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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 both a board-certified plastic surgeon and otolaryngologist (head and neck surgeon) with more than twenty-five years of experience, one of my particular specialties is rhinoplasty, or nose surgery.  Over the years, I have performed more than 5,000 of these popular and extremely versatile plastic surgery procedures on both men and women, and have written numerous articles on the subject for textbooks and medical journals.  Rhinoplasty procedures can accomplish a great deal, and every patient has their own unique reasons for undergoing one.  Those reasons generally fall into one of three basic categories.

Three Reasons to Undergo Nose SurgeryThe Nose Requires Repair for Medical Reasons

One of the most common reasons that men and women seek out rhinoplasty is to correct breathing difficulties.  When the central cartilage of the nose, or the nasal septum, is not perfectly aligned and instead deviates to either one side or the other, patients can often experience trouble breathing and sometimes even an increased incidence of sinusitis or sinus infections.  It is estimated that more than eighty percent of people have some degree of deviated septum, but these can be corrected with a form of rhinoplasty called a septoplasty.

The Nose Has Been Damaged by Accident or Trauma

While many people are born with a deviated septum or other nasal malformations, these conditions may also frequently be caused by an accident or trauma to the nose that shifts the internal bones and cartilage.  In fact, given the prominent position of the nose on the face, nasal deformity caused by accident or trauma is actually quite common.  Moreover, if these injuries occur at a young age they may not become fully apparent until the nose has completed its development.  Performing rhinoplasty on adolescent patients can be difficult given the changes that occur in the nose as we age, but can be accomplished by a plastic surgeon experienced in performing rhinoplasty procedures with extensive knowledge of facial anatomy.

The Nose Needs to Be Altered for Cosmetic Reasons

Finally, many women and men are simply unsatisfied with their nose’s appearance.  Whether they want to remove a bump on the bridge of the nose, lengthen or shorten the bridge, or narrow the base of the nostrils, cosmetic rhinoplasty procedures can often improve the overall appearance of the nose by bringing it into proportion with other facial features.  I also frequently perform revision rhinoplasty procedures to improve the appearance and/or functionality of a nose after a previous rhinoplasty procedure by another doctor was unsuccessful in achieving satisfactory results.

Regardless of the particular reason for a rhinoplasty procedure, it has always been my philosophy that combining small, subtle changes is the best way to balance and refine the facial structure into an aesthetically unified whole.  That is why I sometimes combine nasal surgery with other cosmetic procedures, like chin augmentation surgery or even a blepharoplasty, in order to achieve the best possible plastic surgery results.  If you are interested in rhinoplasty, or in any of the other facial plastic surgery procedures that I perform, please contact me, Dr. Fernando Burstein, at my office to schedule a consultation so that we may discuss your particular needs.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Many of the men and women who come into my office seeking facial rejuvenation are particularly self-conscious about their necks, and I am frequently asked questions regarding “sagging jowls” and “turkey necks.”  As we grow older, and the skin’s firmness and elasticity begins to diminish, tissues of the face can slide downward, creating sagging folds in the lower third of the face and neck.  However, since every individual face is unique and an unattractive neckline can potentially be the result of a variety of causes, it is vital to carefully analyze the soft tissue and underlying bone structure of the face, jaw, and neck before deciding which approach will benefit the patient most.

Neck Rejuvenation Which Approach is Right for YouSmall Lower Jaw

Sometimes a deep under-bite and a naturally small chin leaves less overall bone support for the soft tissues of the jawline, leading to sagging skin around the neck.  In these cases, chin augmentation surgery, or a genioplasty procedure, can help by subtly augmenting the size and projection of the chin itself, effectively giving the neck a smoother and more youthful appearance.

Accumulation of Excess Fat

As we gain weight, fat can accumulate in all parts of the body, including around the neck.  Patients who have excess fat in this area but who still have a good degree of skin elasticity can often benefit from highly-targeted liposuction procedures that remove these hard-to-reach fat deposits and reveal the more shapely neck underneath.

Loss of Facial Volume

Aging can lead to a loss of fat volume in the mid-face, causing the skin to gradually “deflate.”  This can increase nasolabial folds and cause the tissue of the lower face to drape over the jawline, forming jowls.  Replacing this lost volume with artificial facial fillers, like Juvéderm®, Juvéderm Voluma®, or Restylane®, or with natural fat transfer procedures, can often restore a more sharply defined jaw line.

The Irresistible Force of Gravity

Unfortunately we all ultimately fall victim to the effects of time and gravity, which often causes muscles in the neck known as the platysmal bands to protrude and take on a more pronounced appearance, contributing to 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, softening the appearance of the platysmal bands and giving the entire area a smoother look.

