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A Valentine’s Special: Sweethearts’ Plastic Surgery

            Pairs’ plastic surgery is more common than might be expected. Patients often find themselves coordinating procedures with their closest support members. Over the past twenty years we have welcomed simultaneous plastic surgery combinations for siblings, friends, parent-child, significant other (his-hers, his-his, her-hers) and more.


Valentine’s month is therefore appropriate to discuss sweetheart plastic surgery. These procedures are commonly performed for both men and women.


Refresh the Eyelids


            Men and women both begin to first notice aging changes   around the eyes. The tired, heavy look is a combination of extra upper eyelid skin and lower eyelid bags. The lower lid bags are mainly small fat pockets that can be removed for a fresher, more rested appearance. Other factors, such as high blood pressure, salt intake and certain diseases can also contribute to puffy eyes.


Upper eyelid skin can cause hooding that adds to the tired look. The correction is performed by removing the extra skin and a small amount of fat. The combination of upper and lower eyelid tuck can create a dramatic difference in the overall facial youthfulness.



Neck Lift


Another area that commonly concerns men and women is the laxity of skin, fat and muscle under the jawline. Men often come for consultation pinching the waddle under the chin. Although women often opt for full face and neck rejuvenation, men sometimes prefer the less invasive necklift procedure.


We favor the use of ultrasound with neck tightening procedures. Combined with eyelid surgery, the procedure often produces dramatic results and can reduce the aging appearance by decades.



Body Sculpting


Men are usually more discrete about their desire for body contouring procedures but are nonetheless eager and willing participants. Ultrasonic body sculpting typically produces less pain and a rapid recovery, which makes it ideal for men.


The main difference between men and women is in the areas for liposculpting. Men want improvement in the belly and love handles, while women often target the thighs as well. In addition, a unique body sculpting area for men is the breast for a condition called gynecomastia. Ultrasonic is especially useful for this purpose.


Valentine’s reminds us that pair’s plastic surgery can be a unique experience for couples to share. Advantages can even include togetherness during recovery. As always, consultation with a plastic surgeon experienced in the full range of procedures is important. Happy Valentine’s!




About the Doctor:


Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. He has lectured internationally on facial rejuvenation and body contouring topics and has been featured as a plastic surgery expert for major news outlets. Dr. Perez was an original investigator for Ultrasonic Liposuction studies and has been performing the procedure for 15 years. For more information call (954) 351-2200 or visit


Complex Facial Reconstruction: The Miami Face Eating Tragedy (Original Article)

· Reconstruction · No Comments

            The news media and internet have been buzzing with stories about a recent tragedy in Miami, Florida. A homeless man in Miami Beach, under the influence of a drug-induced high, cannibalized another homeless man. The attacker was eating the victim’s face and was eventually shot and killed by a police officer because he refused to stop.


The bizarre attack generated rumors of zombie behavior and soon gruesome photographs of a faceless victim spread throughout the internet. The victim was taken to a Miami trauma center for treatment and is currently recovering. I have been asked to comment on the reconstructive aspects of such an unusual and complex case.


I recall a very similar patient I personally cared for in New York many years ago. Early one morning I was called to our trauma center emergency department to see a young man with a severe facial injury. He had gotten drunk and argued with his mother. He decided to commit suicide and fired a shotgun under his chin. However, the gun angle was forward and his face took the full effect of the blast injury.


Where Do You Start?


The management of these complex facial injuries is divided into 3 phases. The initial phase is acute resuscitation. Just as with any other trauma patient, the ABC’s of airway, breathing, and circulation, must be followed. Often tissue debris or blood can obstruct the airway and compromise breathing. Lacerations to large arteries can also cause significant blood loss.


Once the patient is deemed stable the initial goal is to surgically clean the tissue and close or cover open wounds in order to allow healing and prevent infection. Wound closure can be difficult if there is a deficiency of tissue. The judicious use of biologic dressings and skin grafts is important. In addition, during the subacute phase, infection is a risk because the human mouth contains a high density of bacteria. Strong antibiotics and vigorous wound care are critical during this period which can last for weeks or months.


The third, or reconstructive, phase will require multiple surgical procedures likely over several years. The principle followed by plastic surgeons in such cases is to give priority to function, such as sight, smell, eating and speech. Cosmetic considerations, although important, are secondary to function. Bony structures, if jaw damage exists, are reconstructed first and then soft tissue is built upon this foundation.


Many options exist for reconstruction, however, the patient’s own tissue will generally be the most compatible. For example, a jaw can be framed from the patient’s own hipbone. If possible, it is preferable to use adjacent facial skin and muscle. If damage is too extensive then soft tissue can be harvested from other body areas such as the arm or even the buttocks and transferred to the face by microscopic attachment. Recently, headlines have been made by full face transplantation. These complex reconstructive cases typically require multiple professionals, including surgeons, dentists, therapists, nurses, social workers and others to work cooperatively.

About the Author:


Dr. Perez is plastic and reconstructive surgeon in Ft. Lauderdale, Florida. He is a graduate of The Albert Einstein College of Medicine in New York. Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets.

