Welcome to Delicate template
Fernando Burstein MD, Facial Plastic Surgeon
Just another WordPress site
Fernando Burstein MD, Facial Plastic Surgeon
Just another WordPress site
Fernando Burstein MD, Facial Plastic Surgeon
Just another WordPress site
Fernando Burstein MD, Facial Plastic Surgeon
Just another WordPress site
Fernando Burstein MD, Facial Plastic Surgeon

Having been a board certified plastic surgeon and otolaryngologist (head and neck surgeon) practicing facial cosmetic and reconstructive surgery for over 25 years, I have seen plastic surgery technology and techniques evolve a great deal.  Often, patients have misconceptions about cosmetic plastic surgery procedures based on outdated information.  Here are a few of the questions I am most commonly asked along with answers to clear up some of the confusion.

What is the difference between a brow lift, an upper facelift, and a blepharoplasty?

facial plastic surgery misconceptionsAll three of these procedures target the upper third of the face, from the area around your eyes to your hair line, so it can be easy to get them confused.  However each of them addresses different, highly specific concerns.  A blepharoplasty is the least invasive of the three but is designed only to remove excess skin and fat deposits from the eyelids, giving them a wider, more rested look.  Sometimes however, the eyes seem hooded not because of the eyelids, but because the entire brow has begun to sag.  These cases require the somewhat more extensive brow lift, which tightens the connecting muscles and tissue that have generally become slack over time.  But while a brow lift may alleviate the appearance of frown lines that can occur between the eyebrows and above the nose, it does nothing to address larger forehead furrows.  For this, an upper or even full facelift may be required.

Is a double chin better treated with facial liposuction or chin augmentation?

Every patient is different and the individual idiosyncrasies of facial architecture usually determine which course would be more advantageous.  If the angles of the profile indicate that the chin is set too far back, a chin implant may be able to provide a better forward displacement.  However, in these cases, I often prefer to use the patient’s own natural cartilage or fat in lieu of an artificial implant to alter the angle between the neck and the chin and create a more sharply defined profile.  On the other hand, weight gain or the inevitable sagging of facial tissue can sometimes create the illusion of a small, ill-defined chin when this is actually not the case.  In these instances, liposuction of the neck can often create much the same effect without the need for chin surgery, or genioplasty.  I have also found that the most dramatic results can often be achieved by combining these two procedures during a single surgical operation.

 I have heard that nose surgery, or rhinoplasty, has a particularly long and painful recovery period because the nose often needs to be broken.  Is this the case?

While this may have been the case years ago, advancements in surgical techniques have made rhinoplasty a far more delicate and subtle procedure.  The breaking of the nasal bones, known as a lateral osteotomy, is now only performed in order to close the large gap that can be left when a sizable dorsal hump is removed or to significantly narrow the nasal base.  For these ostemtomies, I prefer to use an intranasal approach with a tiny (2mm) osteotome, which allows me to achieve very precise and stable results.  In many cases, however, smaller humps can be gradually shaved down without the need to break the nose and, of course, even if breaking the nose is necessary, sedation and anesthesia would allow you to sleep through the entire procedure.  During recovery, the temporary discomfort from the breaking of the bones is similar to a very mild headache.  Typically, the initial swelling after a rhinoplasty procedure subsides within a few weeks, however individual recovery times can vary depending on the physiology and natural healing rates of individual patients.

If you are interested in a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Additionally, some reconstructive procedures may be covered by insurance, and Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care CreditSM, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

Aging is a natural and unavoidable part of life.  As we grow older, collagen production within the skin begins to slow, and elastin, the substance that enables skin to snap back into place, comes to provide a bit less spring, leading to the formation of facial wrinkles.  Dead skin cells no longer shed as quickly and the turnover of new skin cells decreases, making the skin look dull and dry.  How quickly this process unfolds is determined, in large part, by our genetic background.  Tiny telomeres at the ends of every chromosome grow shorter and weaker over time, allowing the chromosome to “unravel” and contributing to the deterioration and death of the cells.  Simply put, the information encoded in the genes plays a major role in determining whether one experiences the first signs of facial aging in their twenties, or whether one remains youthful looking well into their forties.

facial rejuvenationWhile these intrinsic, genetic causes of aging are usually best treated by surgical cosmetic procedures, there are also a number of extrinsic, or external, factors that often act in concert with the normal aging process to prematurely age the skin.  Many of these factors can be intercepted with simple changes to ones everyday lifestyle or treatable with comparatively minor, non-invasive techniques.

The Sun
Sun exposure is actually the one external factor that plays a larger role than our chronological age in determining the appearance of the skin.  In fact, according to some estimates, as much as 70% of the skin’s aging process depends on the amount of sunlight the skin is exposed to throughout its life.  Aging caused by exposure to the sun’s rays, or photo-aging, develops over a period of years.  Repeated exposure to the sun, even for just a few minutes a day, can slowly destroy the skin’s ability to repair itself, allowing the damage to accumulate.  Long term ultraviolet (UV) exposure not only breaks down collagen, but also impairs the ability of the skin to synthesize new collagen.  The sun also breaks down elastin, making the skin loose, wrinkled, and leathery.  Fortunately, many of these symptoms can be minimized or even eliminated with laser skin resurfacing procedures.

