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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

One of the most important things that I have learned while performing cosmetic and reconstructive facial plastic surgery is that no two procedures are ever exactly alike.  Even in cases that seem relatively straightforward, like addressing the extremely common signs of aging that can manifest in the lower face and neck, one single procedure is typically not sufficient to address every situation.  A patient’s body type and personal medical history both play a significant role in determining which facial rejuvenation or cosmetic surgery techniques will achieve optimal results.facial plastic surgeonWhen patients gain or lose a significant amount of weight, fat deposits in the neck can result in a loss of definition between jaw line and the neck line or give the appearance of a “double chin.”  Unfortunately, fat in this area is often extremely difficult to eliminate with exercise and tends to resist the effects of a healthy diet.  In many of these cases, the issue can be addressed with simple liposuction.  Carefully extracting these localized fat deposits helps restore jaw/neck definition and can give the entire area a more firm and youthful appearance.

However, simple aging or the damage caused by various environmental factors can often reduce the skin’s ability to “bounce back” into shape after it has been stretched, particularly in patients with a history of cigarette smoking or excessive sun exposure.  In these patients with reduced skin elasticity, the removal of facial fat deposits can sometimes leave stretched and sagging skin behind.  In these cases, a neck lift or lower face lift can help remove this excess skin, making the area appear taut and firm once more.  Some patients suffering from excessive skin sagging in the face and neck may also benefit from Ultherapy® skin tightening, an FDA approved system that uses ultrasound technology to gently warm the underlying layers of skin and promote collagen production.  By strengthening the skin from within, Ulthera® can often help restore the skin’s natural elasticity and give the face and neck a rejuvenated appearance without the downtime associated with more invasive procedures.

Finally, many of my more slender and athletic patients are concerned with the appearance of platysmal bands, the vertical cords that often appear when the neck is strained.  As we age, the platysma muscle, which creates the neck contour, splits into two parts, one on either side of the midline.  As the skin loses volume and elasticity the free edge of the muscle can take on a much more pronounced appearance, creating what is known as a “turkey neck.”  A full neck lift, in addition to removing excess, sagging skin, may also be able to re-suspend the underlying muscles, soften the appearance of the platysmal bands and give the entire area a smoother look.

Since every patient is unique and requires individualized assessment, I would welcome you to contact my office in order to schedule a consultation so that we can determine if a neck lift is right for you.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Rhinoplasty is one of the top five most commonly performed plastic surgery procedures in the United States, with more than 200,000 patients undergoing nasal surgery every year.  While many plastic surgery procedures are specific to a particular age group or demographic, nasal surgery is commonly performed on both male and female patients of all ages, primarily because it can address functional as well as cosmetic concerns.  Even adolescent rhinoplasty has been proven to be safe and effective when performed by a skilled and experienced plastic surgeon.  However, because the tissue, cartilage, and bone that make up the nose are all constantly growing and changing, rhinoplasty procedures require a great deal of experience and technical skill in order to perform successfully.  Even under the best of circumstances, complications can occur that can make revisionary rhinoplasty procedures an unfortunate necessity.

rhinoplasty12Arguably one of the most complex procedures in cosmetic surgery, revisionary rhinoplasty is designed to address the cosmetic and anatomical complications that may arise as the result of a previous rhinoplasty surgery.  Its goal is to correct these functional issues while leaving the patient with a natural appearance where the size and shape of the nose is in a harmonious balance with the patient’s other facial features.  A successful rhinoplasty requires that a number of factors be taken into account simultaneously.  The nose must be reshaped in such a way as to allow an adequate pathway for air flow while also providing enough support so that the underlying cartilage does not pinch or buckle.  A surgeon must predict and account for the regrowth of bone and the shifting of cartilage that can occur as well as the development of scar tissue and healing processes that vary significantly between individuals.  Because the nose is such a central and prominent facial feature, even the tiniest imperfection or asymmetry can be plainly noticeable.  As a result, a significant percentage of rhinoplasty procedures are unsuccessful in meeting the goals of the patient and the expectations of the original surgeon.

