Teaching Facial Plastic Surgery in Las Vegas
I just returned from Las Vegas where I was lecturing at the 7th annual Multispeciality Foundation course on Facial Plastic Surgery. The first reaction from friends is, “oh, Vegas must have been a lot of partying and fun.” This course is so comprehensive that I didn’t want to miss anything, so I was inside the lecture halls from 7 AM until after 6 PM every day for 4 days straight. At night were dinner demonstrations and meetings with the various laser, filler (Juvederm, Restylane, Radiesse, Sculptra, Belotero) and neurotoxin (Botox, Dysport) vendors to see what’s the latest and greatest.
I gave four talks at this meeting. Three were on rhinoplasty:
- spreader grafts for primary and revision rhinoplasty
- What causes nasal obstruction other than a deviated septum
- Treatment of the complications of rhinoplasty
- Wow cheeksTM How to make nasolabial folds look better than just treating the lines.
I also moderated a half day session on eyelid rejuvenation, including lectures on blepharoplasty, browlifts, Botox and fillers for the eye area.
This meeting has an amazing cadre of lecturers, equal numbers from each of the “core” disciplines of cosmetic surgery: Plastic Surgery, Facial Plastic Surgery, Oculoplastic Surgery and Dermatologic Surgery. Attendees can really see how different specialists approach facial aging and the varying ways that internationally recognized experts from each discipline treat facial aging.
This meeting was a true testament to the organizing committee and founder Dr. Randy Waldman; a long time friend and facial plastic surgeon (in that order of importance) from Lexington, KY. He ran a similar but smaller meeting in Newport Beach, CA for 17 years before this and is a true meeting genius.
Steven J. Pearlman, MD, FACS
This morning as I was sitting getting a shoeshine I thought about simple things that make us happy. I was introduced to shoeshines by my fellowship mentor, Dr. William Friedman. He taught me more than surgery and how to treat patients, he also taught style. Out of the blue when he wanted to take a short walk and get a quick “boost,” he would say “let’s go get a shine.” This actually works! So I continued the same tradition with my former junior partner (when I was with a big group), Dr. Eric Cohen. He still talks about it.
Since my move to Park Avenue over 10 years ago, I now go to Jim’s on east 59th St. They have 6 chairs and yet always manage to have a short line.
I figure this is akin to my wife going out to get a mani-pedi, a facial or a new outfit. Amazing what a little thing can do for your spirits. I find that my patients feel the same way after getting a refreshing Probiotic Peel, a little Botox or fillers (Juvederm and Restylane). The peel is performed by Christine Ross, our extraordinary cosmetic surgery nurse; a new peel that doesn’t actually peel but leaves your skin glowing.
A number of patients come in with friends and some mother-daughter teams for quick Botox, maybe some Juvederm or Restylane for the cheeks or lips and then off to lunch in the city. Steven Pearlman, MD, FACS
So, for a quick pick-me-up try a Probiotic facial peel, Botox or even a shoeshine.
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.
Celebrities and Photoshop, is this the norm for magazines?
I am often asked by patients about celebrities and two extremes of results. First, why do they look so good? The second question is why do they look so bad? Don’t they have good plastic surgeons in Hollywood? These questions and comments are a result of the many celebrity focused magazines and TV shows.
From NY Times article
Last week I was sent supposed “before and after” photos of a third-tier celebrity to comment on what she had done; facial plastic surgery or other minimally invasive procedure such as Botox and/or Fillers. The problem was that the “after” photo was so photoshopped that it was a joke. I declined to comment replying to the inquiry, that with the amount of “work” that was done to the photo it could easily be Zsa Zsa Gabor at her current age instead of the forty-something reality TV star.
The N Y Times had an article on that very same topic this week. One former talent agent along with a Dartmouth University computer science forensics expert discussed Photoshop changes on celebrity magazine photos. In a scholarly paper for the prestigious Proceedings of the National Academy of Science, Prof. Farid suggested a software tool for measuring how much a beauty photo has been altered. With this new tool and more “truth in advertising” the consumer would better be able to see what models and celebrities really look like. This could also reduce the often extremely high expectations of individuals seeking cosmetic surgery.
The AMA actually has a policy on truth in advertising. Cosmetic surgeons are supposed to identify when a website or an advertisement has a model and not a real patient of theirs. Of course, before and after photos should always be un-retouched. Lastly, plastic surgeons should identify if the photos on their websites are actually theirs or generic. All before and after photos on my website are actual patients that have given us written consent for use of their photos.
As for the “bad” side of celebrity cosmetic surgery; this is a topic for another blog. I have addressed fillers in past blogs. For some reason, if 1 cc of filler is good for a lay person’s lips or cheeks, for some reason in Hollywood they think 3+ syringes is better.
Celebrities often look better in magazines as a result of Photoshop. Plastic Surgeons cannot do this, so why can the media? Steven J. Pearlman, MD, FACS
“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
Beautiful Lips: Bigger is not better, it’s all about shape – the Cupid’s Bow
New York, NY. I have been fortunate to be featured in the media for two of the most expressive features on the face over the past 2 weeks: lips and eyebrows. This week I will discuss what makes lips beautiful and what doesn’t. On May 4th, Hollywood Life revealed Megan Fox’s new lips. Way overdone, as are a number of other celebrities. While some may look good, most unfortunately don’t; such as Melanie Griffith, Elizabeth Hurley, Priscilla Presley and a host of others. When it comes to lips, bigger is not necessarily better. I was quoted about classic beauty when natural lips ruled. Clara Bow, Gloria Swanson and Carol Lombard all demonstrated well formed upper lips with a cupid’s bow, the true power of beauty. Their lower lips were an appropriate 1 ½ to 2 times the size of their upper lips as it still should be for celebs and patients alike.
As we age, a number of things occur to the lips. They deflate; the cupid’s bow of the upper lip flattens and the lip loses the nice bow shape. The border of the lip loses the nice ridge that defines the lips. To properly restore lip shape, only a half cc of hyaluronic acid filler is necessary, either Restylane or Juvederm. I place the filler just like you do your lipstick. First the lip liner: filler is injected along the border of the lips to re-define the rim and restore Cupid ’s bow. Next the lipstick to fill in the lips: the rest of the filler is placed within the substance of the lips to create fullness to create a soft, subtle pillow. For younger patients seeking bigger lips, I go up to 1 cc. This can be done tastefully for small lips and still look beautiful. The “Cupid’s Bow Lip” technique of mine for lip enhancement was featured in Vogue August 2008.
Actual Before and after lips I enhanced using Restylane, this is what lips should look like:
Tip of the week: lips can be enhanced using the “Cupid’s Bow Technique” yet still look natural, unlike too many celebrities out there.
Steven J. Pearlman, MD, FACS