Stress and Sleep
The body responds to physical or emotional stress by dramatically increasing its production of stress hormones, like cortisol and adrenaline. These stress hormones accelerate the various aging processes and inhibit the normal growth of connective tissue.  Prolonged periods of stress also interfere with the ability of the telomeres to regenerate, contributing to premature cellular aging.  Conversely, adequate sleep is essential to the body’s repair and regeneration processes.  A continuous night’s sleep is actually one of the few times during the day that the adult pituitary gland secretes growth hormone, and it is this hormone that encourages the body to produce young, vital cells that can replace those lost to the natural aging process.  In many cases, this natural connective tissue can be restored with injectable facial fillers, like Juvéderm®, or autologous fat transfer techniques.

Smoking and Alcohol
It is generally typical for fine lines and wrinkles to appear on places where the skin is very thin, such as the sides of the eyes and above the upper lip.  However, these lines usually appear 10-15 years earlier in smokers than in non-smokers, largely because of the reduction of vitamin C levels in their blood.  Vitamin C is a key component in the production of collagen fibers, which are responsible for the elasticity and appearance of youthful and healthy skin, and its lack severely impedes the proper production of this vital substance.  Additionally, the accumulation of toxic breakdown products in the deeper skin layers, which can result from drinking excessive amounts of alcohol, can cause damage to both skin texture and color, exacerbating the appearance of capillaries and redness of the cheeks and on the nasal bridge.  Fortunately there are several, non-invasive techniques designed specifically to alleviate this kind of damage.  The Ultheraphy® skin tightening system, for example, uses high frequency sound, similar to that used by an ultrasound machine, to strengthen underlying layers of skin by gently stimulating collagen production.

If you are interested in learning more about facial aging or a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Additionally, some reconstructive procedures may be covered by insurance, and Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care CreditSM, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

As a board certified plastic surgeon specializing in cosmetic and reconstructive surgery of the face, I have had the opportunity to study faces of every conceivable age and in over twenty-five years of practice, I have gotten a chance to observe first-hand how individual faces evolve and develop over time. I believe that understanding exactly how age can change the appearance of the face is essential in minimizing the effects of facial aging and achieving the best possible cosmetic plastic surgery results.

facial rejuvenation atlanta gaRecent studies have suggested that many of the changes associated with facial aging are actually more than just skin deep.  Researchers have carefully analyzed computer tomography (CT) scans of the facial bones of young people (age 20 to 40), middle-aged people (41 to 64), and more mature-aged people (65 and up).  Detailed measurements of these three-dimensional reconstructions reveal several important differences in the facial bone structure between the age groups.  Simply put, the bones of the face really do change and undergo an overall decrease in volume with increasing age.  For example, the area of the eye sockets increases significantly, becoming wider and longer in both men and women.  The bones of the middle and lower parts of the face are affected as well.  Researchers found reductions in the angles of the brow, nose, and upper jaw bones and a general decrease in the length and height of the lower jaw.  By taking these structural changes into account, I have been able to significantly improve the results of the facial rejuvenations I perform by incorporating facial contouring techniques to augment and sculpt the bones of the chin and cheeks.

As you leave your teens and enter your twenties, the face generally begins to lose the “baby fat,” shifting from a plump, child-like appearance to a slimmer, more adult look.  Although most people in this age group welcome this change, it is, in fact, the beginning of facial aging.  Expression lines, those tiny lines and creases related to facial movement, start to appear on the brow and around the eyes as facial volume diminishes.  Over the next decade, the skin of the face begins to look “tired” as the skin loses more volume and starts to sag.  Crow’s feet around the eyes become more noticeable and previous sun damage may worsen the appearance of small brown spots.  Many of the blood vessels in the face, particularly around the sides of your nose, may begin to dilate, becoming visible beneath the skin.  Facial creasing becomes more evident as well, manifesting as frown lines, those “dreaded 11’s” that pop up between the brows, and the deepening of the nasolabial lines around the mouth.  Many have suggested that injectable cosmetic treatments like Botox® can be particularly effective at this stage.  Evidence seems to indicate that, if you start early, you can actually stop these wrinkles from getting worse and that, in the long run, you’ll need much less to maintain a youthful appearance.

Eventually the skin begins to suffer a massive breakdown of collagen and elastin fibers, the support structures that hold up skin.  Fat underneath the skin breaks down even further, making the skin thinner and brown spots and wrinkles appear deeper and more prominent.  Treatment at this stage focuses on tightening the loosening skin and repositioning or filling in the underlying tissue.  This can be achieved surgically, with a full facelift, or non-surgically with deep tissue treatments like Ultherapy® skin tightening, which stimulates collagen production while tightening the underlying layers of skin by gently stimulating them with ultrasonic energy.

