Schedule a Consult Today!
521 Park Avenue, New York, NY 10065
Tel 212-223-8300
Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

Schedule a Consult Today!

Blog

« Back to Blog

Adventures in Amsterdam Part 2

The second of the course included a live televised rhinoplasty that I performed. This was a stressful, yet exhilarating experience. The patient was recruited by one of the faculty members. She had a deviated septum and was given the option for a cosmetic rhinoplasty by a visiting Professor from the U.S., namely me. I treated her just like one of my own patients. I received the photos by email a few weeks prior. I uploaded the photos into my computer and performed computer imaging on the photos. I then saw the patient the afternoon before for a personal examination and to discuss our plan. Most importantly, to make sure that the patient was comfortable with me and the surgical plan. When the consultation was complete, she was quite excited at the prospect of a new nose. She had a crooked nose and a very wide twisted nasal tip that was over-projected (stuck out too far from her face).

I maintained my routine of doing what Dr. Robert Simons and my mentors always taught: a rhinoplasty is performed 5 times. The first time is when you meet the patient, discuss their desires and perform a thorough nasal examination. The surgery is already being planned in the surgeon’s mind. The second time is reviewing the photos and imaging, often with the patient at a second consult. The third time is the morning of surgery. I review the photos, the written surgical plan and the imaging. The fourth time is actually performing the surgery. For a primary rhinoplasty, surgery rarely deviates from the plan given a careful evaluation and intimate knowledge of nasal anatomy. The fifth time is a year later, comparing the before and after photos to see how the nose actually came out. We critique our own results to help affirm or look to further refine our personal technique. For this young lady, the first two steps were reversed, but the rest adhered to. I had gone over this plan many times in my head before her surgery.

 Back to the surgery, I went to the operating room on Thursday morning, a beautiful newly renovated facility. I was even given bright yellow surgical O.R. clogs to wear. They have them in every size, and are cleaned after every surgery just like the surgical scrubs. I was then wired for sound and off to the surgery. There were three video cameras, one above the patient, a second from the side and a third with a close up view from below the nose. I was quite comfortable narrating my rhinoplasty since I am usually accompanied in surgery by ether a fellow in Facial Plastic Surgery or a resident from the New York Presbyterian, Columbia, Cornell program.  The moderator back in the lecture hall was Prof. Gilbert Nolst-Trenite, a recognized international leader in rhinoplasty education and author of numerous textbooks and hundreds of articles on rhinoplasty.  He asked questions throughout the surgery and related questions from the audience. By the time I started surgery, my butterflies were gone. With a scalpel in my hand, I felt quite at home. Surgery went very well. The feedback during surgery from the other faculty in the lecture hall and attendees was quite positive. 

Thursday afternoon was a relief. Despite having performed thousands of rhinoplasies, this was an exception; the pressure of a live rhinoplasty in front of the symposium as well as a dozen faculty of established rhinoplasty surgeons was now over. I had one more lecture that afternoon.  But first there was a cadaver dissection lab. This is quite routine for me since I have participated in and taught in many of these lab sessions. There is a room with fresh frozen cadaver heads on trays. These are from people who have donated their bodies for medical study. The cadaver heads are always treated with respect and will be used by a number of specialties in pursuit of medical educations. The faculty members helped the attendees perform dissections and surgical techniques on these specimens according to a planned lab manual.

My afternoon lecture was,  “Intra-nasal Rhinoplasty, a dying art?” Another name for intra-nasal rhinoplasty is closed rhinoplasty. This is a topic for another series of blogs. In a nutshell, most young surgeons only taught the open rhinoplasty approach. There are a number of contributing factors for this. However, for most patients, I feel that a skilled, experienced surgeon can get equal results with closed intra-nasal rhinoplasty without an external incision across the bottom of the nose. A better view of the tip cartilages doesn’t automatically make for a better surgeon or better results. It’s as stated prior: precise analysis, understanding nasal anatomy and an armamentarium of sufficient rhinoplasty techniques is what it takes to obtain quality results. This is with or without an incision across the bottom of the nose. 

That night was a banquet dinner for the entire meeting, including faculty and attendees. There were a few speeches and I was honored and surprised with a crystal cut glass wine decanter. At dinner, another faculty member had just arrived for his talks the next day, Prof. Tony Bull from Great Britain. Dr. Bull is recognized as one of the most well respected rhinoplasty surgeons in the world. He also has a tremendous sense of humor that comes out in conversation at dinner plus throughout his lectures.

 

What is a Non-Surgical Facelift?

03Your face often is the first to tell your story. It shows if your life has been one of happiness or sadness, stress or relaxation. It tells how old you are, if you’ve spent your time outdoors or indoors and a slew of other stories about your life. While we all agree that telling our stories can be enjoyable, not all of us want it written all over our faces.

As you age, you may notice these changes to your face that you’d rather not have:

  • Fat loss in the face

Body fat is the substance that gives your face a youthful appearance. Adults that have lost facial volume will have a hollow appearance under the eyes, on the cheeks and through the lips. This will make you look much older than you are — or want to — look.