Understanding the causes that bring about the various signs of facial aging is the best way to formulate treatment plans that are individually customized to each patient’s unique aesthetic needs.  If you have questions about which of the facial plastic surgery procedure that I perform might be most beneficial for you, please contact me, Dr. Fernando Burstein, at my office to schedule a consultation.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Mini-Facelift or Full Facelift: Which is Right for You?

April 12th, 2016 | Posted by drburstein_marketing in Blog | Face Lift Surgery - (Comments Off on Mini-Facelift or Full Facelift: Which is Right for You?)

The facelift has long been considered one of the most effective means to treat the signs of facial aging, and with its ability to address multiple areas of concern simultaneously a full facelift (or rhytidectomy) is still one of the most commonly performed facial plastic surgery procedures in the United States today.  However, during the nearly thirty years that I have been a board-certified plastic surgeon specializing in procedures of the face, it has been my facial rejuvenation philosophy that optimal results are best achieved with a gradual application of subtle changes that combine non-surgical and surgical cosmetic treatments.  Every patient is different and not all portions of the face age at exactly the same rates, so addressing only those areas in need of attention, while leaving other areas alone, can often achieve a more youthful and rejuvenated look without giving the patient an overly artificial or “worked-on” look.  That is one of the reasons why the mini-facelift was invented.  Understanding the differences between a mini-facelift and a full, traditional facelift procedure is an important step in determining which approach is the right fit for your specific aesthetic needs.

facelift surgery in atlanta georgiaThe Traditional “Full” Facelift

A full facelift is a fairly extensive plastic surgery procedure that involves removing excess, sagging skin, tightening the underlying facial muscles and tissues, and then repositioning the remaining skin and tissues on the patient’s face.  It can be an excellent way to eliminate loose skin folds in the neck and cheek areas, while tightening up the appearance of wrinkles across the entire face, including around the eyes.  Although individual recovery times can vary significantly, a facelift usually requires at least two weeks before the bruising subsides and the results start to become evident.  The effects of a facelift are permanent, although they do not prevent additional effects of facial aging from accumulating in the future.  Many patients also choose to supplement a full facelift with supplementary procedures like eyelid surgery or a chemical peel to create a more unified and seamless look.

The Partial or “Mini” Facelift

A short scar mini-facelift procedure is less invasive, involving only a handful of tiny incisions through which surgical instruments can be inserted.  It is designed specifically for patients who are just beginning to experience the signs of aging, and focuses only on the mid-face region from the top of the cheek bones to the jaw line.  Although the limited scope means a substantially reduced recovery time, the procedure cannot address sagging in either the forehead or neck, which are more appropriately treated with brow or neck lifts, respectively.  The effects of a mini-facelift typically last between five and ten years, depending on the individual patient and various environmental factors, although non-surgical maintenance procedures, like laser skin resurfacing, facial fillers, and Botox® injectable cosmetic treatments may be able to prolong the results.

Ultimately, mini-facelift procedures are ideally suited for women and men who have not yet begun to experience extensive facial sagging and need only minor rejuvenation with minimal downtime.  For those patients in need of more generalized facelift results that address multiple areas of the face, a full facelift may still be the best choice.  If you are interested in facial plastic surgery or if you would like more information about what specific procedures may be able to benefit you, please contact me, Dr. Fernando Burstein, at my office to schedule a consultation so that we may discuss your particular needs.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

The Pediatric Treatment of Birth Marks

March 28th, 2016 | Posted by drburstein_marketing in Blog | Frequently Asked Questions | Pediatric Plastic Surgery - (Comments Off on The Pediatric Treatment of Birth Marks)

As the Medical Director of the Center of Craniofacial Disorders for Children’s Healthcare of Atlanta (CHOA), I have frequently performed maxillofacial surgery to correct the facial abnormalities that can occur in children as a result of either congenital defects or traumatic injury.  While there are many different conditions that can be addressed with reconstructive plastic surgery procedures, one that we have had a great deal of success treating in children is a form of birthmark called a hemangioma.

The Pediatric Treatment of Birth MarksNewborns often have temporary marks or blotches on the skin called birthmarks.  While these are mostly harmless and often fade or shrink on their own over time, some can be far more disfiguring and even potentially debilitating.  Hemangiomas, specifically, are a vascular type of birth mark that can appear either on or deep underneath the skin’s surface.  Surface hemangiomas appear as bright red “strawberry marks” while those under the surface may have a blueish appearance, as they involve blood vessels in the deeper layers of skin.  In many cases, small hemangiomas spontaneously shrink and disappear by the time a child is 5 to 9 years old, but larger ones may leave a scar as they regress while others, particularly those that appear on the face or neck, may be large enough to interfere with vision or block the nose or mouth.  In these cases, prompt treatment is necessary in order to remove the obstruction and minimize long-term appearance deficits.

