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Oct 30

In the old days surgeons simply removed those pesk

In the old days surgeons simply removed those pesky bags, accessing them through the back of the eyelid. The problem was the eyelids often looked hollow. Today we remove only some of the excess fat and reposition the rest to obliterate the “circles” below the bags. If it’s just the bags it is 1 hour and 10 days to look normal! Glasses hide the early swelling nicely.

For the surgeons: 30%TCA peel too, a great adjunct.

#lowerblepharoplasty #blepharoplasty #eyelidsurgery #dontlooktired

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Oct 29

Due to the vagaries of wound healing, and sometime

Due to the vagaries of wound healing, and sometimes unrealistic expectations, a perfect effort in the operating room sometimes may not yield a perfect result. A touch-up procedure can turn 90% satisfaction to 100%. They are quick and have virtually no recovery. Less than 5% are candidates. BTW, like some other things in life, this is something that everybody does and nobody talks about!
#makeitperfect #keepthemhappy

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Oct 28

It was a great honor to serve our #1 journal for e

It was a great honor to serve our #1 journal for eight years, reviewing over 900 articles, writing article discussions, and occasional editorials. Thanks to Dr. Rod Rohrich @rod.rohrich, Dr. James Stuzin, Aaron Weinstein and the rest of the fantastic PRS staff @plasticreconstructivesurgery for maintaining the highest standards for our journal. I learned a lot and am a better surgeon for it!

#giveback #prsglobalopen #prs #americansocietyofplasticsurgeons

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Oct 26

Our beautiful patient is seen here only two weeks

Our beautiful patient is seen here only two weeks after breast augmentation. She asked for something conservative to compliment her curves and that is what we did!

For the surgeons: Very petite with small base diameter. 215 cc just right.

#breastaugmentation #breastimplants #siliconeimplants #underthemuscle #looking good #naturalresults

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Oct 24

Long ago facelifts were done by just pulling on th

Long ago facelifts were done by just pulling on the skin. They did not last very long and cheek distortion was common. Today the skin is lifted to expose the deep (SMAS) layer which is a stronger vehicle for moving the overlying skin. The first patient image shows how tightening this deep layer smooths the lower face while passively carrying the skin upward with it. The tightening effect is stronger without causing cheek distortion because the skin is not doing the work!

“Deep plane” and “SMAS lift” are two names for the same deep layer tightening concept.

#facelifting #SMASlifting #naturalresults

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Oct 22

That says it all! This is the immediate view at s

That says it all! This is the immediate view at surgery. Rhinoplasty is so sophisticated today. We make a lot of counterbalancing changes to the framework underneath to end up with a subtle but refined outside appearance.

#openrhinoplasty #rhinoplastysurgeon #nosejob #newnose #lookinggreat #naturalresult

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Oct 21

Our patient is in her 50s and lost over 50 pounds!

Our patient is in her 50s and lost over 50 pounds! There was no abdominal muscle weakness from previous pregnancies so only skin had to be removed. Recovery is far easier in this setting. She also had an inner thigh lift, a much less commonly done procedure. It is reserved for more severe cases due to the scars required. She is thrilled with the outcome! #abdominoplasty #tummytuck #flatabs #worthit #thighlift #thigh

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Oct 19

We are thrilled to have Meghan join our team today

We are thrilled to have Meghan join our team today! She is a 2019 Villanova grad and spent her first year at NYU hospital: all great preparation. We already know we picked a future star!

#rnpower #plasticsurgerynurse #nursesrock #nursesrule

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Oct 17

Our lovely patient graciously allowed us to adapt

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Oct 15

This lovely former patient returned to us years la

This lovely former patient returned to us years later now interested in facial rejuvenation. A facelift was done today to improve her lower face and neck. Neck muscles were tightened in the front and from the sides, a very small chin implant added, and the cheeks tightened in two layers. This is the immediate result in the operating room!

For the surgeons: “witches chin” direct subcutaneous excision too.

#facelifting #faceliftbeforeandafter #smaslifting #platysmaplasty #lookyourbest

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Oct 14

Quick sketches with a model are great training for

Quick sketches with a model are great training for getting proportions, foreshortening, and anatomical shapes correct. It’s a relaxing counterbalance to focusing on minute details all day long in surgery!

