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Fernando Burstein MD, Facial Plastic Surgeon
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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

As medical knowledge advances and we come to better understand the long term benefits of an active and healthy lifestyle, more people are taking measures to get in shape.  Weight loss surgery, liposuction, and rigorous diet and exercise programs are helping millions of people slim down around the world.  However, it is also important to consider the effects that fluctuating weight can have on the features of the face and neck, as well as how those effects can best be addressed with facial plastic surgery procedures, in order to achieve truly optimal, comprehensive results.

double chin surgery atlanta gaThe gradual accumulation of fat, over time, stretches the skin and underlying musculature to such a degree that, if the excess fat is ever lost, sagging skin is inevitably left behind.  In fact, according to a recent article published by the American Society of Plastic Surgeons (ASPS), patients who have lost a substantial amount of weight, in general, find themselves having to deal with a large amount of redundant skin and soft tissue.  While this is true of both the body and the face, the tissues of the face are nearly impossible to exercise, making it much more difficult to eliminate excess skin in this area.  Many patients commonly undergo body contouring procedures to remove excessive skinfolds in the upper and lower body, but those procedures do nothing to relieve the sagging skin left behind in the face and neck.  Such conditions often need to be addressed with facial contouring or full facelift procedures.

In the facial area, excess skin causes cosmetic problems like a “droopy” face and “turkey” neck.  These issues can be particularly problematic in that they mar the overall results of all the hard work that went into losing the weight in the first place and make the patient appear far older than they actually are.  Certain plastic surgery procedures, like neck or facelifts, are specifically designed to address these concerns.  A neck lift, for example, works by removing excess skin and fat from around the neck and underneath the chin, while simultaneously tightening the underlying muscles to eliminate slack jowls and the colloquial “double chin”.  Similarly, a full facelift procedure does much the same for the face itself, lifting and smoothing the facial features to create a more youthful and rejuvenated appearance.  Finally, for faces left looking hollow and gaunt by substantial weight loss, various facial contouring procedures can actually augment the chin or cheeks, giving the entire face more balanced contours and a more elegantly sculpted profile.

If you are interested in learning more about a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Atlanta Plastic Surgery, P.C. also can provide a variety of options for financing, including CareCreditSM, in order to assist you.  Be sure to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

It is almost universally true that, as we get older, our skin begins to sag.  The natural loss of facial volume and skin elasticity, over time, causes the features of the face to slip lower, and causes excess skin to sag beneath the chin.  There are many different facial rejuvenation methods for treating drooping eyebrows and sagging skin around the neck and jowls, including one of the newest and most technologically advanced: the Ultherapy® skin tightening system.

facial-plastic-surgeon-atlanta-gaThis FDA approved technology focuses high frequency sound waves, similar to those that are produced by a common ultrasound machine, onto the deeper layers of tissue, gently warming them in order to stimulate the body’s natural healing factors and collagen production.  This stimulation, in turn, lifts and tightens loose skin while initiating a process by which the tissue begins to strengthen itself from within.  A typical Ultherapy® treatment takes anywhere from 30 to 60 minutes, depending on the size of the treatment area, and requires no surgical downtime.  Because Ultherapy® works by stimulating the body’s natural healing processes, the results slowly become more pronounced over time.  While patients can generally see some degree of improvement immediately, it is usually three months before significant changes become apparent and six months before optimal results are achieved.

However, even though Ultherapy® can seem to turn back the clock, it cannot stop it entirely.  The average duration of Ultherapy® results is about a year, and that duration can vary a great deal depending on the individual’s starting skin laxity as well as how well they take care of their skin.  Healthier, more resilient skin tends to maintain the results longer, while skin that is subjected to harsh environmental conditions such as heavy smoking or extreme sun exposure will age prematurely whether it has undergone Ultherapy® or not.  For results that are more long-lasting, but still subtle and natural looking, many patients opt for softer surgical procedures.  For example, blepharoplasty, or eyelid surgery, can permanently remove excess skin and fat deposits from the upper and lower eyelids, giving the patient an overall younger appearance with a relatively short and minimally-invasive surgical procedure.

