70% of physicians who offer Botox in their practices actually get treated with Botox and half have actually injected themselves! I designed and conducted a survey along with my co-authors on physicians in core specialties regarding Botox and Facial Filler treatments. This survey was published last week in the Archives of Facial Plastic Surgery. Over 6500 doctors from the four specialties were polled including: Facial Plastic Surgery, Plastic Surgery, Dermatologic Surgery and Oculoplastic Surgery (these are considered to be the core specialties for facial fillers and neurotoxins by the Physicians Coalition for Injectable Safety, http://www.injectablesafety.org).

These astounding statistics speak for themselves. Doctors trust Botox and fillers so much that not only do a majority who offer them in their practices get them, but half of these physicians actually inject themselves. Nothing speaks louder when it comes to trust than findings like this. I am often asked if I would have such – and –such a treatment done on myself or a family member, well here it is.

The third part of this study looked at who else doctors trust to inject them. Two thirds preferred a physician colleague, 27% a Physician’s Assistant, Registered Nurse or Nurse Practitioner. Additionally, two percent of those surveyed allowed non-medially credentialed individuals to inject them. Why? I have no idea but this is not condoned by any of the above groups. So, if you are wondering about the safety of Botox or Facial Fillers, consider what doctors actually do. Steven J. Pearlman, MD, FACS.

It’s the New Year and we are all filled with resolutions about how we will eat better, drink more fluids, exercise and take better care of our bodies. Unfortunately, even if that takes place, nothing will firm up your face or prevent the effects of gravity. Of course using sunblock daily, eating well and avoiding smoking will help but nothing can reverse facial aging. As I tell my patients, gravity sucks.

The face ages in 5 ways, we each go through it. Treatment choices depend on your priorities, tolerance and financial means.                           

You can start small with good home skin care and light office peels. My patients love the myBody myPROBIOTIC PEEL^TM peel that our office nurse Christine Ross does.

If you “Like” my page on Facebook you may qualify to win a complementary peel. http://www.facebook.com/PearlmanAestheticSurgery

Other minimally invasive treatments that can be done right in the office chair are fillers and Botox or Dysport. In 20 minutes you can knock off three of the 5 causes of aging. There is really no such thing as a “non-surgical” facelift but many patients can look great with peels Botox and fillers.

Surgery is the next step and can be read about on my website. 

Tip of the week: Exercise, hydration and good nutrition can make your body look younger but doesn’t help your face.

I am often asked by patients about celebrities and two extremes of results. First, why do they look so good? The second question is why do they look so bad? Don’t they have good plastic surgeons in Hollywood? These questions and comments are a result of the many celebrity focused magazines and TV shows.

From NY Times article

Last week I was sent supposed “before and after” photos of a third-tier celebrity to comment on what she had done; facial plastic surgery or other minimally invasive procedure such as Botox and/or Fillers. The problem was that the “after” photo was so photoshopped that it was a joke. I declined to comment replying to the inquiry, that with the amount of “work” that was done to the photo it could easily be Zsa Zsa Gabor at her current age instead of the forty-something reality TV star.

 The N Y Times had an article on that very same topic this week. One former talent agent along with a Dartmouth University computer science forensics expert discussed Photoshop changes on celebrity magazine photos. In a scholarly paper for the prestigious Proceedings of the National Academy of Science, Prof. Farid suggested a software tool for measuring how much a beauty photo has been altered. With this new tool and more “truth in advertising” the consumer would better be able to see what models and celebrities really look like. This could also reduce the often extremely high expectations of individuals seeking cosmetic surgery.

 The AMA actually has a policy on truth in advertising. Cosmetic surgeons are supposed to identify when a website or an advertisement has a model and not a real patient of theirs. Of course, before and after photos should always be un-retouched. Lastly, plastic surgeons should identify if the photos on their websites are actually theirs or generic. All before and after photos on my website are actual patients that have given us written consent for use of their photos.

 As for the “bad” side of celebrity cosmetic surgery; this is a topic for another blog. I have addressed fillers in past blogs. For some reason, if 1 cc of filler is good for a lay person’s lips or cheeks, for some reason in Hollywood they think 3+ syringes is better.

Celebrities often look better in magazines as a result of Photoshop. Plastic Surgeons cannot do this, so why can the media? Steven J. Pearlman, MD, FACS

Late last spring I was interviewed by Inside Edition on Bristol Palin’s surgery. To view the video click here:  Inside Edition Palin chin  The producers brought photos for me to comment on her jaw surgery. Ms. Palin reported that she had chin and jaw surgery to correct an abnormal bite; this is called orthognathic surgery. I don’t personally do this type of jaw surgery but sometimes it is necessary to correct an abnormal bite or TMJ (jaw joint) problems that can result from misaligned teeth. As you know, your bite can be very sensitive and even a small change can make a big difference. Even an abnormality the size of a grain of sand can alter awareness of your bite.