#ilovedrawing #iloveanatomy #ilovesurgery

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Oct 13

Breast augmentation can look great at any age when

Breast augmentation can look great at any age when done tastefully. This super-fit mother of two just wanted to look as good on the outside as she felt on the inside. Implants should always be placed under the pectoral muscles to create a smooth slope on the top and to make mammograms easier to read.

#breastaugmentation #breastimplants #siliconeimplants #underthemuscle #lookinggood

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Oct 12

Our patient is gorgeous and only the nose did not

Our patient is gorgeous and only the nose did not fit with the rest of the picture. Rhinoplasty in our older patients is just as effective as in our teenagers!

#openrhinoplasty #rhinoplastysurgeon #nosejobbeforeandafter #lookinggreat #naturalresults

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Oct 9

Ashley is the tip of the spear at our practice and

Ashley is the tip of the spear at our practice and she is the glue that holds us all together. She is a natural ray of sunshine, uplifting patients and staff alike every day. Moreover, she has an indefatigable work ethic that keeps our office humming. We are thrilled to have her with us 11 years so far!

#candoitall #ourfoundation #teamleader

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Oct 9

This lovely young patient has a tiny waist and fin

This lovely young patient has a tiny waist and fine bone structure. She wanted something elegant, not overpowering. See our video Story posted today discussing how size was selected in her case. She was also self conscious about the visible rib structure. Notice how muted they appear in the “after” image.

#breastaugmentation #looknatural #notfake

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Oct 7

Eyelid aging changes occur earliest and often beco

Eyelid aging changes occur earliest and often become disproportionate by the 40s. Removing hooded upper eyelid skin is straightforward. Lower eyelid bags and circles can be treated without a visible incision. The excess fat is partially removed and the rest of it used to fill in the deep circles from behind. Typically little discomfort and a two week recovery.

#upperblepharoplasty #lowerblepharoplasty #beautifuleyes #eyebags #hoodedeyes

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Oct 6

Some of our patients seeking a “tummy tuck” no

Some of our patients seeking a “tummy tuck” not only have the bulging abdomen but also a “swayback” spine. The front will normally parallel the back in these individuals because there has to be room for all the internal organs in between. Therefore it is challenging (and sometimes not possible) to get the front completely flat when the back has such a deep indentation. In this case it worked out great!

For the surgeons: Thin patients who have markedly protuberant abdomens (i.e. not an excess intra-abdominal fat issue) should always be checked behind for deep lordosis. Not recognizing this can lead to disappointment later. This patient required three rows of vertical plication and a major transverse plication to get the abdominal wall flat. Keep in mind compartment syndrome in these situations!

#tummytuck #abdominoplasty #flatabs #ouch #worthit #getitback

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Oct 2

Many patients say “I just want my neck done, I d

Many patients say “I just want my neck done, I don’t want a facelift.” Actually, a facelift only treats the lower face and neck, not the whole face. It also corrects the jowls and provides a more powerful neck lift because the cheek and neck are rotated both upward and backward thereby creating more neck movement. A neck lift alone, in contrast, pulls in only one direction that is less effective by itself: straight back. Notice the improvement in the jowl area in this patient. The downward lines at the mouth are eliminated which enhances the rejuvenating effect of the neck lift.

For the surgeons: that’s not a chin implant, just a jaw thrust effect from the other side as we took the airway out and snapped the picture! Platysmal plication and subplatysmal fat excision.

#facelift #nevertoolate #naturalresults

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Oct 1

Our lovely patient sent us this photo 4 years afte

Our lovely patient sent us this photo 4 years after her rhinoplasty. I am thrilled that she thought of us to express her delight with the outcome!
#closedrhinoplasty #rhinoplastysurgeon #lookinggood

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Sep 30

Lip lifts are a popular fad now but overutilized.

Lip lifts are a popular fad now but overutilized. The best candidates are over 60 and typically exhibit a thinning upper lip and elongating distance between the bottom of the nose and the lip itself, both natural aging changes. Removing a strip of skin just below the nose and partially hiding the scar within the nostrils both shortens the distance to the lip as well as rolls it out so it appears thicker. This patient is a vibrant woman in her 70s who desired to have this aging sign corrected. The stitches have been blurred in the “after” picture taken at surgery today. Doing this procedure in young patients often leaves more noticeable red scars that can take many months to resolve. Also, proper judgement is required to avoid over-shortening the lip!

