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

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Plastic surgery – reconstructs your self-esteem, too.

ultherapy1A rhinoplasty can do more than rebuild your nose – it can build confidence, too.

Looking good is something that everyone wants and there is nothing wrong with that. If a little bit of plastic surgery is going to give you the confidence that you need to take that extra leap, either professionally or socially, then cosmetic plastic surgery is something you shouldn’t feel ashamed to consider.

This is especially true if there is something about your appearance that makes you want to hide or keeps you from exploring new opportunities due to fear and anxiety.

This isn’t only for cosmetic procedures like nosejobs, accident victims also fall into this category and tend to be great candidates for reconstructive  facial plastic surgery.  This may affect your social life, love life, or even your willingness to take professional risks like public speaking or leadership positions.  While your surgeon will recommend that you receive mental health care to deal with any emotional or psychological trauma you suffered during your accident, he will be able to assist you with the physical trauma and scars to help you along as well.

It’s important to note that facial plastic surgery is a major operation, so choose your surgeon wisely.   An unskilled doctor could, instead of raising your self esteem, botch a procedure and leave you worse off than when you started. In fact, many skilled plastic surgeons who are very talented in body plastic surgery procedures do not achieve the same results a facial plastic surgeon can for facial cosmetic surgery procedures as they do not specialize. Also, make sure you ask you friends and family for references and then do a check with the national medical association on your doctor. Ask your doctor to see before and after pictures of other patients they have worked on. This will give you the courage to go ahead with your plastic surgery.

Plastic surgery can take years off of your face & neck. Live like a celebrity, and treat yourself to a more attractive you.

Call for a consultation today: (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.

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

Revision Rhinoplasty and Septoplasty in New York

The new Flexible PDS Plate is a great tool for difficult revision rhinoplasty, septoplasty and even for children with smashed noses

In November, I blogged about my initial experience with the newly approved flexible PDS plate for a difficult revision nasal septoplasty. That patient is now three months post op and doing very well. He is breathing much better after I performed his third (my first for him) septoplasty.

Last month I operated on the 6 year old I talked about in that blog; I will call him “N.” N is a cute, energetic little boy who just can’t stop smiling. He smashed his nose at Yankee stadium last summer. He had severe swelling inside his nose that looked like a hematoma. Nasal septal hematoma is one of the very few emergencies you can have that accompanies a broken nose. Blood collects and swells the inside of the nose. If the blood is not removed quickly, the nose can collapse. So, a colleague brought N to the operating room under the assumption N had a hematoma. What the surgeon found was that the cartilage was so damaged that it was zigzag with portions lying horizontally instead of vertically, mimicking a hematoma. However, due to severe alteration of his nasal septum his nose collapsed anyway, despite the rapid care he received. This doctor subsequently referred N to me for revision surgery.

After allowing the nasal cartilage to heal, I operated on N in early December. Externally his nose had collapsed and what we call a “saddle” nose. This may be subtle I the photos but would get exaggerated as he grows. When I opened up his nose, I found pieces of septal cartilage pointing in every direction and parts overlapping. I used the flexible PDS plate to rebuild his nasal septum and restore a natural nasal profile. That was accomplished by actually removing the entire nasal septum and rebuilding it on a back table using the flexible PDS plate as a template hold the fragments straight. Because the cartilage was partially destroyed, I also used some cartilage from the flat part of his ear (so it would not show any deformity whatsoever after healing) to fill in missing pieces.

The new septum was stitched back into place and the remaining middle third cartilage (called the upper laterals) and the tip cartilages were elevated and sewn to the newly repaired septum at the restored height. This has been commonly used by rhinoplasty specialists in Europe for many years but is still very new in the U.S. since flexible PDS plate use was only FDA approved in September 2010.

N is doing extremely well. He and his parents report much better breathing and he is no longer snoring at night. N also says that he can smell everything better.

I feel strongly that the new Flexible PDS Plate is an excellent tool that will improve results in difficult revision rhinoplasty and septoplasty and for correcting very crooked noses, even for pediatric cases.

Revision rhinoplasty and Revision septoplasty innovations with a PDS Plate

PDS Plates, the latest and greatest in revision rhinoplasty and septoplasty.