Patients with even more pronounced signs of facial aging, specifically those who have already lost a great deal of skin volume and elasticity, may enjoy more significant and long lasting benefits from a full facelift procedure.  A recent study published by the American Society of Plastic Surgeons found that at least three fourths of facelift patients look younger five years after their facelift procedure than they did before it.  Moreover, a full facelift can be complemented with various secondary procedures, such as fat grafting or facial contouring procedures, designed to balance the facial features and further enhance the final aesthetic results.

Ultimately, the longest lasting, most natural looking results are the product of a gradual, tiered approach, using minimally-invasive facial rejuvenation technology and techniques early on to forestall the effects of facial aging, and then moving on to facial cosmetic surgery procedures when necessary.  If you are interested in any of the facial plastic surgery procedures I perform, please contact my office, to schedule a consultation.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Many claim that the eyes are the windows to the soul.  Whether or not you believe that to be the case, it is true that the eyes are the place where people’s attention is most focused during any social interaction.  We carefully examine a person’s eyes when trying to tell if they are telling the truth, think highly of a person if they can maintain good eye contact, and gaze long into the eyes of a potential love interest.  But this heightened scrutiny means that, when the first signs of facial aging being to appear, the first places that people notice them are around the eyes.  Fortunately there are several steps that you can take to keep your eyes, and the rest of your face, looking young and vital.

eyelid surgery in atlanta gaOne of the first steps to addressing older-looking eyes is prevention.  Constantly shifting facial expressions can, over time, wear out facial muscles and tissues, accelerating the natural loss of skin elasticity.  As a result, tiny expression lines and wrinkles begin to form at the corners of the eyes.  These common signs of facial aging, generally referred to as “Crow’s Feet,” can often be minimized or even erased for a few months by Botox® treatments, which temporarily relax the facial muscles responsible for their formation.  Some physicians have even found that repeated Botox® injections can actually train the muscles of the face to remain relaxed, delaying the appearance of these expression lines even longer.

Unfortunately the effects of time cannot be avoided forever.  Eventually, many people begin to notice that their eyes seem smaller, darker, and more recessed than before and that the dark shadows that form in the eye sockets make them look tired, angry, or sad.  As we age, our skin gradually loses its resilience and elasticity and starts to sag, and this process can progress relatively quickly in the thin, delicate skin of the eyelids.  Ultimately the eyelids start to droop and hang over the eyes or pool in puffy looking bags underneath them.  A blepharoplasty, or eyelid surgery, removes excess tissue and fat from the upper eyelids, lower eyelids, or both, making the eyes appear wider and more youthful, and people who spend time interacting face to face with customers and colleagues need to look as alert and youthful as they feel.

For some patients, however, simply reducing the excess skin and fat from the eyelids may not be enough.  If the facial aging process is more progressed, the skin of the upper face and forehead may have started to sag as well, adding deep, horizontal furrows to the brow and making the eyes appear deeper set and even hooded.  A brow lift, or forehead lift, can help tighten the underlying muscles while trimming excess skin, giving the whole area a smoother and more lifted appearance.  I am even frequently able to perform brow lift procedures using an advanced, endoscopic “key-hole” technique, which can greatly diminish the appearance of scars and speed overall recovery time.

In the final analysis, it has always been my philosophy that facial aging is best approached with graduated procedures, beginning with minimally invasive cosmetic injectables and facial fillers and slowly transitioning to the use of subtle plastic surgery procedures that maintain the face’s natural look.  If you are interested in any of the facial plastic surgery procedures I perform, please contact my office, to schedule a consultation.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

The Cost of Facial Rejuvenation

February 9th, 2015 | Posted by drburstein_marketing in Blog | Frequently Asked Questions - (Comments Off)

In the more than twenty-five years I have been practicing cosmetic and reconstructive facial plastic surgery, I have come to realize that optimal, long-term results are most often obtained by incorporating subtle facial surgery procedures with periodic non-invasive facial rejuvenation treatments. This graduated approach allows me to confer closely with my patients in order to formulate a customized care plan that addresses the specific areas with which they are most concerned and to treat emerging issues as they arise.

jowl-surgery-atlanta-georgiaOver the years I have had many patients wonder whether it is ultimately more cost effective to pursue expensive facial plastic surgery or simply to attempt to counteract the signs of facial aging with less expensive, non-invasive facial rejuvenation techniques.  Women and men who have been receiving regular treatments with Botox® and injectable facial fillers frequently grow tired of the ongoing expense, discomfort, and inconvenience of injections that need to be repeated every four to six months and are looking for a more efficient alternative.  Although every case is unique, and requires individualized consideration, after a certain age the tissues and muscles that support facial architecture naturally begin to weaken, making minimally invasive facial rejuvenation techniques less effective.  Recent studies, however, have shown that surgical procedures can often be an extremely cost effective way to address the signs of facial aging.

