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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 thing that always fascinates me about the face is its complexity.  Although we tend to think of it as a single, unified area of the body, it is actually an extremely complex combination of different elements, including muscles, organs, bones, and cartilage, that all work together and complement one another.  That is one of the many reasons why it has always been my philosophy of facial aging that small changes to specific facial features made gradually over time can achieve the most effective and natural looking facial plastic surgery results.  One of the elements of the face that often goes ignored is the humble ear.  Few realize that the size, shape and placement of the ears are vital not only for overall facial aesthetics, but also for several vital anatomical functions.  Here are some fascinating things to consider about these often-overlooked features of facial architecture.

ear surgery The outer portion of the ear, which is called the pinna or auricle, is made up almost exclusively of skin stretched tight over a flexible cartilage framework.  The unusually scalloped shape of the pinna is extremely important, as it collects, amplifies, and guides sound waves down the ear canal so that they cause the eardrum to vibrate.  Moreover, the twists and folds of the outer ear specifically enhance sounds with a pitch that is typical for a human voice, leaving other pitches unaffected.  This has the effect of dampening background noise and helping the brain to focus on what we consider to be most important.  Finally, the projection and location of the ears also play important roles in helping us to determine where sound is coming from.  Sounds coming from the front or sides of the head are amplified, and sounds from the back are slightly muted.  These tiny differences in volume, combined with minute variations in the time a specific sound reaches each of the two ears, allows us to deduce the location of the source of the sound.

The intricate and highly specialized shape of the pinna can potentially make any plastic surgery intended to change the appearance of the ears, or cosmetic otoplasty, very difficult.  Whether a problem with the formation of the ear’s folds during fetal development causes the ears to protrude unnaturally far from the head, or the outer ears are damaged by repeated blunt trauma, as is the case with cauliflower ear, correcting the ear’s appearance requires a great deal of care and experience in order to preserve the outer ear’s functionality.  As a board certified plastic surgeon and otolaryngologist (head and neck surgeon) I have written several professional articles on ear surgery and performed thousands of otoplasty procedures on both children and adults over the years.  That experience and attention to detail has allowed me to consistently achieve extremely natural looking ear surgery results.

Whether you are an adult or a child, appearance can make a difference.  However it is important to carefully balance aesthetics with functionality in order to ensure long-term satisfaction with your plastic surgery results.  If you have any questions about cosmetic or reconstructive ear surgery or about any of the other facial plastic surgery procedures that I perform, please feel free to contact me, Dr. Fernando Burstein, to schedule an appointment for a full consultation so that we can discuss your particular needs.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Eyelid Surgery Ideal for Subtle Facial Rejuvenation

May 2nd, 2016 | Posted by drburstein_marketing in Blog | Eye Rejuvenation | Frequently Asked Questions - (Comments Off on Eyelid Surgery Ideal for Subtle Facial Rejuvenation)

During the more than twenty-five years that I have been a board-certified plastic surgeon in Atlanta, I have seen trends in plastic surgery change a great deal.  Decades ago, celebrity facial plastic surgeons developed signature looks that were clearly identifiable, and their patients proudly flaunted those looks as a sign of wealth and privilege.  Today however, even though cosmetic plastic surgery procedures have become increasingly popular and accessible, patients are usually more concerned with achieving a natural-looking, nearly undetectable result.  They come to me wanting to look more youthful, refreshed, or rejuvenated, but want to avoid a “wind-blown” or “worked-on” appearance.  In my experience, this is best achieved by using techniques that are less extensive and more highly-focused to make minor alterations that are noticeable but extremely subtle.  One of the most effective techniques for achieving this purpose is a blepharoplasty, or eyelid surgery, for a number of very specific reasons.

eyelid surgery atlanta gaProminent Location for Maximum Visibility

The eyes are the focus of the vast majority of our social interactions, and so the signs of facial aging that affect the area around the eyes are often the first that become obviously noticeable.  A blepharoplasty removes the excess fat and skin from the eyelids while tightening the tiny underlying muscles, improving the appearance of the upper eyelids, lower eyelids, or both, as needed by the individual patient.  This alleviates the hooding and puffiness that can make the eyes appear tired, sleepy, or sad.  Since the eyes are such an important focal point of the face, even tiny changes in this area can make a big difference.

