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

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A Rhinoplasty Story Three Years in the Making.

rhinoplasty surgeryA week ago  I did a rhinoplasty on a very lovely and determined young lady. I first met her in 2010 at the age of 22, when she was a student and waitress. She came to see me from New England because I did a rhinoplasty on a relative of hers and “loved” the result. She was very eager and determined to have a rhinoplasty, but couldn’t afford the surgery and was going to do this on her own.  Over the past 3 years she sent us checks starting at $200 every month.

More recently she graduated and is working in her chosen profession. Since then the checks were more in the $400 range. Finally she called 2 months ago and booked her actual surgery. The balance was paid and she came down with her mother for surgery, who also remembers me from the previous rhinoplasty.

Even though I have done thousands of rhinoplasties, I felt more pressure than usual for this young lady since her surgery was three years in the making. The rhinoplasty went very well and her nose looked great on the table. We can usually tell how a nose will turn out when the surgery goes exactly according to the pre-op surgical plan and how it looks right before we put the cast on and swelling begins. She is also getting married late next spring, so she should look great by her wedding pictures.

Laser Scar Removal vs. Surgical

about-weight-loss-surgery-ga-1 What’s the difference between Laser Scar Removal vs. Surgical ? Laser scar treatment is a modern technique for improving all types of scars.  This also can be accomplished by time tested techniques such as dermabrasion as well. Whether your blemishes were caused by acne, a wound or a medical condition, laser treatments or dermabrasion can help reduce the appearance of the scar. Even if your scar has extended beyond where the initial injury occurred, the built up collagen that has caused this to happen can be removed with laser procedures. For more severe scars or those that are “against the grain” of facial lines see the last section below on z-plasty and w-plasty.

Of course, not everyone should get laser treatments for scar removal. If you have skin already struggling with the pressure of a condition such as psoriasis, it isn’t a good idea to use lasers to reduce scarring. In fact, scar removal on sensitive skin can just make things look and feel worse. There are also some medications that shouldn’t be mixed with laser scar removal.

The basics of how lasers remove scars is by removing layers of skin. Exposing fresh, healthy and ultimately unmarked skin below, you leave each treatment with your scar less and less visible. The laser also activates collagen cells in your skin, the very things that help your skin heal and stay firm. This means that getting laser treatments for scar removal can actually help your skin look, feel and actually be healthier and firmer.

The biggest risk you will be taking in getting laser scar removal is a change in color around the area treated. The sun often makes the color difference more obvious, too. In the case of infections post laser scar removal, antibiotics can keep you healthy and healing.

The most common type of scar removal these days is done with lasers or dermabrasion. This is a simple, low risk procedure that takes less than two hours to complete. Depending on the strength of the scar, more treatments may be needed.

For very severe scars, your doctor may recommend getting it surgically removed or re-arranged instead. Techniques such as z-plasty or W-plasty can improve the appearance of facial scars by re-orienting the scars into what are called resting skin tension lines. Your own wrinkles and facial muscles then help the re-aligned scars to heal better. This type of scar removal takes a lot longer to heal and is usually only done in severe cases. However, it is the more traditional method as laser scar removal is still a relatively new technology. What type of procedure is best for obliterating your blemish is a decision to be made with your cosmetic surgeon.

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

When is it OK for kids to have plastic surgery?

So when is it ok for kids to have plastic surgery? Otoplasty is from the Greek word “to shape,” but specifically refers to surgery to the ears, the most common plastic surgery procedure for children.

The need for otoplasty may come from a congenital defect, trauma, or deformities. Natural proportion, contours, and general appearance of the external ear are managed during the otoplasty procedure.

Otoplasty one of very few facial plastic surgery procedures that are appropriate for young children. Others include procedures to correct cleft lip and cleft palate as well as other craniofacial deformities.

There are three main deformities that may require otoplasty:

Protruding ears that are due to excess cartilage
Lop ears that bend down and forward
Cupped shell ears that may be tiny or without natural creases.
A typical surgery is outpatient and will be completed in two hours.
General anesthesia is used in small children.
Afterward, the childs head is wrapped in a large bandage.
A few days later, the child will visit the surgeon to change to a lighter bandage.
Children will have to restrict activity for seven days after the procedure.
Up to three weeks after the surgery they may need to restrict certain activities.
Up to six months after the procedure they may need to wear a head band to bed to prevent the bending of the ear.
If you’re considering this procedure, please discuss the procedure with a board-certified facial plastic surgeon.

Children’s ears are fully formed by the age of five years old. Most facial plastic surgeons will suggest this as the age to begin considering otoplasty if your child is a candidate. The cartilage in the ear is most pliable at this age and is easier to mold than an adults.

Abnormal physical appearance in children can have long-term psychological affects due to teasing from other children. The younger a child is when they undergo the procedure, the longer they will have to reap the psychological benefits.

What to expect during an otoplasty procedure:

As many parents can attest, young children are usually very resilient. Taking children for a visit to the surgeon can help them become comfortable with the procedure. Computer imaging helps a lot too. Children really light up when they see how they will look with theirs ears pushed back.

To make the surgery easier on your child, you can even bring a special stuffed doll or favorite toy to hold during the procedure to enhance comfort. Filling recovery time with special activities can also make the process go more smoothly.

When total ear reconstruction is needed, a surgeon may graft cartilage from the rib cage onto the ear, to serve as material for reconstruction. Artifical bone like substances such as Medpor are also commonly used. This is called Microtia repair.

Want to see the results of an otoplasty procedure performed by Dr. Pearlman? Watch some of our Youtube videos,  and 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


A Gift.

photo I have been teaching residents since I was a fellow in 1987-88. Teaching surgery and the art of Medicine is one of the most rewarding parts of an academic medical practice. Even in private practice, the residents from the Columbia University/ New York Hospital program continue to rotate through my office.

They learn facial plastic surgery from me.  I get to see green, nubile surgeons grow into mature skilled individuals who then go on to medical practices or fellowships. The gift in the photo came along with two antique mirrors (which I collect) from Ben Talei, MD. He is an outstanding resident with great ambition, skill and a personality to match.

He is going to be an outstanding surgeon and doctor when he completes his fellowship next year.  Tomorrow night is the graduation dinner for the residents as well. Over the past few decades, over 1/4 of the graduating Otolaryngology (ENT) residents choose to pursue facial plastic surgey fellowships. Many attribute that to my mentorship and the example I have set through my teaching and hosting their visits to my office.

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