The key to successful revision rhinoplasty is to formulate a surgical plan that addresses both the cosmetic and functional elements of the nose, one that finds a way to correct the external appearance, including asymmetry, twisting, and projection, while at the same time dealing with the more troublesome problems that can range from breathing troubles to a collapse of the nasal bridge.  It is generally accepted that before undergoing a revision rhinoplasty, the operation should be postponed for nine months to one year, during which time local swelling decreases, and the scar tissue is given time to soften and heal.  Revision rhinoplasty is never a cookie-cutter procedure and must be customized to each individual in order to address the specific issues that may have developed from previous nasal surgery.  A thorough and honest discussion of realistic expectations and potential pitfalls is essential during the consultation and preoperative period in order to help ensure the best possible outcome.

In the more than twenty-five years that I have served as a board certified plastic surgeon and otolaryngologist, I have performed more than 5,000 rhinoplasty and revision rhinoplasty procedures, and in my practice revision surgery has been necessary in fewer than 5% of cases.  My extensive experience with facial anatomy and development helps to give me keen insight into repairing and restructuring the nasal bones and cartilage in order to achieve optimal rhinoplasty results.  If you have additional questions about revision rhinoplasty, or any of the other facial plastic surgery procedures I perform, please contact me, Dr. Fernando Burstein, in order to schedule a consultation.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

What Can a Face Lift Do For You?

June 4th, 2015 | Posted by drburstein_marketing in Blog | Face Lift - (Comments Off)

We all get older.  As time progresses, the tissues that make up the face gradually come to produce less collagen, reducing their elasticity and bringing about the appearance of fine lines, wrinkles, and eventually sagging folds of skin.  The loss of youthful contours in the face can be due to a variety of factors, including heredity, gravity, environmental conditions, and stress, but while facial rejuvenation treatments like Botox® or facial fillers can delay these effects and maintain a youthful appearance for a time, eventually more extensive plastic surgery procedures become necessary.  These sort of broad, all-encompassing results are often best achieved through the use of a full face lift, or rhytidectomy procedure.

atlanta faceliftIn 2014, more than 128,000 men and women chose to undergo facelift surgery making it one of the five most commonly performed cosmetic plastic surgery procedures in the United States.  The most extensive way to remove or reduce the appearance of wrinkles and sagging of the face caused by age, a face lift can alleviate sagging in the middle of the face, minimize deep creases below the lower eyelids and along the nose extending to the corner of the mouth, and even address loose skin and excess fatty deposits under the chin and jaw that can create the appearance of a double chin.  Ultimately a face lift can make the face appear younger and healthier and can indeed “take years off” your appearance.

A face lift procedure specifically targets three key factors that contribute to the appearance of facial aging: the appearance of the jowl (caused by the sagging of the platysma muscle), the increase of the nasolabial fold running from the side of the nose to the corner of the mouth (caused by the descent of cheek fat), and the drooping of the area underneath the eyes (caused by the decreasing tone of the orbicularis oculi muscle.  Traditionally, the procedure involves the repositioning of the underlying layers of muscle, a subtle sculpting and redistribution of the fat deposits, and the trimming away of excess skin, but ultimately the effectiveness and safety of any face lift surgery depends heavily on the skill of the surgeon.  With more than twenty five years of experience performing facial cosmetic and reconstructive plastic surgery procedures I can achieve successful face lift results that appear natural without over-tightening the skin and creating a wind-blown, clearly artificial look.

Although a face lift can reduce the signs of aging to a great extent, it cannot reverse sun damage to the skin or remove all facial wrinkles around the eyes, below the nose, and around the lips.  For best results, face lifts are frequently combined with less invasive ancillary procedures that can address long-term skin damage and even help minimize the appearance of post-surgical scars, such as laser skin resurfacing or a chemical peel.  If you have questions about these non-surgical facial rejuvenation procedures, or about face lifts or any of the other cosmetic plastic surgery procedures I perform, contact my office to schedule a consultation.

In the more than twenty-five years that I have been a board certified plastic surgeon and otolaryngologist I have had many patients come to me with questions about nasal surgery, or rhinoplasty.  Whether to improve facial symmetry and appearance or correct functional issues caused by accidental trauma or defect, surgical procedures to modify the size and shape of the nose are among the most popular cosmetic plastic surgery procedures performed in the United States today.  Still many men and women have questions about what exactly these procedures entail.  Here are answers to a few of the questions I am most commonly asked about nasal surgery.

