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101 Old Short Hills Road Ste 510
West Orange, New Jersey 07052
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Category: Plastic Surgery

ASAPS 2016

ASAPS (American Society of Aesthetic Plastic Surgery) 2016

I was honored to be chosen as a speaker for the full day instructional course on cosmetic breast implant and lifting surgery.  It was an international panel composed of eleven world leaders in combination breast lifting and implants.  This nearly 11 hour symposium was extremely well attended as it was actually scheduled for the day before the National/International meeting (American Society of Aesthetic Plastic Surgery, ASAPS) officially got underway.

It was especially nice to see how well my talk was received.  I had numerous plastic surgeons coming up to me telling me how amazed they were at my outcomes, and wanting more information, even asking if they could fly into town to watch me do surgery!  Additionally, the symposium chairperson has told me that the post meeting comments were overwhelming with many plastic surgeons very impressed with my techniques and outcomes.  I showed many videos of my surgical techniques and shared 34 cases of before and after which brought down the house.

My combination approach to superior aesthetic outcomes with breast lifting and implants, and revision of previous breast implant surgery resonated with the sophisticated and experienced audience for its artistry and technical merit.

I will continue to bring the same strategy to all future patients here at Spiro Plastic Surgery.

Nipple Tattooing

There has recently been a lot of press about certain tattoo artists who are all of a sudden seemingly specializing in 3D tattooing of a nipple and areola in breast reconstruction. This is nothing new to me or our practice as I have been doing this for nearly twenty years. As an accomplished artist, it was a natural marriage of sorts between art and surgery of sorts. I have done thousands of nipple reconstructions for post mastectomy patients with a fairly unique technique I developed in the 1990’s. (it can be seen on our YouTube channel at Spiro Plastic Surgery). I have done the tattooing personally into most of those nipples I reconstructed over the years. There is a subset of women who just don’t want a formal nipple reconstruction procedure, so for these women I do 3D tattooing. I use only approved medical grade, natural pigments (nonmetals) and often blend or use a variety of colors (sometimes up to 5 per patient) to get a real Trompe-l’oeil look! Check out my YouTube video documenting me doing nipple tattooing- you’ll love it! https://www.youtube.com/user/SpiroPlasticSurgery

Why is cellulite so hard to treat?

Before we talk treatment, we have to discuss what cellulite exactly is. Cellulite is the visualized interaction of gravity’s influence, affect and consequences on the interactions between skin, underlying connective tissue attachments, and deeper tissues of fat, muscle and fascia.

The fewer (looser) the connective tissue (fibrous) attachments the looser the cellulite. The longer, lower and larger the column of tissue (thighs) the greater the chance for cellulite.

Genetics and age influence greatly the propensity for (or lack thereof) cellulite. Thin skin and fatty tissue show it far worse. Thick skin with little fat and good attachments rarely show cellulite.

The treatments therefore focus on diminishing the variables that can be addressed. Lifting tissues and/or tightening (tummy tuck, body lift, thigh lift, and arm lift) serve to reduce or eliminate cellulite. Reduction of fat volume can aide in reducing cellulite; liposuction and Coolsculpting can both achieve this to varying degrees.

In conclusion, there is no panacea, no magic bullet, no simple solution, but improvements are achievable.

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.

Positive Evolutionary Changes In Shaped Gel Implants

Shaped gel implants have undergone a renaissance in the last year or so. In one of my first blogs I was particularly difficult on them. There were limited options of shapes and sizes. The manufacturer’s have implemented significant advances including many many new shapes and sizes which open up the use of Shaped Gel filled implants to augmentation and reconstruction patients. Lets make it clear, no one style implant fits all patients.

There are a multitude of body shapes, breast shapes, conditions and patient desires. There is no perfect device.

I have been using shaped gel implants more and more for certain characteristics with good results. It is not necessarily based on a patients desire to have a Shaped or “natural result”. Some of the most natural results come from round smooth surface gel implants!

It is a complex decision process that only an experienced Plastic Surgeon has a grasp of. (torso curvature, rib asymmetry, starting breast volume, internal tissue laxity or tightness, nipple to breast fold starting distance, existing asymmetries and goals for outcome just to name a few…).

…So don’t look at the website and try to guess who has what. You (along with other plastic surgeons) will be and have been statistically wrong in your guess nearly 50% of the time!

In the end it takes good listening, thoughtful examination, and planning to limit the innumerable variables the human body presents.

Botox Gone Haywire!

I’m going to preface this by saying that i like Reese Witherspoon. I find her to be a really good actress, a nice person and an attractive woman, but…

…but the Botox she received prior to being on the Red Carpet at the Oscar’s revealed itself (during her animated interviews) to be incomplete and unartistically done. Overdoing one area ( in this case, central glabella for the eleven’s) and forgetting about the other animating parts of the forehead (crow’s feet and transverse lines) lead to glaring oddities during facial expression. Reese was shown to have a flat, almost hollow, area between her eyebrows with an oddly curving cascading series of lines around it.

I painstakingly think Botox patterns out in the faces I inject. My “TV Personalities” generally want to leave some areas of the face to show animation but this Botox example sadly failed to do in in a discrete blended manner.

