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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

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Melissa, a nursing student working as a medical assistant for an EMT office in Atlanta, has known Dr. Fernando Burstein for nearly her entire life.  Born with craniosynostosis, a congenital disorder caused by the improper fusing of the skull’s plates, Melissa was referred to Children’s Healthcare of Atlanta, where she first met Dr. Burstein.  When the cranial sutures, fibrous bands of tissue that connect the bones of the skull, fail to fuse correctly, the result can be a misshapen skull or even neurological side effects if the brain is impacted by the malformations.  To correct this condition, Dr. Burstein performs surgery to re-separate the sutures so that they may properly grow back together.

Melissa underwent her first reconstructive surgery when she was just a baby.  Because of the neurological impact this condition can have, the procedure is typically performed on infants before they reach their first year of age, so that the brain can have a chance to develop normally.  Dr. Burstein frequently works closely with a pediatric neurosurgeon, as he did in Melissa’s case, in order to help ensure that there are no neurological side effects.

“By the time I was seven, I guess that most people couldn’t tell that there had ever been a problem, but I was still very self-conscious,” Melissa went on to explain.  “I felt like I still had these dents in my skull.”

While the fontanels (or soft spots) on the skull generally solidify sometime between 20 months and 2 years of age, the bones of the human body, including the skull, continue to grow and shift throughout puberty, so it is not uncommon for some craniosynostosis patients to seek additional reconstructive surgery procedures later in life.

“He completely fixed the problem, and after that I felt much more outgoing and confident.  I even got involved in dance and gymnastics.  Even though I was just a kid, I can remember thinking that Dr. Burstein finally made me feel normal.”

Now a professional woman in her twenties, Melissa went in for her last surgery just this past August.

“I never even considered going to anyone other than Dr. Burstein; he had always been so nice and understanding and I felt like he knew my head better than anyone else alive.  I was amazed that he immediately saw exactly what I wanted to have done.  I had some concerns about my brow region, but felt awkward asking for extra cosmetic attention.  As Dr. Burstein went over minor reconstructive improvements he wanted to make, he explained how he would be able to blend in elements of a brow lift to address the very concerns I was having.  It was almost like he was reading my mind.”

With over twenty-five years as a practicing, board-certified plastic surgeon and otolaryngologist, Dr. Burstein has a tremendous amount of experience with facial anatomy.  Understanding the subtle interplay of the muscles and bones that underlie the facial features allows him to achieve subtle, natural looking cosmetic surgery results.

“It’s the gradual, subtle changes that build up over time to make a drastic difference,” Melissa commented.  “Because of Dr. Burstein, I have always been extremely open and willing to talk about my condition.  It always makes me feel good when people say that they never would have noticed if I hadn’t told them, but it means even more to me to be able to help educate people and alleviate some of the fears that they may feel.”

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 CareCreditSM, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

We all have to grow older, and each of us has to deal with a uniquely individual combination of factors, including heredity, sun exposure, and lifestyle choices, that impact the rate at which the signs of aging begin to manifest in our bodies.  Because no two faces age in exactly the same way, I have developed an approach to facial plastic surgery and anti-aging cosmetic procedures that is individually tailored to each patient’s unique cosmetic needs.  My goal is to promote an open line of communication with my patients, so they can help me to understand their chief concerns and we can devise a graduated care plan that naturally enhances their best features while minimizing risk, recovery time, and patient expense.

atlanta-eyelid-surgeryOne of the most useful tools in achieving those ends is the mini-facelift.  I have found that the best plastic surgery results are often obtained when smaller scale, minimally invasive procedures can be used to make subtle but lasting changes that can postpone or even alleviate the need for more extensive procedures later on.  A mini-facelift is a precision technique designed to target a highly specific region of the face, treating certain signs of facial aging when they first begin to appear and before they can become pervasive.  A mid-facelift, for example, lifts and repositions the fat in the cheeks to a position over the cheekbones while removing excess fat from under the eyes.  These subtle changes accentuate the natural contours of the face, alleviating the subtle signs of facial aging without the need for a traditional full facelift procedure.