Minimal, Nearly Invisible Scarring

All surgery causes scars, but because only minute amounts of skin and fat are being removed from the eyelids, the tiny incisions required for an upper blepharoplasty can be easily concealed in the natural folds of the eyelid.  Moreover, using an advanced transconjunctival blepharoplasty technique, I can make the incisions for a lower blepharoplasty inside the lower lid itself, making them even less conspicuous.  Minimizing post-surgical scarring is a vital part of achieving the most natural looking eyelid surgery results.

Universally Useful for Both Men and Women

Drooping, sagging eyelids are a common result of the loss of elasticity as the facial skin grows older.  While this can be troubling for anyone, many men in particular complain that this makes them appear tired, angry, or unapproachable, impairing both their social and professional interactions.  This is one of the reasons why blepharoplasty is actually second only to nose surgery among the most popular facial plastic surgery procedures for men.

Significantly Shorter Recovery Time

We live in a fast paced, busy world and many patients cannot afford to take an extended amount of time off to recover from cosmetic plastic surgery.  Eyelid surgery generally only takes from one and a half to two hours and patients can usually go home that same day.  Although every patient is different and individual healing rates can vary significantly, recovery after a blepharoplasty generally requires less time than any of the more extensive facial plastic surgery procedures.

If you have any questions about eyelid surgery or any of the other facial plastic surgery procedures that I perform and would like to schedule a consultation to discuss your particular needs, I would welcome you to contact my office for additional information.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

Facial Plastic Surgery Procedures Achieve Longer-Lasting Results

January 29th, 2016 | Posted by drburstein_marketing in Blog | Face Lift Surgery | Facial injectables | Plastic Surgery news - (Comments Off on Facial Plastic Surgery Procedures Achieve Longer-Lasting Results)

Non-surgical facial rejuvenation techniques are more popular than ever.  Since 2000, the number of Botox®-related cosmetic facial procedures performed in the United States increased by nearly 750%.  Similarly, the numbers of soft tissue filler and laser skin resurfacing treatments have each more than tripled over the same period.  Altogether, these minimally-invasive techniques accounted for more than 60% of the cosmetic plastic surgery procedures performed in the United States in 2014.  But despite the popularity of these versatile procedures, many patients have found that they can achieve much more substantial and long-lasting results by combining them with more traditional plastic surgery techniques.  Advancements in surgical technology and technique allow for modern plastic surgery procedures to be tailored specifically to the needs of the individual patient, allowing them to achieve exceptionally natural-looking results with significantly reduced recovery time and cost.

non surgical facial rejuvenation atlanta ga - dr fernando bursteinIn the more than twenty-five years that I have been a practicing facial plastic surgeon in Atlanta, I have come to believe that patients should begin their treatment plans earlier in the aging process, and only undergo more comprehensive, surgical procedures as they become necessary later in life.  It is my facial rejuvenation philosophy that this graduated approach, focusing on each patient’s specific areas of concern, is the best way to address the traditional signs of facial aging and keep the patient looking younger, longer.  Early in the process, particularly when patients are in their early thirties, non-surgical facial rejuvenation procedures are usually enough.  Laser skin resurfacing treatments can help treat skin that has been damaged by excessive sun exposure, and injections of Botox® or facial fillers like Juvéderm® can alleviate the appearance of tiny expression lines early, preventing them from deepening to form more substantial facial wrinkles later on.  As the years go by, however, the tissues and muscles that support facial architecture naturally begin to weaken, potentially making these techniques less effective.  The effects of facial rejuvenation treatments can generally only last for several months, but studies have found that patients who had undergone facelift surgery still looked younger than they did before the procedure even after an average of five and a half years.  Ultimately, minimally invasive facial rejuvenation procedures do not have the long-term persistence that full plastic surgery can provide.