Am I a good candidate for rhinoplasty?

reconstructive-rhinoplasty-atlanta-gaIdeal candidates for nasal surgery are men and women who are in good physical health, do not smoke, and who have realistic goals in mind for the improvement of their appearance or nasal function.  While nasal surgery is ideally performed on patients whose facial features are fully grown and developed, there is not a specific age at which I will begin performing facial plastic surgery on a patient for cosmetic purposes and adolescent rhinoplasty performed by a skilled and experienced surgeon has been proven to be both safe and effective.  I believe that multiple factors, including a patient’s expectations and their physical and emotional maturity, need to be carefully taken into consideration in order to maximize each patient’s satisfaction while minimizing the need for revisionary rhinoplasty.

What is the recovery time following rhinoplasty surgery?

Nasal surgery is most frequently performed on an outpatient basis under general anesthesia, and takes between one and two hours, depending on the amount of internal nasal surgery that is combined with the aesthetic procedure.  Patients generally do not require an extended hospital stay, and can return home on the day of the surgery.  However, I strongly advise rest and relaxation, including head elevation for five days and cold packs for the first 24 hours, in order to hasten recovery and minimize bruising and swelling.  Showering can resume the next day and all nonresorbable sutures will be removed, along with the nasal splint (if one is used), at a follow up visit five to seven days after the surgery.  Patients can usually resume light exercise after the splint is off but should refrain from heavy contact for at least six weeks.  Nasal congestion may persist for up to six weeks, and nasal edema may take up to a year to completely resolve, although approximately 75% will be gone by the time the splint is removed.

What do I need to do in order to help make sure that I get the best possible results?

As with any cosmetic plastic surgery procedure, the best outcomes require clear communication between the surgeon and patient both before and after the surgery.  This process begins with a thorough and honest discussion of realistic expectations and potential pitfalls that may occur.  Only when the doctor fully understands exactly what a patient wants, and the patient completely understands exactly what is reasonably attainable, can they both work together towards the same goal.  I recommend that my patients who want external nasal changes undergo computerized facial imaging prior to surgery.  This allows the patient and surgeon to view the potential surgical results and these computerized images provide a guide or a template which I refer to during surgery.  After surgery, it is absolutely imperative that you scrupulously adhere to all post-op instructions and attend all of your follow-up appointments.  When patients fail to follow after-care instructions, complications may spoil an otherwise excellent result.  These concerns are much easier to correct when discovered during early follow up visits and addressed immediately after the procedure.

Since every patient is unique and requires individualized assessment, I would advise that you contact my office in order to schedule a consultation so that we can determine if rhinoplasty is right for you.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

It has always been my philosophy that the best way to address facial aging is to take a gradual approach, beginning early with small, subtle procedures focused on highly specific areas of concern and only moving on to more comprehensive procedures when necessary.  In my experience, some of the most effective plastic surgery results can be obtained by treating the small, delicate areas around the eyes.  According to statistics published by the American Society of Plastic Surgeons (ASPS), more than 200,000 eyelid surgeries, or blepharoplasties, were performed in the United States in 2014, making it one of the five most commonly performed cosmetic plastic surgeries.  Many patients, both men and women, come to me with questions about this extremely popular procedure.

Am I a good candidate for eyelid surgery?
facial-plastic-surgeon-atlanta-gaEvery person is unique and each face has its own individual areas of concern, so ultimately the best way to determine if you are a candidate for a blepharoplasty is to come in for a consultation so that I can evaluate your facial anatomy thoroughly and determine what procedures might best remedy your concerns.  In general, however, any healthy men or women without serious eye conditions or medical conditions that would impair healing may be candidates for a blepharoplasty procedure.

Will the results of my eyelid surgery be permanent?
While cosmetic surgery procedures can help alleviate the changes in the face that can occur as the result of aging, they cannot stop the aging process completely.  Even after your procedure, a combination of time and environmental conditions will continue to age your face, and so additional procedures may be necessary to address additional facial aging concerns.  Still, upper eyelid surgery can last at least five to seven years, and in some cases even longer, and lower eyelid surgery rarely needs to be repeated.

What can I expect during recovery after eyelid surgery?
All patients heal at different rates, but after a blepharoplasty you will most likely have small stitches in your upper eyelids that will remain for as long as a week.  Swelling and, less frequently, bruising, is common after the procedure and some patients may even experience temporary blurry vision.  Surgical tape placed over the lower eyelids and cold compresses can help alleviate these side effects, but most patients are able to return to their normal activities within ten days.

A blepharoplasty is just one of the many ways that facial plastic surgery procedures can help keep you looking young and vital.  If you are interested in any of the other procedures that 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.