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101 Old Short Hills Road Ste 510
West Orange, New Jersey 07052

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Category: Facial Surgery

In Office Rhinoplasty

The use of Injectable fillers for filling defects in the nose.

The use of cosmetic hylauronic acid based injectable fillers has expanded to many applications over the years. For nearly 10 years now, I have used these fillers (Restylane and Juvederm most commonly) to treat minor to moderate secondary defects post Rhinoplasty. The typical patient is one who had undergone Rhinoplasty elsewhere, was dissatisfied with the outcome, came to me for evaluation, and was deemed to have a contour anomaly treatable by filler injections in the office, saving the patient the need for another surgical procedure and recovery.

The use of injectable fillers for subsurface contour improvement in the nose, is well documented. In certain areas of the face, filler injections can last (and remain in place) for several years before dissolving away. This can be far greater than its initial approved use in nasolabial fold region. The most common defects treated include smoothing out an irregular bridge, filling in grooves or depressions, and camouflaging some crooked aspects. The process takes about 20 minutes and may leave some minor bruising and swelling which may take 7-14 days to fully resolve. There is generally no other recovery restrictions. There is no need for splints, and activities can resume immediately.

Patient satisfaction is generally very high, and it’s a welcomed and accepted alternative to repeat surgery.

Leave Beautiful Renee Zellweger Alone!

As a plastic surgeon, artist, and above all, kind and respectful person, it upsets me to see so many people piling on and giving their opinions on Renee Zellweger’s appearance.  Most are not worth the “two cents” they attempt to give.

I can’t believe the multitude of “haters” disguised as experts, pundits, non-experts (lay people), and columnists who are weighing in on Renee Zellweger’s appearance and possible activities.

Basically, I despise gossip, and today’s social media scene makes everyone a gossip columnist.

“I think Renee Zellweger looks Beautiful”. Why haven’t I read this anywhere??  She does.  I am a plastic surgeon, an artist, a male.  I don’t have to look and spend time over analyzing her.  To what end?  To denigrate her?  Why? Her choices in appearance haven’t hurt anyone, have they?  Oh, I get it; I think it’s a subterfuge of fear of the self-empowered attractive woman trying to make herself even more attractive.  What is wrong with that?  I personally think she looks radiant, tasteful, artful, and beautiful now.

What I detest is the modern social concept that we should all stick pins in her voodoo doll through social media outlet.  Is it today’s objective to constantly shoot people down? Leave her alone. Your jealousy wreaks of sour grapes.

And Andrea Peyser, I am shocked at you! One of my favorite NY Post columnists for years, you even got sucked into the melee.  I expected more from you.

Renee’s choices are her own.  Her intent by whatever means, happened to have a very nice result.  I am standing up for all my “Renee Zellwegers” and all the countless “Renee Zellwegers” out there.  Let people express themselves and if they don’t harm you, leave them alone and just be happy (and encouraging) that they are happy.   The world will be a far better place – trust me on this one…

Selfies and Your Neck

In the social media age, everyone has their picture taken. If you have ANY saggy skin in your neck, you undoubtedly “crane” your neck, raising it upward as too elongate and pull neck skin taught.  So all, not so young women, now are trained to crane upward and outward. I have a simple and more permanent solution- a neck lift or face and neck lift! Than you can proudly display your youthful contours!

Patient Testimonial

I have decided to share with my blog readers some of the kind words my patients have had about their experiences with me. So each week for the next nine weeks you will get to read the reflections of former patients. Their words will reveal a lot about me to you.


Thank you Dr. Spiro! Thanks to your excellent surgical talents, my energetic and youthful attitude now matches my facial appearance. The reflection I now see in the mirror is in sync with my youthful and energetic attitude about life. It took me more than six months to make a decision to have surgery, and although it was a very, very tough decision to make, I look back with 100% certainty that it was the right decision.

It has been about two months since the surgery, and I absolutely love my youthful profile and overall facial appearance. What I love more than anything is that I look like a very refreshed and younger “me.” You did not change what existed; you enhanced it. By putting my trust and confidence in your very capable hands, I feel as though I have gained more than just a youthful appearance; I have gained a renewed sense of myself, which has a direct impact on everything I do in life.


Combined upper eyelid and lower eyelid blepharoplasty with lateral cheek lift

I’ve been getting a lot of interest from other Plastic surgeons regarding my approach to periorbital rejuvenation (blepharoplasty). I believe that several events combine to create aging appearance in the eyelid and cheek region. Firstly, the skin loses its vigorous attachments to underlying tissues. Additionally, the underlying tissues (cheek pad) separate from the underlying bone and fall.