However, modern facial plastic surgery techniques are very different than the ones that were used even a few decades ago.  Long gone are the dramatic, stretched, wind-blown appearances that characterized facelifts in the 1970’s and 80’s.  Instead, today’s plastic surgery patient can benefit from highly targeted procedures, specifically designed to address individual areas of concern.  Mini-facelifts, for example, can focus on the upper, middle, or lower thirds of the face, depending on which areas of concern the patient would most like to address and which are needed.  This increased specialization makes it possible to achieve subtle effects with less extensive surgery, which means less post-surgery recovery time and results that will give you a rejuvenated look without making it obvious that you have had any work done at all.

It is important to note that facial aging can vary dramatically from person to person, and the different areas of the face usually do not age at precisely the same rate.  I believe that every patient needs a personal treatment plan to address facial aging in order to achieve the best results.  Contact me and schedule a personalized consultation to find out how you can achieve the look you want with a minimum amount of surgical downtime and discomfort.

About Dr. Fernando D. Burstein, M.D., F.A.C.S., F.A.A.P.

Dr. Fernando Burstein is a well-respected Atlanta facial plastic surgeon with board certifications in both plastic and reconstructive surgery and otolaryngology (head and neck surgery.)  With nearly thirty years of experience specializing in cosmetic and reconstructive facial plastic surgery procedures, Dr. Burstein has served as both the chief of plastic and reconstructive surgery and the director of the Center of Craniofacial Disorders at Children’s Healthcare of Atlanta as well as a clinical professor of plastic and reconstructive surgery at Emory University.  He has authored and published more than 100 articles and book chapters on facial plastic and reconstructive surgery and has been honored as one of Atlanta Magazine’s Top Doctors, a peer-nominated award in the field of plastic surgery, for the past seven consecutive years.

Correcting Pediatric Malformations of the Ear

December 18th, 2015 | Posted by drburstein_marketing in Blog | Ear Surgery | Pediatric Plastic Surgery - (Comments Off on Correcting Pediatric Malformations of the Ear)

When I was Chief of Plastic and Reconstructive Surgery at Children’s Healthcare of Atlanta (CHOA) at Scottish Rite, I had the opportunity to help many infants born with a variety of congenital facial deformities, and one of the most common concerns that I addressed was ear malformation.  Minor problems during normal fetal development cause the ears to protrude unnaturally far from the head or, conversely, may result in constricted ear or “cup ear” where the patient’s ears are abnormally small, or microtia where the majority of the external ear is missing.  In all of these cases, ear surgery, or otoplasty, may be able to help give the ear a more balanced and natural looking appearance.

ear surgeryThe ear is a very intricate organ, composed of cartilage, skin, and fat folded into its characteristic complex pattern.  Although every patient is unique, and every case requires its own distinctive approach, congenital ear deformities tend to fall into a handful of distinctive categories.  Some of the specific malformations that I commonly address include:

  • Prominent Ears: Between the third and sixth months of fetal development, the cartilage forming the outer ears begins to undergo a series of folds which give the ear its characteristic appearance. In some cases, the process can be interrupted, and a missing fold causes the ears to protrude more than 2 cm from the side of the head.1
  • Constricted Ears: Also known as a “cup ear” or “lop ear” deformity, this malformation occurs when the upper helical rim is either folded over, wrinkled, or tight. In the most severe form, the ear may be rolled up almost into a tube and the front part tilted forward, requiring additional cartilage taken from elsewhere in the body to fully correct.

surgery of the earsIn general, the goals of cosmetic ear surgery are to decrease the prominence and protrusion of the ear, create an antihelical fold and superior crus if these are absent or effaced, and make the lobule proportionate to the rest of the ear.  In addition, any successful ear surgery needs to appear natural, and avoid a “pinned ear” appearance.  In the more than twenty-five years that I have been a practicing board-certified plastic surgeon and otolaryngologist in Atlanta, I have developed my own technique2 for addressing these concerns that incorporates principles and technical innovations from a variety of sources, allowing me to achieve excellent, easily reproducible otoplasty results with minimal complications.

