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

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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.

Do I need fillers, facelift or facial implants?

04Have you ever wished you could enhance certain parts of your face without surgery?

The good news is that you have multiple options.  If you are not quite ready for a facelift or facial implants; a less invasive procedure might be a good start.

Facial Fillers
Fullness in the cheeks is a highly desired feature for women of all ages.  Through our body’s natural aging process, we lose volume from our upper cheeks. Injectable fillers such as Juvederm, Restylane, Perlane, Belotero, Radiesse, and Sculptra are effective in immediately restoring that volume, and are becoming increasingly popular due to their minimal downtime, and immediate results.  These procedures are performed as outpatient procedures, right here in our office, to fill out any area of the face that needs a little lift, or plumping up.

Not to be confused with facial fillers; Botox,  Dysport, and Xeomin are different types of FDA-approved botulinum toxins which are used to relax the muscles responsible for ‘active’ wrinkles.  An example of a common ‘active’ wrinkle is what is known as the ’11’ between your eyebrows.  We call this an ‘active’ line because it is caused by over-activity of the underlying muscles that you use to frown.  In contrast, facial fillers are effective in treating ‘static’ lines which are not due to activity of underlying musculature.  An example of ‘static’ lines are the naso-labial folds, which run from the outsides of your nostrils, to the corners of your mouth.

When you visit our office we can show you examples of amazing results of restoring youthfulness without the need for a facelift or implants.  The combination of toxins and fillers can shave years off of your appearance both quickly, and inexpensively.

The effects of facial fillers varies by the type of filler used.  Some have a duration of just a few months, while other ‘long lasting’ fillers may last up to two years.  Some of these fillers have even been reported to stimulate new collagen growth; such as Radiesse and Sculptra.  This stimulation of collagen rebuilds the face’s natural support structure, and creates longer lasting effects. The wonderful thing about these products that carry what we call a ‘bio-stimulatory effect’ is that they recruit the help of your body’s own natural materials to rejuvenate your face.

Facial fillers are not meant to correct sagging skin along the neck, brow or jaw line. These cosmetic issues may require surgical procedures (although only a visit to see us can help you be sure).

Facial Implants
If you are seeking a more long lasting solution to your facial features, facial implants are a popular option.  In contrast to the injectables that we discussed earlier, which plump up the soft tissues of the face; facial implants go right to the source and give support to what you already have. Facial Plastic Surgeons insert these facial implants at the bone level to enhance your natural bone tissue, supporting the soft tissue above. Because of this, the results of facial implants are much more predictable.

One common method for inserting these implants used by Facial Plastic Surgeons is to make small incisions in discreet areas of the mouth, so the implants can slide into place. Although the procedure is long lasting, it is reversible if results are not optimal for you.

Conclusion
When you make the decision between injectable facial fillers and facial implants, it is important to consider the long-term effects of your choice. If you want a long lasting change, facial implants are probably your best choice. However, you may just want a temporary, or more subtle fix.  In this case, the use of facial fillers; with or without botilunum toxins, can produce amazing results.

If you’re considering a cheek or other facial enhancement, please take a look at our WOW Cheeks procedure in this video and call us for a consultation: (212) 380-1541

Teaching Facial Plastic Surgery

Dr. Pearlman, course director for the AAFPRS

Two weeks ago was the 46th Annual Fall Meeting of the American Academy of Facial Plastic and Reconstructive Surgery. As co-director with Dr. Rick Davis from Miami, Florida, we spent countless hours over the past year working hard to make this meeting a success. From the feedback we received, it certainly was. There were approximately 85 hour-long courses, 9 invited lectures, 10 panels, 7 half day workshops, over 100 vendors, plus a number of special luncheon sessions. By meeting time, all of the hard work was done. We spent most of the meeting just making sure things ran smoothly and that all speakers and panels stayed on time and on topic. 