For the surgeons: A vertical measurement over 19 mm or so usually indicates a good candidate provided the anticipated change does not throw off the balance within the lower 1/3 of the face.
#bettersmile #lusciouslips #liplift #lips #plasticsurgerybeforeandafter #plasticsurgery #plasticsurgeonnyc

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Sep 29

Like the recent similar post this patient also had

Like the recent similar post this patient also had a rhinoplasty elsewhere and liked everything except the tip. I love these cases! They are interesting puzzles. While having a good idea from the outside what needs to be done, there are always hidden surprises within. Cartilages are often more weakened and deformed than surmised. Rearranging and rebuilding, typically borrowing cartilage from other sites, is the order of the day.

For the surgeons: left spreader, caudal septum extension graft, columellar strut after resecting medial crura 3 mm, resect redundant left lateral crura, alar rim grafts. Septum + MTF sources

#openrhinoplasty #rhinoplastysurgeon #nosejob #nasalreconstruction #lookinggreat #muchbetternow

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Sep 28

Christopher, our ace Practice Manager, popped the

Christopher, our ace Practice Manager, popped the question to now fiancé Rea in Central Park this weekend. He put huge thought and preparation into this and his 655 Park fam are thrilled to hear it was a great success. We are not sure who is luckier but know for sure she has a brilliant, sensitive, and highly organized partner for the next 50 years!

#soulmates #bestdecisionever

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Sep 25

Abi leaves her daytime family at 655 Park to furth

Abi leaves her daytime family at 655 Park to further evolve as a super mom, wife, part time athlete, and much more. She has set and impeccably maintained the highest standards for our operating room since the day she arrived. Abi has an iron work ethic and always treated the practice as her own. So many fun and tough spots together, with her will and equanimity key factors in always achieving the best outcome. You will be missed but we are all thankful for the large part of your life you devoted to us and wish you an exciting and happy future!

#superstar #rolemodel #GOAT

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Sep 24

Minor asymmetries are magnified with enlargement a

Minor asymmetries are magnified with enlargement and often become noticeable for the first time. As a surgeon it can drive you crazy trying to get everything perfect. Fortunately, such differences are barely visible when you look at the gestalt of the final result.

PS: She has enough breast tissue to conceal saline implants well. This allowed use of a small armpit incision. Saline implants typically last longer and do not require MRI scans for future monitoring.

For the surgeons: Dingman dissector only, no endoscope!

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Sep 23

Lower eyelid surgery takes about an hour, causes g

Lower eyelid surgery takes about an hour, causes generally mild discomfort only, and looks good at 10-14 days. It can be done by itself or included with upper eyelid surgery or any other procedure.

#eyelidsurgery #eyebags #eyecircles #blepharoplasty

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Sep 22

Our patient had breast implants placed ten years a

Our patient had breast implants placed ten years ago elsewhere and came to us for repair. The right side had hardened and the left side slipped downward. The former condition occurs randomly in about 5% and the latter is extremely uncommon. Here she is after correction and new implant placement.

For the surgeons: In a case like this do the capsulectomy side first and then match the capsulorrhaphy side crease position to the same height.

#breastaugmentation #breastlift #backtonormal

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Sep 19

Drawing the desired result adds clarity to goals o

Drawing the desired result adds clarity to goals only verbalized previously. The added study of individual patient anatomy during the process also helps me better achieve those goals at surgery.

#rhinoplastydesign #rhinoplastysurgeon #lookbetterfeelbetter

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Sep 19

It’s Friday afternoon at 3. All patients have be

It’s Friday afternoon at 3. All patients have been seen and all calls returned. The office is quiet. It’s time to indulge in the pure joy of performing the last surgery of the week. The immense trust placed in surgeons is both humbling and inspiring to get it right every time!

#rhinoplasty #openrhinoplasty #rhinoplastysurgeon #lookbetterfeelbetter

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Sep 12

Our beautiful patient had it all there - we just a

Our beautiful patient had it all there - we just adjusted one feature. These rhinoplasty selfies are taken 11 months after surgery. Not that she needed it but she is in the beauty business herself!@balayage_courtney

For the surgeons: L-shaped strut on right as both spreader and to support weak anterior septum, normal spreader left, columellar strut, transdomal and interdomal sutures, lateral crura repositioned inferiorly (after Sheen), minor trim left medial crura, Pitanguy ligament repair.

