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

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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

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.

3-D Imaging for Rhinoplasty and Facial Rejuvenation

I’m thrilled to announce that we now have the latest in imaging: a Vectra-3-D

The difference between men and boys is the price of their toys. I have a fabulous new “toy” for my office. It’s called Vectra 3-D imaging. This system uses 6 cameras that take simultaneous photos of your face to construct a 3-dimensional virtual model. This model then can be morphed, like the now old fashioned computer imaging, but with fewer yet more sophisticated steps. What makes this even cooler are the 3-D glasses that give a stereoscopic 3-D view of these images. Here are the main advantages of 3-D imaging;

  • Faces can be rotated and viewed from any angle imaginable
  • Morphing is performed on a 3-D image so it doesn’t need to be repeated for each view as is necessary with 2-D imaging
  • Actual volume changes, such as how much to remove from a nose or add to a cheek or chin are instantaneously available
  • Far superior for facial surgery such as facelifts, facial implants and facial fillers than 2-D imaging, which I felt was great for noses and chins, but not much else

Another advantage of the Vectra 3-D system is the many analysis tools available. Facial contour changes can be evaluated by color changes and actually measured, similar to a geographical contour map. Since I have an academically active practice and like to analyze everything we do to assess improvement and maximize patient results, we can actually measure volume changes following facial fillers. To see a consultation with 3-D imaging please check out this link: http://www.youtube.com/watch?v=MjHOjl5TqGA

 Our Facial Plastic Surgery fellow is currently conducting a study on facial fillers and assessing volumes placed with aesthetic improvement. We want to see how much it takes to get the “Wow” in Wow cheeksTM.

3-D Facial Imaging adds an exciting new tool to facial assessment and is a wonderful device for evaluating facial changes that may and do result from surgery and facial fillers.

Botox and Fillers Doctor Self Treatment

Physician Heal (or treat) Thyself

70% of physicians who offer Botox in their practices actually get treated with Botox and half have actually injected themselves! I designed and conducted a survey along with my co-authors on physicians in core specialties regarding Botox and Facial Filler treatments. This survey was published last week in the Archives of Facial Plastic Surgery. Over 6500 doctors from the four specialties were polled including: Facial Plastic Surgery, Plastic Surgery, Dermatologic Surgery and Oculoplastic Surgery (these are considered to be the core specialties for facial fillers and neurotoxins by the Physicians Coalition for Injectable Safety, http://www.injectablesafety.org).

These astounding statistics speak for themselves. Doctors trust Botox and fillers so much that not only do a majority who offer them in their practices get them, but half of these physicians actually inject themselves. Nothing speaks louder when it comes to trust than findings like this. I am often asked if I would have such – and –such a treatment done on myself or a family member, well here it is.

The third part of this study looked at who else doctors trust to inject them. Two thirds preferred a physician colleague, 27% a Physician’s Assistant, Registered Nurse or Nurse Practitioner. Additionally, two percent of those surveyed allowed non-medially credentialed individuals to inject them. Why? I have no idea but this is not condoned by any of the above groups. So, if you are wondering about the safety of Botox or Facial Fillers, consider what doctors actually do. Steven J. Pearlman, MD, FACS.

Botox, Juvederm, Restylane and Laser Hair Removal in New York

“At What Price Beauty” Check out Today’s Deals

This is the title of an article from the New York Times on April 14, 2011 in which I was quoted. I guess that shows how far behind I am in my blogging. Anyway, the article interviews a number of high end providers such as Oscar Blandi Salon and Jennifer Jablow, DDS, a highly respected dentist. I was asked about placing an offer in Gilt City for discounts on Botox, facial fillers (Juvederm and Restylane) and laser hair removal. I chose Gilt City since I am a regular consumer and I see that they represent quality manufacturers and businesses. My promotion ran in December so people can get a quick fix to look younger for the holidays.

I found the vast majority of patients to be really nice people and high end consumers who were looking to try Botox or fillers for the first time, people looking for a new doctor to perform these treatments on them, and a few just looking for a bargain.

The next question was, would I do this again? I don’t want to repeat this offer for a long time since I don’t want to undercut my loyal patients who have been coming to me for years and paying higher prices and “cheapen my brand.” This sentiment was echoed by a patient on who I had performed surgery last year who owns a boutique public relations firm. She said she was impressed that I was forward thinking in running the offer on Gilt City but that I should “never do that again.”

Steven J. Pearlman, MD, FACS

Frequent Filler Miles, Juvederm and Botox in NYC

First it was frequent flier miles, then hotel chains. We even get to use almost any airline with Amex rewards. I drew the line there. It seems everywhere you turn you can get frequent user points: Starbucks, the local car wash, even nail salons. I choose not to save these cards. But now it’s right here in my office. Brilliant Distinctions is for patients who get repeat treatments with Botox and/or Juvederm. You can accumulate points on their website so that rewards can be accumulated towards money off (from Allergan) on Botox, Juvederm or even donate your points to charity.

To me, this is a no-brainer. As we know, Botox lasts an average of 3 to 4 months and Juvederm from 6 months to a year. To maintain the same level of rejuvenation you then need to return a few times a year to stay looking fresh and young. So, why not sign up?

A few years ago my Botox rep suggested that we have patients come in automatically at around 3 ½ to 4 months as their Botox is wearing off for repeat treatments. At first I thought it was a ploy to sell more Botox. However, by keeping muscles at rest and not allowing them to fully recover they undergo atrophy. That means the facial muscles get thinner from disuse.  This will enhance the smoothing action and after a few years may reduce Botox requirement for steady patients. So, when my receptionist offers to schedule your next Botox appointment right after you just had one, it’s to help maintain your wrinkle-less face.

In summary, Botox and fillers help rejuvenate your face. Timely visits will maintain a youthful look and now can even be redeemed for discounts on future treatment.

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