thread lift.

How Does Facelift Surgery Differ?

Unlike the Silhouette InstaLift™ that uses the insertion of threads to mildly lift and tighten the underlying muscles, facelift surgery removes excess skin on the lower to midface while significantly tightening the muscles. Facelifts restore a more youthful appearance and can noticeably improve sagging jowls, vertical banding on the neck, and loss of volume in the midface. There are several levels of facelift surgery available depending on your needs. These range from the “mini-lift” that focuses on early signs of aging in the jowls and lower face to the “deep plane lift” that provides extensive rejuvenation of the jawline, jowls, midface, cheeks, and neck.

Which Procedure Are You a Candidate for?

Both of these procedures are suited for those in good physical health with realistic expectations. Candidates who have noticeable and significant aging indicators such as extensive sagging, deep creases, jowls, and drooping skin under the chin are likely best suited for facelift surgery. While the Silhouette InstaLift™ will subtly reverse the early signs of aging, it cannot reach the same level of correction of traditional facelift surgery. The Silhouette InstaLift™ is typically ideal for younger patients experiencing the onset of facial aging and skin laxity. These patients are those who wish to delay the need for surgery and want to combat the signs before they worsen. This procedure is also best for patients who have already undergone facelift surgery but require a “touch-up” due to further skin laxity.

Dr. Pearlman is a facial plastic surgeon who has been in practice for almost 30 years. When it comes to the face, for both surgical and non-surgical facial rejuvenation, you should trust your face to a facial plastic surgeon. Contact our office at 212-223-8300 to schedule a consultation to see what facial rejuvenation treatment would be best for you.

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.

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