In 2012, Drs. Barry M. Jones of King Edward VII Hospital, London, and Steven J. Lo of Canniesburn Plastic Surgery Unit, Glasgow published a long-term follow-up study assessing the long-lasting results of facial plastic surgery.  After analyzing standardized photographs of 50 patients who had undergone facelift surgery an average of five and a half years previously, and carefully measuring certain key factors of facial aging, such as jowl height and angle of the chin to the neck, they concluded that more than three-fourths of the patients still looked younger than they had before the surgery, providing strong evidence that facelift surgery can provide significant long-term aesthetic gains.

I have seen similar examples of the long-term efficacy of facelift surgery time and again.  In my own practice, I recently had the opportunity to revisit a woman on whom I had performed a facelift procedure more than a decade ago.  She was just beginning to notice signs of facial aging re-emerging and wanted a way to keep herself looking youthful.  Had she chosen to undergo Botox® or other minimally invasive treatment options over those ten years, instead of a facelift, her costs could have easily exceeded $15,000.  However, because we had acted early to delay the onset of facial aging, we were able to give her exceptional, natural looking results with considerably reduced recovery time and expense.

However, it has been my experience that the best way to address facial aging is by incorporating both approaches into a single, graduated treatment plan.  As a board certified plastic surgeon and otolaryngologist (head and neck surgeon) I can bring to the table extensive experience with facial anatomy and the various techniques for treating areas of concern.  This allows me to customize surgical solutions for each patient while using Botox® and facial filler treatments in small quantities less often to perform minor touch-ups and prolong the overall plastic surgery results.

If you are interested in learning more about a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Atlanta Plastic Surgery, P.C. also can provide a variety of options for financing, including CareCreditSM, in order to assist you.  Be sure to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Despite the fact that plastic surgery procedures can correct a number of different formative and structural concerns, they are most often used to achieve overall cosmetic improvement.  However, optimal cosmetic surgery results are seldom achieved by merely altering the appearance of a single facial feature.  The individual shapes and contours that make up the face work best when they balance and complement one another, working together to achieve a harmonious whole.  This is why facial contouring procedures work best when we look at the face holistically, focusing on how each individual feature can contribute to the whole.

atlanta-facial-plastic-surgery-fernando burstein (4)atlanta-facial-plastic-surgery-fernando burstein (1)For example, many patients come in and ask me if I can reduce the size of their nose.  However, simply performing a reduction rhinoplasty would be doing these patients a disservice.  A significantly smaller nose may look unnatural or oddly proportioned on their face, or worse may cause obstructions in airflow and breathing.  I can usually achieve far superior results by combining a less drastic nose surgery with augmentations to the patient’s chin or jaw, depending of course on the specific details of an individual patient’s facial anatomy.  By adjusting the balance of the facial features, we can create a natural looking and aesthetically pleasing profile with only very minor structural adjustments.

Adjustments to the chin, jaw, or cheeks can generally be accomplished through a variety of facial contouring techniques.  Artificial implants can increase the size and projection of a chin, the width of the lower third of the face, or even the projection of the cheekbones, adding volume to areas that may appear recessed for flat.  However, whenever possible, I prefer to use an autologous graft made up of cartilage, bone, or fat taken from other areas of the patient’s body in lieu of an artificial implant.  In my experience, using natural grafts or fat transfer achieves much more natural looking results while significantly reducing the risk of allergic reaction or post-operative infection.  Moreover, because these augmentations can be made through incisions inside the mouth, they can be done without visible scarring.

If you are interested in learning more about a plastic surgery procedure I perform, please contact me, Dr. Fernando Burstein, today.  Atlanta Plastic Surgery, P.C. also can provide a variety of options for financing, including CareCreditSM, in order to assist you.  Be sure to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.