If you have any questions about ear surgery, or are interested in discussing how any of the cosmetic or reconstructive facial plastic surgery that I perform can help you, please contact me, Dr. Fernando Burstein, to schedule a consultation.  Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

  1. Cohen, SR., Burstein, FD.: “Protruding Ears.” In: Spitz, L., Coran, A.G. (ed.), Rob & Smiths’ Operative Surgery. Chapman & Hall Medical, London, 1995.
  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.

Eyelid Surgery: The Tiniest Details Achieve Impressive Results

December 4th, 2015 | Posted by drburstein_marketing in Blog | Eye Rejuvenation - (Comments Off on Eyelid Surgery: The Tiniest Details Achieve Impressive Results)

The human face is incredibly complex.  Made up of more than forty distinct muscles each capable of their own intricate movements, the face is able to twist and contort into an almost infinite number of different expressions.  Most of us spend our entire lives learning to decode the subtle interplay of these muscles, and can distinguish individual nuances of expression from even the tiniest shifts and twitches.  This is just part of the reason why I believe that the most effective approach to facial rejuvenation involves making subtle and gradual changes.  Because the underlying muscles and tissues in the face all work together, even the tiniest alteration can give the entire face a different appearance, so it has long been my philosophy on facial rejuvenation that minor cosmetic procedures performed during the early stages of the aging process can create long-lasting, natural-looking results.  One of the most effective of these subtle facial plastic surgery procedures is blepharoplasty, or eyelid surgery.

Eyelid Surgery The Tiniest Details Achieve Impressive ResultsIt is common knowledge that, as we grow older, the skin of the face gradually loses its elasticity and begins to sag.  This is an underlying factor in nearly every one of the traditional signs of facial aging, from frown lines, to crow’s feet, to drooping jowls.  One of the first places that this process becomes evident is in the parchment-thin skin of the eyelids.  As the constant pull of gravity slowly causes the eyelids to stretch and the muscles supporting them to weaken, excess skin can collect both above and beneath the eyes.  This skin wrinkles and creases in the lower eyelid and can form bulges that hang over the eyelashes on the upper lid.  In some cases, this hooding can even become so severe that it can obstruct peripheral vision.  Moreover, the fat cushioning the eyeball within skull can start to form heavy bags underneath the eyes when the thin membrane that holds it in place weakens.  In the midst of this extremely expressive and obvious location, even minute changes can have a dramatic effect, making the eyes, and by extension the entire face, appear tired, sleepy, or sad.

Cosmetic eyelid surgery, or blepharoplasty, is a highly specific procedure that removes the excess fat and skin around the eyes while tightening the tiny underlying muscles.  In a single short session that generally takes between one and a half to two hours, a blepharoplasty can achieve impressive cosmetic surgery results with minimal cost, risk, and recovery time.  Since the incisions are naturally concealed in the folds of the eyelid or, in the case of a transconjunctival blepharoplasty, inside the lower lid, the appearance of scars is minimized.  Overall, by addressing the very smallest of details, I am able to noticeably rejuvenate and improve the appearance of the entire face.

If you have any questions about eyelid surgery or any of the other facial plastic surgery procedures that I perform and would like to schedule a consultation to discuss your particular needs, I would welcome you to contact my office for additional information.  Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.

About Dr. Fernando D. Burstein, M.D., F.A.C.S., F.A.A.P.

Dr. Fernando Burstein is a well-respected Atlanta facial plastic surgeon with board certifications in both plastic and reconstructive surgery and otolaryngology (head and neck surgery.)  With nearly thirty years of experience specializing in cosmetic and reconstructive facial plastic surgery procedures, Dr. Burstein has served as the chief of plastic and reconstructive surgery at Children’s Healthcare of Atlanta and as a clinical professor of plastic and reconstructive surgery at Emory University.  He has authored and published more than 100 articles and book chapters on facial plastic and reconstructive surgery and has been honored as one of Atlanta Magazine’s Top Doctors, a peer-nominated award in the field of plastic surgery, for the past seven consecutive years.