The most outstanding part was the speakers that we invited. We kicked off with Dr. Timothy Marten from San Francisco, an excellent lecturer on facelift surgery. Dr. Val Lambros presented his unique ideas on facial aging, based on years of studying individuals and how they age and comparing generations within the same family. Prof. Wolfgang Gubish from Stuttgart, Germany, a prolific rhinoplasty surgeon, gave a few outstanding lectures on treating very crooked and devastated noses; a topic on which he is world renown. Dr. Raj Kanodia lectured on his personal technique of subtle rhinoplasty and minimally invasive facial rejuvenation. Dr. Fred Menick demonstrated why he is one of the recognized experts in nasal reconstruction following cancer removal. Dr. Jeffrey Spiegel gave us new insights into beauty with a lecture on facial gender transformation surgery. Three endowed lectures were also given. Dr. Fred Stucker spoke on over four decades of performing rhinoplasty. Dr. Mohit Bhandari discussed the ever growing field of Evidence-Based Medicine. Dr. Richard Linnehan gave an inspiring presentation having flown four Space Shuttle missions. 

Overall, running this meeting was a busy but very rewarding experience. Having been involved in academic medicine for 24 years, I am able to fulfill one of the original definitions of doctor: to teach others.

Steven J. Pearlman, M.D., F.A.C.S.

Facelift in New York; getting even

Don’t get mad.. get even!

Revenge Surgery 

What’s better than getting even when it’s time to move on with your life? In an April article i the NY Post, a number of women were interviewed who were

NY Post, for full text please click on link in the blog

going through life changes. Included in this article is Sue, a patient of mine who, at the time, was scheduled for a face/neck lift. Sue is now over a month post op and feeling great.

Sue is a wonderful lady with the most amazing and sensitive disposition, but her marriage of 12 years was coming to an end. She was also transitioning in another big life change: a new career as a schoolteacher. Like so many young minded women, her face didn’t match her young body and mind. A facelift is just what she needed for an, excuse the pun, “pick me up.”

I expect to be posting her before and afters in a few months when all healing is over, but already she is thrilled and has been told by many friends that she looks like her old self, not someone pulled or “done.”

If you feel like you look dated, you might do with a little tweak or two to get a fresh outlook on life. Revenge is sweet, especially when you look younger than your old spouse!

Facial Plastic Surgery, best patient care in NYC

Reflections from a facebook post

I recently posted new photos of my office staff to my Facebook Fan page, Dr. Pearlman. Yes, I have a Facebook fan page to update friends and interested parties on the latest and greatest in facial rejuvenation. Back to the photos, one “friend” who happens to live in the building where my office is asked “who is the person in the hat.” He well knows it’s the Doorman, Chester Adamik.  Chester is the first and last individual patients see when they come and go from 521 Park Avenue. Doormen in a landmark Park Avenue building need to be diplomats and ambassadors, yet support both the physicians and tenants alike.

I posted the staff photo to demonstrate the extraordinary individuals who go into making the patient experience the most comfortable and pleasant possible. It was at a staff meeting that Chester first came up. We were discussing the process for patient consultations: a patient arrives at the office and is greeted by Salma (Reception manager or as a friend refers to this individual, patient experience coordinator.) Kim is also often at the front desk (patient coordinator.) Forms are then filled out, or turned in since they are now available on our website. They are then escorted to my office to discuss why they are here, with a wait that rarely exceeds 10 minutes.

We discuss patients’ goals and desires as well as reviewing their medical history. We then go to the exam room where I examine each individual and we plan their treatment, surgical and non-surgical. For rhinoplasty and revision rhinoplasty, I really like computer imaging as an excellent discussion tool and establish mutual goals for the surgery. 

Following my examination and any treatments, patients then meet with Kim in the consult room for scheduling and other business matters. To discuss ins and outs of having surgery, Christine (Plastic Surgery RN) is always available. They then finish with Salma. BUT, on the way out, there is always Chester, the last person they see here, who helps them exit with a smile. He is always extra kind, sensitive and helpful with patients who are bandaged from recent surgery.

We do our best to make every patient’s experience the most favorable possible, from the time they enter the building until they exit, refreshed and more beautiful.  Steven J. Pearlman, MD, FACS

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