By the same token, an upper facelift can smooth the appearance of deep forehead furrows and frown lines, but does not involve more extensive tightening of the muscles to address the hooding that occurs over the eyes when the eyebrows start to sag, like a full forehead lift would.  Likewise, a lower facelift can remove excess fat and skin while tightening the underlying muscles of the lower jaw region, but requires significantly less alteration than a neck lift.  Because these procedures are less invasive, and can frequently even be done endoscopically, using only very tiny incisions above the hair line or behind the ears, they require less post-surgical downtime and allow you to get back to your regular routine with minimal interruption.

Finally, it has been my experience that a balanced, even skin tone is often one of the most effective ways to give the whole face a younger, fresher look.  I often recommend to my patients a chemical peel after a surgical procedure in order to minimize the appearance of minor skin imperfections, like fine lines and wrinkles, rough patches of skin, and even minor scars and maximizing their facial plastic surgery results.

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 CareCreditSM, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

Minimizing Plastic Surgery Complications

November 11th, 2014 | Posted by drburstein_marketing in Blog | Plastic Surgery news - (Comments Off)

No surgery is completely without risk, and cosmetic surgery is no exception.  According to the American Society of Plastic Surgeons (ASPS), the facelift, or rhytidectomy, is one of the five most commonly performed cosmetic surgeries in the United States, and although the procedure has proven to be extremely safe and effective, it does carry certain inherent risks that should be taken seriously.  Fortunately, there are several procedures that I work through with my patients before, during, and after surgery that can effectively reduce the likelihood of plastic surgery complications and increase the chance for optimal surgical results.

Before Surgery:
Our initial pre-surgery consultations are the ideal time for my patients to ask as many questions as possible and educate themselves on the risks associated with their plastic surgery procedure.  It also gives me an opportunity to take a detailed and thorough patient history, an absolutely essential step in avoiding the various complications that can arise.  It is important that you bring up any serious health conditions or adverse reactions you have had in the past to anesthesia or other medications.  In addition, we will discuss your current supplements and medications, alcohol use, tobacco use and medical conditions as well as the effects these can have on your procedure.  Finally, I will also explain the increased risks involved with patients who have high blood pressure or hypertension, as well as those who take certain pain medications or blood thinners.

During Surgery:
Many minor surgical complications, like bruising and scarring, can often be minimized by a skilled and experienced surgeon.  Surgery that is completed quickly and precisely produces noticeably less bruising than longer procedures.  However, this level of skill and timing usually can only be developed after years of extensive practice.  By the same token, surgical skill plays a major role in reducing the appearance of scars or in keeping them limited to areas of the body that can be hidden altogether.  Patients who carefully follow post-operative care instructions usually experience far less noticeable scarring as well.   Unfortunately, some scarring may be inevitable, which is why I often recommend chemical peels or laser skin resurfacing treatments to help even skin tone and reduce the appearance of scars even further.

After Surgery:
The value of post-operative care, and particularly of following your doctor’s post-operative instructions, cannot be overstated.  Some of the worst stories about botched plastic surgery procedures are actually the result of patients simply failing to follow post-operative care instructions.  Moreover, diligently attending post-operative visits can often allow me to catch and correct complications before they become serious concerns.  A number of external environmental factors can also mar your plastic surgery results.  Smoking, for example, impedes the natural healing process and can result in increased scarring or skin necrosis.  Alcohol and certain medications can also thin the blood, increasing the risk of bleeding and exaggerating bruising.  Take care to avoid activities involving smoking or alcohol use for at least six weeks before and after your surgery in order to ensure a speedier recovery.

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 CareCredit®, in order to assist you.  Be sure to connect with me on FacebookTwitter, and Google+ for the latest facial plastic surgery news.

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.