  • Facial sun damage

Repeated exposure to sun over the years causes less elasticity in the skin fibers. Fine wrinkles often appear as you age, and your skin is often referred to as leathery. If you’ve spent a lot of time in the sun, went tanning a lot when you were younger, or just forgot to wear your sunscreen, you may begin noticing this unsightly change to your skin’s appearance.

  • Extra hanging skin

The loss of elasticity due to less collagen production in the aging body often affects your eyebrows and neck. It can also cause the phenomenon commonly referred to as jowls along the jawline.

Although you may wish to ease these effects of aging, you may also be reluctant to go through surgery. Fortunately, there are newer technologies available which provide a facelift while eliminating the need for surgery.

Fat Injections and Fillers
Though you may have joked about it, a fat transplant really is possible! Plastic surgeons are able to inject fat from your abodomen below the facial skin and plump up the areas that have become hollowed out. However, with all the fabulous new facial fillers we now have, Dr. Pearlman is finding less and less of a need for fat transfer. Why not take something off the shelf that lasts close to a year instead of an invasive fat transfer that requires time off and healing?

A liquid facelift product called Sculptra is also used as an injection to fill in sagging areas. It helps the body create its own collagen with no scarring or negative lasting effects.

Although not technically a filler, Botox relaxes facial muscles. It is best if you have fine wrinkle lines such as those caused by sun damage.

Facial Rejuvenation
The popular product available to stimulate your own body’s collagen production is Thermage. This is a helpful procedure if you have lost elasticity in the face. It applies heat therapy, and the procedure typically only takes an hour. The results are very minor. 

Laser Skin Tightening
The use of lasers has proven successful in everything from correcting vision to removing offending gallbladders. It can also be used for general skin tightening. This is the alternative to the traditional facelift which required cutting and anesthesia and often produced scarring. Again, this is skin tightening and can work great for your skin but won’t lift jowls or saggy neck skin.

Ulthera

Ultherapy is the only non-invasive FDA approved treatment that can specifically target the deep foundation below the skin that is addressed in cosmetic surgery without cutting or disrupting the surface of the skin. It is also the only procedure to use ultrasound imaging, which allows us to actually see the layers of tissue we target during treatment and ensure the energy is deposited precisely to where it will be most effective. Generally patients see about  30% to 50% of the result of a surgical facelift for a quarter of the price.

 Improving your appearance as you age has never been easier.  Remember, in truth there is no such thing as a “non-surgical facelift.” However, marked improvements can be made in skin color, texture, wrinkles and volume loss. Plastic surgery may be just the option for you, except there might not be a need for a scalpel, should you choose to avoid that route.

 

Copyright 2013. As licensed to Pearlman Aesthetic Surgery. All rights reserved

What Should I Know when I Come to New York City for Plastic Surgery?

What should I know when I come to New York City for plastic surgery? Over the past several decades there has been a huge upswing in medical tourism. Medical tourism is the practice of traveling to another locale to undergo plastic surgery procedures. The reason for medical tourism gaining a foothold outside of the US, often in under-developed countries, is largely due to the fact that medical care in such areas is much more affordable. Coupled with a tropical climate and pristine white sandy beaches, people flock to these destinations for combination surgery-vacation jaunts. However, medical tourism may have a downside.

The cost of care may be lower, but many times it comes at the expense of the level of care received. Facility accreditation can be iffy at best, leaving you open to much higher risk than in a hospital or clinic in the United States. Plus if you have a complication after surgery, there is little to no recourse or chance to follow up if you travelled outside the US for surgery.

So, if you have your heart set on the experience of a destination cosmetic surgery coupled with a recuperative vacation, come see us in The Big Apple. New York is an obvious choice when considering contenders for the medical tourism crown. Not only should all Americans visit New York City at least once in their lifetimes, visiting a Park Avenue facial plastic surgeon can give you the experience of a lifetime…the beginning of the rest of your life, if you will. You won’t find that in Barbados!

Our office is located in Manhattan on the famous Park Avenue, just two blocks away from Central Park, a short 16-minute walk to Rockefeller Center and Radio City Music Hall, and a short 7 minute drive to the MET – Metropolitan Museum of Art.

After your procedure, New York City has countless luxurious and elegant five star accommodations for you to relax and recuperate in. In fact, Pearlman Aesthetic Surgery has special arrangements with a number of high quality New York Hotels. The Kimberly is a beautiful boutique hotel with mostly suites in the heart of mid-town, yet price sensitive. For real luxury we have affiliations with the Pierre, Lowell, and Carlyle hotels. Another option is the Affinia Gardens, a hotel specializing in post-surgery care. When some time has passed and you’re feeling up to it, the countless delights of New York City are yours to discover. Try out your new face on a nice stroll through Central Park to the Central Park Zoo, or during a visit to the Museum of Modern Art. Indulge yourself in a trip up to the top of Empire State Building, or a little retail therapy in one of many New York City boutiques.