#openrhinoplasty #newnose #lookinggreat #naturalresults #crookednose

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Sep 10

Our patient today is fit, near ideal weight, and h

Our patient today is fit, near ideal weight, and has tight skin without cellulite. She also exhibits the classic areas of fullness largely resistant to nonsurgical measures. Liposuction is the most effective one step treatment for this with only modest discomfort and rapid recovery typical.

#liposuction #bettershape #lookbetter

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Sep 10

About half of our breast implant patients seek to

About half of our breast implant patients seek to restore their original look before multiple pregnancies rather than primarily for size enhancement. Implants do this much better than lifts because the implant insertion scars are largely inconsequential. Silicone is the preferred choice in this group because the tissues have thinned out too much from breast feeding to be compatible with saline implants. Silicone implants must be changed every ten years but our young patients accept the trade off. Moreover, there are other options down the road to mitigate this requirement.

#breastaugmentation #breastlift #breastimplants #siliconeimplants #getitback #notoverdone

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Sep 8

There is a precise amount of upper eyelid skin to

There is a precise amount of upper eyelid skin to remove for the best result. While the drawing may look random the instrument allows accurate measurements at intervals before finalizing the lines.

For the surgeons: using the Green forceps to grab the lower line drawn, simulate minimal lagophthalmos and holding the pen tip over the end of the forceps at that point, pull the lid down on tension and place a dot on the skin at that same point, and repeat at intervals. This will determine the proper course of the top line of the design. Extra-fine Sharpie pens make the thinnest line that will not bleed!

#upperblepharoplasty #eyelidsurgery #beautifuleyes

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Sep 7

This drawing I am working on today will be part of

This drawing I am working on today will be part of the new website. It will introduce the breast procedure section. Welcome to our 655 Park family joining us today!

#labordayweekend #rest #falliscoming

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Sep 5

I painted this 5’ x 6’ oil painting in college

I painted this 5’ x 6’ oil painting in college and it hangs in my garage today. It was done when photorealism was at its height in the art world and took 6 months to do. I was inspired after taking my then girlfriend on a date to the Watkins Glen races. She married me anyway! LOL

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Sep 4

“Tummy tuck”! All of the skin within the patte

“Tummy tuck”! All of the skin within the pattern will be removed. The top of the design and lower portion are then joined together after the underlying muscles are tightened. The navel will be preserved and stays in its original location. Very effective surgery but long scar (it’s a trade) and 1st week recovery challenging.

For the surgeons: A pinch test with the back at 45 degrees accurately identifies the top of the design so that incision is safe to make at the start. There are 4 tiny dots marking that point on the video and the design is slightly lower as you move laterally. Marking at no more than 45 degrees builds in some leeway for further elevation if needed for closure.
#tummytuck #abdominoplasty #flatabs #ouch #worthit #getitback #rectusdiastasis

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Sep 2

Individual plastic surgery procedures are most pop

Individual plastic surgery procedures are most popular at different times of the year. Summertime “rhinoplasty season” is winding down as the school year starts. The fall “facelift season” is now starting in earnest, an early start facilitated by the quarantine and mask wearing. I love the change in procedures that these transitions bring, just like the change in the seasons themselves!

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Sep 1

Breast augmentation is the most popular cosmetic s

Breast augmentation is the most popular cosmetic surgical procedure, with 300,000 performed annually in the U.S. It is very successful in the vast majority. In 5% scar tissue hardening can occur around the implant and requires surgery to correct. In a small number it can come back, but we now have a new method to successfully treat those cases! #breastaugmentation #capsularcontracture #naturalresults #plasticsurgeonnyc #aesthetics

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Aug 31

This patient had a rhinoplasty elsewhere and liked

This patient had a rhinoplasty elsewhere and liked everything except for the tip. I love these cases because they are real art projects! They often require unique, off the beaten track solutions using multiple cartilage grafts to re-create smooth, symmetric contours.

For the surgeons: columellar strut, right alar batton graft, left transdomal suture, interdomal sutures, camouflage grafts both sides, infralobular tip graft, membranous septum resection.

#openrhinoplasty #rhinoplastysurgeon #nosejob #newnose #lookinggreat #naturalresults

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Aug 29

Long before doing facelifts my first job was at Me

Long before doing facelifts my first job was at Memorial Sloan-Kettering Cancer Center repairing faces. Microsurgery techniques permitted transplanting blocks of tissue including muscle, skin, and bone from non vital areas of the body to restore missing tissue. Circulation to the tissue was re-established by sewing small blood vessels together with stitches finer than human hair under the microscope! The tissue was then shaped as needed. The next screen shows an example of what was accomplished with these techniques. A short procedure was 8 hours! Sometimes I miss those days!