Jaw surgery usually has the added benefit of moving the chin forward helping to improve the patient’s profile and align facial features. If Ms. Palin truly had jaw problems, she also aesthetically benefitted from the surgery. Since her surgeon was already there, jaw surgery is sometimes accompanied by a chin implant or sliding the chin bone forward (a sliding genioplasty).  

During the interview I was asked if I thought Ms. Palin’s surgery was cosmetic. I said that I could only go by what was released to the press, that she had jaw surgery. However, the consequence of her surgery was also an aesthetic improvement. After being asked the same question three or four different times, they got a sound bite with me saying that the surgery was cosmetic. Well, yes it might have been, but as a consequence of or in conjunction with functional surgery. No matter what, she looks great. The “after” photo makes her look more like a Kardashian than a Palin.   

Weak chinks can be improved by chin implants, but may also herald jaw problems that may require corrective jaw surgery

Steven J. Pearlman, MD, FACS

National Breast Cancer Awareness Month is celebrating 25 years of awareness, dedication and empowerment. Even many pro football players are wearing pink shoes, socks and towels to heighten awareness for this devastating disease.  Breast cancer affects women young and old. While Breast cancer isn’t something that I come across as a treating physician since I confine my practice to the face and neck, this subject still holds dear to my heart. I know excellent physicians who dedicate their skills to helping victims. 

I dedicate my expertise to another dreadful cause for human suffering that is also being recognized this month – Domestic Violence.  Every 9 seconds a woman is battered in the U.S. by her partner. Over 500,000 cases of domestic violence are reported each year; however experts say that the incidence may be as high as three times that number. This applies to teenage relationships as well.

We are doing our part by participating in the Face to Face program of the American Academy of Facial Plastic and Reconstructive Surgery. The organization offers complimentary consultations, surgery, counseling and support to shattered victims of domestic abuse who otherwise would not be able to afford reconstructive or facial plastic surgery. My office is taking action against domestic violence and offering pro-bono reconstructive surgery through Face to Face. Facial trauma is a visual reminder that can never be hidden. The brave lady below met with me last spring through the Face to Face program. She had reconstructive surgery of her nose and a deviated septum. Her new nose means so much more to her than just ‘a new nose’. She no longer sees her past while glancing into the mirror each morning. She now has a new career, a beautiful family, and a new reflection on life.

If you know someone who is being abused, you must get them help and out of the relationship. It’s been documented that abuse is most likely to escalate. If you know someone who has been or might be subject to domestic violence, have them call the Women in Distress 24 – Hour hot line at 954-761-1122 or visit http://www.womenindistress.org/.

This is the month to protect and empower women who fall victim to two devastating conditions: Breast cancer and domestic violence. There are many ways that you can take a stand and spread awareness on both issues. You can walk a marathon, contribute to charities, or, like many teams on the NFL, show your support by wearing pink! Steven J. Pearlman, MD, FACS

Two weeks ago was the 46^th Annual Fall Meeting of the American Academy of Facial Plastic and Reconstructive Surgery. As co-director with Dr. Rick Davis from Miami, Florida, we spent countless hours over the past year working hard to make this meeting a success. From the feedback we received, it certainly was. There were approximately 85 hour-long courses, 9 invited lectures, 10 panels, 7 half day workshops, over 100 vendors, plus a number of special luncheon sessions. By meeting time, all of the hard work was done. We spent most of the meeting just making sure things ran smoothly and that all speakers and panels stayed on time and on topic. 

The most outstanding part was the speakers that we invited. We kicked off with Dr. Timothy Marten from San Francisco, an excellent lecturer on facelift surgery. Dr. Val Lambros presented his unique ideas on facial aging, based on years of studying individuals and how they age and comparing generations within the same family. Prof. Wolfgang Gubish from Stuttgart, Germany, a prolific rhinoplasty surgeon, gave a few outstanding lectures on treating very crooked and devastated noses; a topic on which he is world renown. Dr. Raj Kanodia lectured on his personal technique of subtle rhinoplasty and minimally invasive facial rejuvenation. Dr. Fred Menick demonstrated why he is one of the recognized experts in nasal reconstruction following cancer removal. Dr. Jeffrey Spiegel gave us new insights into beauty with a lecture on facial gender transformation surgery. Three endowed lectures were also given. Dr. Fred Stucker spoke on over four decades of performing rhinoplasty. Dr. Mohit Bhandari discussed the ever growing field of Evidence-Based Medicine. Dr. Richard Linnehan gave an inspiring presentation having flown four Space Shuttle missions. 