There’s really no need to take the risk of leaving the good old USA for a cosmetic surgery vacation. It’s safer to do it right here at home. So pack your bags and prepare for an adventure in the city that never sleeps. You’ll come home looking like a million bucks with memories that will last a life time.

To learn more about traveling to New York City for facial plastic surgery for Dr. Pearlman, please visit our Concierge page.

Then call for a consultation: (212) 380-1541

Erasing the Stigma of Plastic Surgery.

facial-treatment-300x285No disrespect meant to a superstar that has passed on, but Michael Jackson gave plastic surgery a bad name and a bad face to go with it. His money and mania took a handsome face and turned it into a Halloween mask. He had so many surgeries that real damage was done to his nose, eyes and lips, but he is not an example of the wonderful effects you can get from plastic surgery. In fact, plastic surgeons are acutely aware that rejuvenation of one’s body or face is accomplished by far less surgical intervention than you might imagine.

I tend to turn down 1 out of 8 patients who come to me for plastic surgery. It’s about understanding what will really help and if someone has realistic expectations. It is actually harder (and takes longer) to turn someone down than to schedule a surgery.

Plastic surgery fanatics like Michael Jackson are anomalies. Most people seek out surgery to repair distinct flaws like overly large noses, weak or receding chins, sagging upper eyelids that impair vision or skin that begins to puddle or wrinkle in the jowls or neck area. Surgical intervention is often needed to fix unsightly flaws and desired even if all you want to do is look better but not necessarily different or decades younger.

Facial rejuvenation can even be accomplished without invasive surgical procedures today, and looking good, healthy, refreshed and happy does not carry with it a single negative connotation. On the contrary, erasing frown lines, lifting eyelids, sculpting chins and reshaping noses can give you an appearance that honors and enhances your own natural good looks without anyone realizing exactly why you look so rested, youthful and attractive. Ethical plastic surgeons will only make subtle and/or necessary changes to your face or body. A plastic surgeon may reshape a large or wide nose to a size more suitable for your face, but should never replace it with an upturned, button nose.

A chin implant can add symmetry to your face but won’t give you a Jay Leno jaw; a brow lift will make you look rested and beautiful, not unnaturally bug-eyed. The miracle of today’s plastic surgery is that small alterations can make huge differences in how you look to yourself and others. You’ll look like you, only better! There’s no stigma in that!

 

Copyright 2013. As licensed to Pearlman Aesthetic Surgery. All rights reserved

 

Cosmetic Treatments and Surgery Increasing in Men and the Alternative to Facelifts.

 Cosmetic facial treatments and surgery increasing in men according to the official AAFPRS stats. I have found the same in my practice. More men are looking to look refreshed.

The face ages in five ways, there are skin changes, dynamic lines,loss of facial volume, loss of elasticity, and the effects of gravity. So when treating these signs you needed to address the specific issue. Improving dynamic lines by using Botox. We treat the skin with lasers and skincare products. We restore facial volume with a procedure we call “Wow cheeks”. However the procedure isn’t fully effective because the real issue is loss of facial volume as well as cheek volume. So fillers will help with cheek volume but it’s not going to lift the tissue. What you really need to do is restore and re-suspend the tissue.

So what do we have that can do this? A Facelift, which re-suspends the tissue by tightening the muscle and lay the skin down gently. Until recently we’ve had no other alternative for this procedure. That is until Ultherapy, the first FDA approved non-surgical face and neck tightening procedure that uses high frequency ultrasonic technology that penetrates all 4 1/2 MM of facial tissue. This restores the jaw lines, the neck, the jowls, and even the brow line.

These are the exact layers I would treat while doing a facelift, without having to preform surgery. Patients will get anywhere from 30% to 50% of the effect you would when getting a facelift. But there are no incisions  it’s a quater of the cost, minimal bruising if any, little down time, and patients can return to work the next day.

Ultherapy is an amazing alternative for either men or women who are considering plastic surgery but either cannot afford the full price or cannot afford being away from work for more than a day.

I talk more about Ultherapy in this Youtube video which you can watch by clicking here or the image above.

Facelift in New York: turns a Ma’am back into a Miss

I recently performed a facelift on a very popular and stunning 50-something lady. I have known her for years and have been treating her with Botox and Fillers for cheek definition; Wow cheeksTM. These treatments didn’t really help her jowls that much. Along with many wonderful features, she always had a beautiful jawline but over the past few years even that was starting to droop.
A few weeks after her facelift, she came in glowing. She was in a store and a young male clerk referred to her as “miss.” She said she hasn’t been called “miss” for years and was really getting tired of getting called “ma’am.” The next visit she was glowing again: on the way to her visit she was visibly “checked out” by a group of 20-something young men. These were both feelings and situations that she was certainly used to in her 20’s, 30’s and even into her 40’s. Now as a 50 year young lady, that star is back.

Back To Top