When this cheek pad falls, it reveals the three distinct fat bags below the eye. Over time, the connective tissue thins out over these bags and the bags start to prolapse outward. This gives the characteristic bulging bags appearance.

Treatment involves addressing all of these issues. The mini lateral cheek lift is a key component. It is done by dissecting the lower lid tissues down over the cheek. Then using the upper lid incision, the muscle pennant tissue is elevated and sutured through to the bone,( lateral orbital wall). Fat is separated from the three fat pockets and teased apart in order to redistribute the fat across the rim, thereby creating a far more powerful effect.  The results can be truly amazing.

Facial Rejuvenation

Buyer Beware – Facelift?

There have been a lot of questions lately about “lifestyle lift” for facial rejuvenation.

A couple of clarifications first. Lifestyle lift is a type of brand marketing. Patients contact a call center where they are referred to a lifestyle doctor. The business end is completed at these call centers. Lifestyle then refers the patient to a lifestyle doctor near them. This could be, but not always is, a board certified plastic surgeon. It is up to the lifestyle surgeon to decide what things other than a basic lifestyle procedure should be done.

The basic lifestyle procedure is simple and is done under just local anesthetic. But that’s the problem folks!!!! It is so simple that it is essentially like a 1960’s face lift.

Now here is the complex part. Since all lifestyle surgeons have the ability to add or change, you the patient could be subjected to the poor technique, poor execution, and poor choices made by non – vetted plastic surgeons. You the patient are asking lifestyle to choose your surgeon! You don’t choose!! You just choose lifestyle. Now, there may be some good plastic surgeons who want to maintain a busy practice or want to develop a cosmetic practice so they join lifestyle. But ask yourself why? Is it because they can’t get a following?? And why???  The variability of what us done is scary and disappointing. But yes, it is cheap!! Now, is that what we’re after though?

Be smart people, don’t call a call center that is a marketing machine to get referred to a lifestyle doctor. Find out from friends and other doctors or nurses who they’ve seen results from or worked with. That’s the smart way of going about things!!

Good luck


Natural Look Facelift

I had hoped we’ve grown away from the windblown over pulled look characterized by so many face lifts done in the eighties and nineties. But sadly, we all can still see these faces everywhere. Sometimes they are as a result of a cookie cutter approach, and sometimes they are from over pulling the skin to compensate for under dissection of the deeper tissue planes that contribute to sagging. Nevertheless, the outcomes to me are suboptimal. Excessively tight pulled faces have skin which looks shiny and it tends to flatten the face. Flattening ages the appearance. Youthful faces have volume right?

Excessive pulling causes odd pull strains which set up as strange lines across the face. In my estimation, people want to look younger, not more strange. At least most people anyway!

We all are guilty of gently pulling our skin back across our cheeks and neck in a horizontal motion as we look into our mirrors! It probably happens countless times a day across America, but this is not how surgeons need to correct facial aging. There-in lie’s the trap. The face ages complexly, so the corrections can’t rely on one force to make change, and that is where weird outcomes stem from.  For example using “Threads” to tug on the undersurface of the skin, or doing a “skin only” lift. The corrections have to take into account the many levels of aging, problem is that there are anatomical considerations of where facial motor nerves run which prohibit certain things from being done. So knowing that surgeons must compromise for patient safety of outcome we have devised approaches which satisfy most of the requirements.

The face, including the eyes, age in pockets. We have areas of good adherence and areas of poor adherence. Well adhered areas stay fixed to underlying tissues. Poorly adherent areas sag.  The sagging progresses to the next fixed point. The interface between lower eyelid skin and cheek skin is one example. The nasolabial fold is another. The jowl is a third. Restoring these to their youthful location and adding back volume to some faces at the same time is the solution.

There are many fancy words to describe the numerous techniques out there. “Composite lift”,   “DUAL PLANE”, are just some of them.

My approach is simply this.

1-      Make a proper diagnosis. What really is happening to that face?

2-      Listen to the patient. What are they trying to achieve?

3-      Design a plan. Do they need volume added and where? Should it be fat grafting or filler? Combine this with a good extended “SMAS” face lift and extended skin undermining without extensive pull.

4-      Execute the surgery well

5-      Have patients agree to a long term skin surface replenish program with products and light periodic peels

And there you have it. A primer on plastic surgery of the face!

Best of luck!

Promises to fill the needs of our patients who are seeking non-surgical facial & body regenerative skin care.