It’s Thanksgiving: Time To Deal With The Turkey…Neck

· Face and Neck, Safety · No Comments

Jorge A. Perez, M.D., F.A.C.S.

            One of the most common areas requested for plastic surgery improvement by both women and men is the neck. Youth and attractiveness are defined by a strong jawline and a firm, clean neckline.


The aging process in the neck usually starts by age 40 and is affected by several components: the skin, bones and cartilage, and the underlying soft tissue, including the muscles and fat. Treatment options will depend upon the correct evaluation of each of these elements.


Jaw surgery or chin implants can help compensate for a bony profile deficiency. These procedures however can be complicated and should be approached cautiously with experienced surgeons.


Younger patients with excess neck fat alone and good skin tone may benefit from liposuction. Ultrasonic lipoplasty is an advanced liposuction technique that will also stimulate neck skin tightening.


The most common aging change affecting the neck is hanging skin, affectionately known as the “turkey neck”. In addition, loose muscles can contribute to the “gobbler” or wattle.


A muscular sling in the neck that is tight in youth but begins to separate as we age is called the platysma. The separation in this muscle causes two ridges that define the neck bands of age. A common treatment to correct this separation is to sew these bands together with a small incision under the chin.


A unique, less invasive, operation performed by our office is to combine neck muscle repair with ultrasonic lipoplasty for skin tightening in carefully selected patients. We were privileged to present this procedure last year to plastic surgeons in the U.S., Europe and Asia.


The gold standard for neck rejuvenation however, continues to be the conventional face and neck lift. The procedure allows for redraping of the cheeks, jawline jowls and neck in a more even and complete fashion. The anatomy of this area is complex, therefore a thorough consultation with a plastic surgeon experienced in face and neck surgery is required.


Many options exist for rejuvenation of the neck and lower face. The procedures can be safe and effective in proper hands. The plastic surgeon, facility and anesthesia all play an important role in the outcome. Cost should never outweigh quality, experience and safety. Happy Thanksgiving.



About the Doctor:


Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. He has lectured internationally on face and neck rejuvenation surgery and has been featured as a plastic surgery expert for major media outlets. Surgery is performed at the Broward Health Weston facility with physician anesthesiologists.

To schedule a consultation with Dr. Perez call (954) 351-2200. To learn more about any of these procedures visit


It’s Spring. Time for a Lift? Face, that is. (Original Article)

· Eyelids, Face and Neck · No Comments

Spring is that time when we like to freshen things up. The options to freshen our appearance seem endless and often confusing. Lasers, peels, fillers and other “non-surgical” choices often compete with the more traditional surgical procedures. However, just like an artist chooses the right colors for his canvas, the plastic surgeon must guide the patient to choose the right treatment for the desired effect.

The last decade has seen an explosion of fillers used to treat facial wrinkles. In addition, it seems every day we hear another slick “lift” procedure advertised that promises dramatic results with minimal down time. It is more important now than ever for patients to seek honest, competent advice from multiple practitioners versed in the whole array of treatment options.

I like to evaluate the facial rejuvenation patient by dividing the face into thirds. We start at the top by examining the forehead and eyebrows. If the brows are below the rim of the bone, or if the patient is bothered by significant forehead wrinkles, a forehead/brow lift procedure may be indicated. I have a high threshold for recommending this procedure however, since these patients can look overdone and surprised. Botox offers a simple alternative for forehead wrinkles. It works well but is temporary and expensive.

The middle third of the face are the eyelids. If the eyes are the windows of the soul, then the eyelids are the curtains that allow us enjoy the view. They are truly the most expressive part of the face and the first place we notice our age. Usually by age 40 most of us have aging changes around the eyes. The upper lids develop excess skin causing hooding.  The puffy bags on the lower lids create a tired look.

The procedure of choice to correct tired eyelids is the eyelid tuck or blepharoplasty. It is a commonly performed surgery with a very high degree of patient satisfaction. It is one of my personal favorites to perform and is the most commonly performed aging procedure for men. The procedure takes 45 minutes and patients soon enjoy a refreshed and less tired look.

The lower third of the face includes the area of the cheeks, jawline and neck. As we age the skin and other tissues sag from the underlying bony structures. In addition, wrinkles in the skin, often affected by smoking and sun exposure, contribute to the facial aging changes. The two problems should be treated differently. Facial laxity is treated by surgical face and neck lift procedures, while skin changes are best addressed by injectable fillers or topical treatments such as peels and lasers.

Although highly advertised under many catchy terms, surgical facelift procedures generally fall into two categories, mini and full. A mini-facelift is best suited for patients in their 40’s or younger who just want to freshen the cheek and jawline. The advantage is that it is quick procedure with a rapid recovery. My preference for isolated mild neck fullness is a less invasive, unique ultrasonic liposuction tightening procedure.

The patient for traditional face and necklift is in her late 40’s and older with laxity of the jawline and neck, often with turkey-like banding. Combined with eyelid surgery, the procedure often produces dramatic results and can reduce the aging appearance by decades. It is another one of my favorite procedures to perform.

As with all procedures, an honest consultation with a reputable and experienced physician is the best place to customize an individual treatment plan.