Overall, running this meeting was a busy but very rewarding experience. Having been involved in academic medicine for 24 years, I am able to fulfill one of the original definitions of doctor: to teach others.

Steven J. Pearlman, M.D., F.A.C.S.

Revenge Surgery 

What’s better than getting even when it’s time to move on with your life? In an April article i the NY Post, a number of women were interviewed who were

NY Post, for full text please click on link in the blog

going through life changes. Included in this article is Sue, a patient of mine who, at the time, was scheduled for a face/neck lift. Sue is now over a month post op and feeling great.

Sue is a wonderful lady with the most amazing and sensitive disposition, but her marriage of 12 years was coming to an end. She was also transitioning in another big life change: a new career as a schoolteacher. Like so many young minded women, her face didn’t match her young body and mind. A facelift is just what she needed for an, excuse the pun, “pick me up.”

I expect to be posting her before and afters in a few months when all healing is over, but already she is thrilled and has been told by many friends that she looks like her old self, not someone pulled or “done.”

If you feel like you look dated, you might do with a little tweak or two to get a fresh outlook on life. Revenge is sweet, especially when you look younger than your old spouse!

This is the title of an article from the New York Times on April 14, 2011 in which I was quoted. I guess that shows how far behind I am in my blogging. Anyway, the article interviews a number of high end providers such as Oscar Blandi Salon and Jennifer Jablow, DDS, a highly respected dentist. I was asked about placing an offer in Gilt City for discounts on Botox, facial fillers (Juvederm and Restylane) and laser hair removal. I chose Gilt City since I am a regular consumer and I see that they represent quality manufacturers and businesses. My promotion ran in December so people can get a quick fix to look younger for the holidays.

I found the vast majority of patients to be really nice people and high end consumers who were looking to try Botox or fillers for the first time, people looking for a new doctor to perform these treatments on them, and a few just looking for a bargain.

The next question was, would I do this again? I don’t want to repeat this offer for a long time since I don’t want to undercut my loyal patients who have been coming to me for years and paying higher prices and “cheapen my brand.” This sentiment was echoed by a patient on who I had performed surgery last year who owns a boutique public relations firm. She said she was impressed that I was forward thinking in running the offer on Gilt City but that I should “never do that again.”

Steven J. Pearlman, MD, FACS

One of the greatest rewards as a surgeon is the ability to use my skills to give back to others. I have been lucky to be associated with the Little Babyface Foundation. We surgeons donate our time and expertise to perform pro-bono surgery on children with facial deformities from around the world. The foundation pays for travel, housing and all associated medical costs other than surgeon’s fees for these deserving children.

Post op day 6, the day the bandages came off

In May, I corrected congenitally (inborn) deformed ears for a sweet seven-year-old girl named Samantha from South Dakota. Samantha had protruding ears with one side folded over, called a lop ear. Good Morning America featured Samantha’s story, which was about bullying and her mother’s proactive decision to get Samantha surgery. Otoplasty surgery for an inborn deformity is corrective plastic surgery—not cosmetic. Samantha’s confidence is now soaring, her peers embrace her, and she looks beautiful! You can see this segment by clicking on the following link: (Samantha on Good Morning America)

To summarize:  It is wonderful being able to use the unique opportunities I have had by allowing me to become a surgeon to give back to others.

Two new drugs were just approved for the treatment of advanced Melanoma (NY Times) and the FDA just announced that they are going to standardize SPF ratings for sunscreens (FDA announcement), all within the same month. How’s that for a coincidence?

According to the American Cancer Society, over 2 million skin cancers are diagnosed per year with 120,000 Melanomas. It’s so much better to talk about prevention. While we all know that the sun affects our skin on a daily basis (e.g. walking to work, school, out to lunch, driving in a car, etc.), most people only put on sunscreens on weekends before the beach, or playing a sport outside. Maybe you don’t need the heavy stuff, but you should use at least an SPF 20 on a daily basis. For prolonged outdoor activities, this should be upped to at least SPF 50. This is the maximum SPF that will be allowed on a label by the FDA when the new regulations go into effect.

 Sunscreens have also evolved rapidly over the past few years. The stronger sunscreens are no longer heavy, greasy or make your skin break out. We love the new Colorscience. It is a mineral powder makeup that has SPF 50 in it. You can apply it onto your skin daily and look great while protecting your skin. Plus it can be used under your eyes, an area that has very thin skin and needs protection. We even have Colorscience lip gloss with SPF

Sun protection is getting better and better, but you have to apply it on a daily basis and repeat for it to effectively protect your skin. That’s always better than the alternative: treating skin cancer. Steven Pearlman, MD, FACS