If you are interested in learning more about facial aging or a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Additionally, some reconstructive procedures may be covered by insurance, and Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care CreditSM, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

The Intricacies of Nose Surgery

October 6th, 2014 | Posted by drburstein_marketing in Blog | Rhinoplasty (Nose Surgery) - (Comments Off)

Ask a plastic surgeon what they think is the most technically difficult plastic surgery to perform, and most will, at the very least, list rhinoplasty among the top three.  This operation to change the size and shape of the nose requires a great deal of experience and technical skill, because the tissue, cartilage, and bone that make up the nose are all constantly growing and changing.  In order for nose surgery to have the most successful long-term rhinoplasty results, the surgeon must account for the regrowth of bone and the shifting of cartilage that can occur.  This is why rhinoplasty has one of the highest revision rates of all cosmetic surgeries.  With board certification in both plastic surgery and otolaryngology (head and neck surgery) and over twenty-five years of experience specializing in facial cosmetic and reconstructive procedures, I have developed a keen understanding of the complex intricacies of facial anatomy which allows me to specialize in this particularly delicate procedure.

Nose SurgeryThe purpose of rhinoplasty is to change the size, shape, or angle of the nose and bring it into better proportion with the rest of your face.  The procedure may also correct structural problems with the nose that can cause chronic congestion and breathing problems.  During rhinoplasty, I make incisions, either hidden inside the nose or across the columella, a narrow strip of tissue that separates the nostrils, to access the supporting bones and cartilage.  An overly large nose may be reduced by removing bone or cartilage, while a small or misshapen nose can be augmented and re-sculpted with the addition of cartilage grafts.  I generally prefer to take these grafts from the septum, the partition in the middle of the nose, or (more rarely) from the ear or ribs.  The use of a natural tissue rather than artificial materials reduces post-operative risks and achieves a natural-looking result.

Many patients seek rhinoplasty for purely cosmetic reasons, such as to remove the bump on the bridge of the nose, lengthen or shorten the bridge, or narrow the base of the nostrils.  However, nose surgery can also correct a number of specific structural defects that may cause congestion or respiratory difficulties.  Specifically, a septoplasty is a form of reconstructive nasal surgery specifically designed to correct a deviated septum, which is one of the most common causes of breathing impairment.  It is always my goal to restructure the nose so that it can most efficiently perform its necessary functions and balance aesthetically with the other features of the face.

If you are interested in learning more about a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Additionally, some reconstructive procedures may be covered by insurance, and Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

Everyone would like to stay looking younger, longer.  As plastic surgery has advanced, we have gained a greater understanding of the mechanisms involved in facial aging and this understanding, when combined with ongoing advancements in technology and facial rejuvenation techniques, has made it possible to address the signs of facial aging earlier, alleviating the damage caused by time and environmental factors and maintaining a fresh and youthful appearance.  The use of non-surgical cosmetic facial rejuvenation procedures now can often forestall the need for more comprehensive surgical procedures down the line by minimizing the effects of facial aging.

atlanta-eyelid-surgeryOne of the key maintenance techniques in the modern plastic surgeon’s tool box is laser skin resurfacing.  Simply put, laser skin resurfacing treatments use focused, high intensity light to revitalize the skin of the face in one of two ways.  Ablative lasers gently exfoliate the upper, outermost layers of damaged skin while lower power, higher frequency, non-ablative lasers pass through the skin’s upper layers harmlessly and heat the deeper layers, stimulating collagen growth and tightening the underlying skin from within.  These two approaches offer distinctly different advantages in treating a number of different specific skin conditions.

Ablative laser systems work like a chemical peel, removing the outer to mid-epidermal layers of skin in order to improve the skin’s overall texture and tone.  The laser beam can be scanned across the entire treatment area, precisely removing a layer of skin, or targeted to remove pinpoint columns of skin, leaving the surrounding tissue intact.  This allows ablative lasers to treat broad area skin conditions, like pigment irregularities, acne scarring, and wrinkling or highly localized blemishes like sun damage, keratosis, or surgical scars.  As the skin heals, the natural increase in collagen production grows vibrant, new skin cells that improve skin texture and tone.  The fine precision of the laser allows the treatment to be customized to each patient’s individual skin and needs, so it can safely treat even sensitive areas like the face and neck.

Using higher frequency wavelengths and lower power, non-ablative laser systems make it possible for laser light to bypass the outer layers of the skin entirely and heat the deeper layers, stimulating the body’s natural healing processes.  This reverses the tendency of the skin to droop and sag and stimulates deep collagen production.  The newly growing tissue strengthens and revitalizes the outer layers of skin, relieving the appearance of acne, uneven skin texture, and skin discoloration.  While the results are often more subtle than those achieved with ablative laser systems, the procedure is less invasive and requires less recovery and downtime.

If you are interested in learning more about a plastic surgery procedure that I perform, please contact me, Dr. Fernando Burstein, today.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.