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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

Considering a Nose Job? Ask yourself these 5 key questions

Rhinoplasty, better known as a “nose job”, is performed to alter the size and/or shape of the nose and is one of the most commonly performed types of plastic surgery. An estimated 77,000 people got rhinoplasty in 2010; while some simply didn’t like the noses they were born with, others needed corrections to previous surgeries or accidents that damaged their noses.

Before opting for any kind of cosmetic surgery, there are some key questions you should ask yourself before going under the knife.

Am I healthy enough to get plastic surgery?

Cosmetic surgery has its risks just like any other type of surgical procedure. The risks are even greater in people who have preexisting health conditions. That is why it is wise to take your health into consideration before getting any type of cosmetic procedure. Your plastic surgeon may require that you receive clearance from your physician.

Have I considered the alternatives?

There are a number of ways you can improve their appearance without getting rhinoplasty. Trying a new hairstyle or wearing makeup are two of the many ways to improve your looks without going under the knife. Makeup tricks can also change how your nose appears, and some cosmetic injectable fillers can alter the appearance of your nose temporarily without invasive surgery.

Am I doing this for myself or to please others?

Far too many women get cosmetic surgery to conform to society’s standard of beauty or to impress someone else. While a nose job, or any cosmetic surgery, can improve your appearance and life, it’s important to do it for the right reasons. Do it for yourself, not someone else.

Can I afford this procedure?

Nose jobs can cost thousands of dollars, depending on the surgeon and the complexity of the procedure. Because most nose jobs are elective, they aren’t covered by insurance. While you may be able to setup a payment plan with your surgeon’s office, you may be expected to pay a significant amount up front. Note that many med spas and clinics accept credit cards, so that’s always an option as well.

Can I afford to take time out of work and school?

In the end, it’s worth it, but in the meantime, you will be sore after your nose job. Patients are expected to stay home for at least a week after surgery and are advised to avoid strenuous activity. Make sure you can afford to miss work or school during this time period and that you have help with daily tasks, such as child care and household chores.

Once all the above answers are “yes” make sure you choose a doctor who specializes in rhinoplasty. Ask your doctor of choice, how many they perform per year, look at their before and after photos and consider computer imaging to make sure you are both on the same page.

 

Copyright 2012. As licensed to Pearlman Aesthetic Surgery. All rights reserved

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.

Nasal Fracture, Broken Noses in New York

What should you do when you break your nose?

This sounds simple but even some doctors don’t know how a specialist in facial plastic surgery treats broken noses. First, there are only two true emergencies when you break your nose. First and most obvious is a non-stop nosebleed. Obviously, get to the nearest ER or specialist and have them treat your nose, which likely requires topical decongestants and/or nasal packing for a few days.

The other emergency that rarely occurs when you break your nose is called a septal hematoma. The same very delicate blood vessels in the septum that may bleed can also bleed under the “skin” or mucosa of the nasal septum. This causes the septum to blow up like a balloon on both sides of the nose with blood that can’t get out. If this blood isn’t drained (by a specialist), it can cause the septal cartilage to get weak and collapse over a few months time causing a saddle deformity (severely scooped nose). So, if you have trouble breathing after breaking your nose, the inside needs to be checked for a hematoma, preferably within 24 hours.

Now to address the nasal bones: If you do break your nose use ice right away and keep in place, 20 minutes on and 10 minutes off for the first two days. If the only problem is shifting of the nasal bones to the side, they can be repositioned by a minor surgical procedure called a “closed reduction.” Unless you are seen right after trauma, the nose is usually too swollen to do this right away. However, after about two weeks, the bones start to heal so the ideal time is somewhere between three days and two weeks. Beyond two weeks, we may need to wait two months for the bones to fully heal before re-breaking.

If there is a simultaneous deviated septum, cartilage heals differently. I prefer to wait at least six to eight weeks before treating the crooked septum. So, if both a nasal bone fracture and deviated septum are present, I delay fixing the broken nose for the stated minimum of six to eight weeks then re-break it when I fix the septum so the patient only has one operation instead of two (closed reduction then septoplasty).

As for a rhinoplasty after sustaining a broken nose, I prefer waiting at least two to three months to let everything heal and settle if I we are to do more than straighten the nasal bones and a deviated septum.

Treatment for a broken nose can be a simple surgical procedure. But if not treated properly, the consequences can be more severe.

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 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.

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