Two weeks ago I was lucky to get a sample of the new PDS plate to use in a tertiary revision septoplasty case. The PDS plate is made of the same material that is used in my favorite suture material for sewing cartilage in rhinoplasty. PDS suture material lasts around three months, long enough for healing and long lasting cartilage bonding to take place but not so long that the body rejects it and tries to “spit” it out. The PDS plate has been around in Europe for a number of years. European colleagues have talked about it in their lectures and published on it in 2005: Dr. Wolfgang Gubisch, Archives of Facial Plastic Surgery vol 7, July/Aug 2005 and Boenisch and Trenite also in Archives of Facial Plastic Surgery vol 13 Jan/Feb 2010.

Finally us of the PDS plate for nasal surgery was FDA approved for use in US early this fall. The parent company, Mentor, was well represented at the AAFPRS (American Academy of Facial Plastic and Reconstructive Surgery) meeting in Boston with very informed vendors and an armful of papers documenting the advantages of using PDS plates.

After all that fanfare, I had the ideal case 2 weeks following the meeting (2 weeks ago); a gentleman who had two prior deviated septum operations with persistent nasal septal deviation and nasal obstruction. What he needed was to have the septum taken completely apart and have something like this plate to hold the healing cartilages pieces in place as the septum heals straight. After all this buildup, I was told that they were back ordered and the product wouldn’t be available for many weeks. Well, it pays to have a good relationship with a superb rep. She was able to procure a plate for me in time to use for the surgery and I really think it will help get a superior result.

This weekend, I am an invited guest to go to St. Louis to hear lectures by the doctors who invented and perfected the use of the PDS plate as well as a lab demonstrating the many ways they suggest it can be used. Fortunately for me and my patient, I had a jump start on the process.

By the way, I already have my next case in mind. This is a 6 year old boy who smashed his nose last summer and had a failed attempt at fixing his destroyed septum. His nose is also collapsed. I believe the PDS plate will help restore a straighter septum nasal height with less surgery than he would otherwise require without it.

I really feel that the new PDS plate is an excellent new product that will help enhance the results in revision rhinoplasty and revision septoplasty.

Rhinoplasty, Revision Rhinoplasty and teaching Facial Plastic Surgery

It’s been a few weeks since my last post. I have been quite busy, academically. I was lecturing in a course on Rhinoplasty in mid-September in St. Louis. The following week was the AAFPRS annual meeting followed by lecturing last week at the ENT (Ear Nose and Throat) annual meeting.

The week before last was the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Over 800 facial plastic surgeons from around the world were in attendance. I really enjoy going to this meeting for three reasons:

  1. From attending and lecturing at 4 to 6 meetings and courses per year, I have made some great friends given our mutual interests and backgrounds.
  1. I get to lecture to peers and young physicians on surgical techniques that I have mastered such as rhinoplasty and revision rhinoplasty.
  2. I learn from my peers. If I pick up at least two pointers at a meeting, I deem it a success. The most learning is done in the hallways between lectures, when I can get the real scoop on the latest techniques and lasers right from the innovators.

 

As for social events, the past president’s dinner is always at a top restaurant. This is one group that no one can join, buy in or donate to attend. As a past president of the AAFPRS we are invited to a black tie dinner where we socialize and really discuss very little medicine. The next night was another black tie function, the founders club. This is always held at an unusual venue. This year it was in Fenway Park, a fun place to visit as a long time Yankee fan.

I gave three lectures and seminars. I taught a course in revision rhinoplasty. I pointed out the most common things I see that brings patients in to see me for revision surgery and discussed what likely went wrong. The best treatment is doing things right in the first place and avoiding the need for revision surgery. I also included a description of how I restored these noses to a normal appearance and function.

My second lecture was given with Wendy Lewis, who is a world authority on plastic surgery. She lectures to physicians around the world, advises potential patients about what and who is best for them to see. Wendy has written 11 books on cosmetic surgery. This seminar was on how to talk to patients and media in “non-medical” speak. Too many doctors address patients and writers/reporters in technical terms that leave heads spinning.

My third lecture was at the ENT (otolaryngology) meeting the following week. I went back to Boston for the day to teach a course on the nasal valve with Dr. Maurice Khosh. We discussed this important area of nasal anatomy and physiology, and how it is important to respect as well as sometimes strengthen the nasal valves in rhinoplasty.

Next week I will review what new educational pearls I picked up that I am going to use to improve my surgical techniques.

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