#memorialsloankettering

For the surgeons: secondary reconstruction with fibula and scapula free flaps at two separate procedures. Result shown is twelve years later.

#memorialsloankettering

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Aug 27

We are thrilled to see our article published in th

We are thrilled to see our article published in the number 1 specialty journal Plastic and Reconstructive Surgery September issue. The topic is a successful new method to treat breast implant hardening. @prsjournal @drandrewweinstein

Writing is important to advance the field but is challenging. You need a good idea and enough patient experience to provide meaningful data. Then comes designing the study, writing it up and submitting it to a peer review process, all done on your personal time!

The rewards are great if you consider the prospect of affecting 1000 surgeons more impactful than treating 1000 patients yourself!

For the surgeons: take home point of this paper is for either recurrent unilateral CC or first time bilateral CC, use ADM to line the implant pocket. See procedure videos at: www.capsularcontracturecures.com

#breastimplants #breastaugmentation

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Aug 25

Our patient is only six weeks after open rhinoplas

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Aug 24

Surgeons have to be very fit, like serious bikers

Surgeons have to be very fit, like serious bikers or swimmers. Body contouring surgery such as breast reductions @hammdc1, tummy tucks” @alanmatarasso.md, body lifts @drjahmad and “Brazilian butt lifts” @uptownbodycontouring @drghavami require stamina, intense concentration, and considerable upper body flexibility and strength. Busy surgeons do multiple procedures like these per day, as often as every day!
#stayinshape #fitnessmatters

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Aug 22

Abi admires the charcoal drawing in the waiting ro

Abi admires the charcoal drawing in the waiting room of her two boys (in the middle) with their friends. When she showed me the original photo years ago I knew it would make a great drawing because of the perfect composition and message of spontaneity and happiness. Abi has run our operating room for 18 years better than I would run it myself! Loyal, hardworking, expert logistician, and the perfect foxhole mate when the going gets tough. #howluckyami #supernurse #rn

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Aug 19

Meet Samantha, hired out of nursing school a year

Meet Samantha, hired out of nursing school a year ago. She is smart and has an indefatigable work ethic. We have barely scratched the surface of her capabilities. A common response to requests is “I’ve already taken care of that”. We are thrilled to have her as part of our team!
#amazing #workethic #teammate #rn

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Aug 18

Non surgical fat removal with CoolSculpting works

Non surgical fat removal with CoolSculpting works for small spots in certain areas. However, liposuction is best suited for treating multiple areas simultaneously in one step. Much larger volumes can be removed too. Tight skin and lower BMI favor best results.

#liposuctionsurgery #fatremoval #bestshape ##narrowwaist

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Aug 17

These timed art class sketches are great training

These timed art class sketches are great training for the eye! You have assess proper proportions quickly to finish the figure in time. The benefits are transferable to making aesthetic judgements in surgery too.

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Aug 15

Lucky me! Best picture I ever took too.

Lucky me! Best picture I ever took too.

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Aug 13

Making the nose straight is a seemingly simple con

Making the nose straight is a seemingly simple concept. However the bump is half cartilage and half bone and each component is shaped with different tools and methods. Also, the overall angle and how it aesthetically connects with the tip is critical. Additionally, how it looks on the front views adds another three dimensional variable. However, compared to the variability and complexity of the tip structure, my colleagues would all agree that this is the “easy” part. #rhinoplastysurgeon #nosejob #nosejobs #nosejobbeforeandafter #nose #newnose #lookinggreat

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Aug 12

Wednesday morning breast augmentation #breastaug

Wednesday morning breast augmentation

#breastaugmentation #lookinggood #plasticsurgeonnyc #naturalresults

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Aug 11

Upper and lower eyelid surgery – a popular reque

Upper and lower eyelid surgery – a popular request for the earliest signs of aging in the late 30’s to mid 40’s. Often times done much later with facelifts.

For the surgeons: lowers done with minimal fat excision, transposition and 30% TCA peel.

#blepharoplasty #eyelid #plasticsurgery #aging #eye #beautifuleyes #eyelidexpert #brighteyes #gorgeouseyes #upperblepharoplasty #lowerblepharoplasty #eyelidexpert

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