I felt bad for Reese Witherspoon. She likely told her injector to leave her with the ability to be expressive. ( I don’t like the stark immobile look either).

I wanted to turn away but found that I couldn’t. Instead I was drawn to the bizarre pattern of facial animation. Poor Reese.

A message to everyone then …

Make sure there is thoughtful decision making by your injector! And if something goes awry with Botox, you can often re-manipulate it 7-10 Days later with added small injections. The goal should be to look rested and youthful…and normal, above all!

The Spirit of the New Year!

I turn this blog post over to one of my patients. nothing else needs to be said…

“Dr. Spiro,

As we ring in 2015, I just wanted to thank you for the journey you went on with me-getting me through multiple surgeries and always being a source of hope and anticipation. I will be 3 years cancer free and without you my recovery both mentally and physically would not be anywhere near the same. I can not put my gratitude into words- I carry it in my heart.

I took off my garment today, 6 months to the day of my last surgery. I actually liked the garment, it comforted me. I will actually miss it! Go Figure!

My legs are amazing and in the year of butts being “in”, I am Rockin’ it! It’s so amazing and has given me the confidence my illness took away.

I send you and everyone in the office all the best for 2015. What you do transforms lives and your care transforms the human spirit. Thank you for everything!”

Correction of Tuberous (Tubular) Constricted Breast Malformation

Tuberous breast malformation can be extremely difficult to correct.  Also known as constricted breast, these conditions create oddly shaped breast and nipples which appear to herniate out from the breast.

Correction requires a complex release of fibers creating the problems and peri-areola mastopexy.

See Case #1 in section ” Challenging Breast Anomalies”. 

We’re number ONE!- Spiro Plastic Surgery and Regeneration The Medical Spa awarded best Spa in Essex county

We’re number one!. That is, Spiro Plastic Surgery and Regeneration the Medical Spa is number one. We were just awarded this distinguished honor from a poll taken by Suburban Essex magazine regarding best Spas in Essex county. Regeneration the Medical Spa offers the latest in comprehensive Medical Grade skin care Products and Peels, non surgical facial rejuvinative procedures such as Botox and cosmetic facial fillers, and the latest in non invasive fat reduction treatments using cool sculpting by Zeltiq. These services are provided by myself (director of services) for fillers and Botox, by my experienced, licensed, medical aesthetician (Beata) for skin care services, and by our two experienced, licensed, registered nurses ( Mary Beth and Maria) for cool sculpting, and for scar repair by our entire staff.

Our encompassing coordinated services are provided in our comfortable spacious office suite from 9 AM to 5 PM daily, evenings and on some weekends. By coordinated I refer to our efforts to coordinate and develop skin care regimens to the specific needs of both our surgical and nonsurgical patients. Interaction between nursing staff, aesthetician, and myself enhance the patient experience and improve the quality of our patients outcomes.

But, the complexity of coordinating Spiro Plastic Surgery and Regeneration the Medical Spa could really only happen with a professional like minded business staff to assure that the clinical outcomes we aspire to achieve are actually met. This includes coordinating, in some instances, a peel, a botox and or filler treatment, a cool sculpting session, and education about our product offerings all in the same visit. Mel, Diane, Veronica, Dina, and Kelly ( our expert office staff), are the reason we can get this done. Their main goal is to make our patients happy and they take great pride and joy in doing just that. None of this could happen without them.

We are committed to providing patients with the safest, most reproducible, effective products and services. We are always balancing the latest in science available with assuring that we provide products and services that really work. So when Zeltiq released the latest cool sculpting hand piece flat applicator for saddle bags, we were the first to receive it.  We offer the latest available Skin Medica and Obagi peels and products. We are  constantly evaluating new technologies, but we are very very picky in what we bring in. ( I might reject a technology merely because in our trials it was anticipated it would yield less than a 90 percent patient satisfaction rate).

Please join us in celebrating our staff, Spiro Plastic Surgery, and our happy patients. Follow our posts on instagram and Facebook closely as we are about to make a big announcement regarding our plans for a celebration.

Thank You for a great 2014 and heres to an even better 2015!

Follow her Recovery…

The “follow her recovery” section of our website is a  unique section where we follow the progress of healing from surgery with periodic post op photos. This is particularly useful to see in breast augmentation where variability in female chest wall and breast anatomy as well as patient desired outcomes often require a certain period of healing time in order to see the “final” cosmetic outcome. In breast augmentation, the immediate post op outcome may be visually altered for a period of weeks by tight tissues and sub-optimal cosmetic anatomy. Release of constricted anatomy, for instance, may take several months to fully loosen and soften. (see new case 1 in follow her recovery.) Extra tight (tighter than typical) tissues may take more time to soften (about six weeks) than more ideal anatomy (which may take only three weeks to soften). Implants (Technically speaking) in my practice are precisely placed, it is the anatomy surrounding the implant that needs time to soften and remodel. By doing this, the volume within the implant re-positions itself( generally speaking) to the anticipated planned outcome set forth at he original surgical procedure.

Therefore, it is constructive for patients to see how typical outcomes come about. Enjoy!

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