My colleagues and I have conducted several long term birthmark treatment studies(1,2) involving the use of intralesional laser treatments to reduce the size of capillary hemangiomas.  While the use of external laser light, applied to the surface of the mark to shrink the blood vessels supplying blood to the area, has been used effectively for years, its limited ability to penetrate deep beneath the skin restricts its usefulness in cases where there is a deeper cavernous component or a completely subcutaneous lesion.  By using a form of fiber-optic technology to introduce the laser energy to deeper levels of the skin, we have been able to consistently affect significant reductions in both the diameter and thickness of the lesions with an extremely small incidence of post-treatment complications.  In particularly severe cases, where laser treatment has either proven ineffective or is not a viable option, surgical excision may be necessary to remove either the lesion or the scars that may result from it.  Scar revision or autologous fat transfer techniques can also be used to rebuild the area and help achieve a more aesthetically pleasing appearance.

For more than twenty-five years, I have worked to offer the ultimate in pediatric surgical care to make both parents and children comfortable before, during, and long after their reconstructive surgery procedure.  If you are interested in learning more about the pediatric reconstructive surgical procedures that I perform, I would welcome you to contact my office and 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.

  1. Burstein, FD., Simms, CA., Cohen, SR., Williams, JK., Pascal, M.: Intralesional Laser Therapy of Extensive Hemangiomas in 100 Consecutive Patients. Annals of Plastic Surgery. 2000 Feb;44(2);188-94.
  2. Burstein, FD.: Cartilage-Sparing Complete Otoplasty Technique: A Ten Year Experience with 100 Patients. Journal of Craniofacial Surgery. 2003 Jul;14(4):521-5.

What’s the Difference between Chemical Peels and Laser Skin Resurfacing?

March 21st, 2016 | Posted by drburstein_marketing in Blog | Frequently Asked Questions | Non surgical facial rejuvenation - (Comments Off on What’s the Difference between Chemical Peels and Laser Skin Resurfacing?)

Ever since the earliest recorded history, people have been looking for ways to make themselves appear younger, and in most cases this involves trying to figure out how to eliminate facial wrinkles.  Many different facial rejuvenation treatments have been used over the years to minimize the appearance of static and dynamic facial lines, ranging from full facelifts to localized treatments with cosmetic injectables like Botox® or facial fillers.  However two distinct procedures have consistently proven to be extremely effective: chemical peels and laser skin resurfacing.  Since I regularly perform both of these minimally-invasive cosmetic plastic surgery procedures in my practice, many patients ask me which technique works best.  In my opinion, both approaches have different advantages and disadvantages, and so the question of which is “better” is really more about which is more suited to a particular patient’s individual skin care needs.

What’s the Difference between Chemical Peels and Laser Skin ResurfacingIn truth, both chemical peels and laser skin resurfacing technology work very similarly.  The outermost layers of the skin are made up of dead and damaged skin cells that are constantly being shed as newer skin cells are generated to replace them.  Both chemical peels and laser skin resurfacing effectively accelerate this process, exfoliating the skin by destroying and removing a large portion of these dead and damaged skin cells at once, encouraging the body’s own natural collagen production while revealing newer, smoother skin underneath.  Chemical peels accomplish this with varying concentrations of acid, which can be custom formulated to affect the skin at different depths.  Laser skin resurfacing, on the other hand, uses focused light energy to excite the water molecules in the dead skin cells, instantly vaporizing them from the inside.  While the specific mechanisms may differ, the final goal, getting rid of old skin and replacing it with refreshed, new skin, remains the same.

In both cases, the results are smoother, younger-looking skin and a noticeable reduction in fine lines and wrinkles.  Because damaged layers of outer skin cells are removed, the procedures can also often help eliminate the appearance of sun damage, freckles, skin discoloration, and acne scarring, which have the most noticeable effect on these outermost skin cells.  I even frequently use both of these procedures to smooth skin texture after more-invasive cosmetic plastic surgery procedures in order to help minimize the appearance of post-surgical scars, and both require similar amounts of recovery time.

Effectively using chemical peels requires a great deal of experience and surgical skill, as the depth of penetration depends on the type and texture of the skin as well as the strength of the peel and the time it is left on the face.  Similarly, laser skin resurfacing technology, like the Sciton® Erbium laser, must also be precisely calibrated to each patient’s specific skin type in order to remove the skin tissue to an exact, pre-determined depth and achieve results that are customized to the intricacies of an individual face.  Chemical peels do tend to be less expensive than laser skin resurfacing procedures, but patients with particularly sensitive skin may not be optimal candidates for this procedure.  Ultimately, when deciding between the two, one needs to consider the patient’s skin type, condition, goals, lifestyle, and budget in order to get the best possible results.  During our consultation, I will work with you to determine your specific requirements so that we can find the technique that will be best for you.

If you are interested in learning more about how any of the facial plastic surgery procedures that I perform may be able to help you, please contact me, Dr. Fernando Burstein.  Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, in order to assist you.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.