News and Articles
Psychosocial Effects of Otoplasty in Children with Prominent Ears
Aesthetic Plastic Surgery, 06/13/08 Published online: 6 June 2008
Abstract This study aimed to investigate changes experienced by children during the pre- and postoperative periods of prominent ear corrective surgery. A total of 30 patients with prominent ears, sometimes called “lop ears” or “cup ears,” ranging in age from 6 to 14 years were consecutively enrolled in this study. Half of the patients (n = 15, 50%) were male. The inclusion criteria specified children with prominent ears and reports of evident anatomic deformity. Clinical evaluations, routine laboratory tests, and interviews were performed in the pre- and postoperative periods. To assess the dissatisfaction or social maladjustment caused by the prominent ears, questionnaires, which are used routinely in psychological and psychiatric practices, were applied in the pre- and postoperative periods. The tests used were the Child Behavior Check List, the State-Trait Anxiety Inventory for Children, and the Children’s Depression Inventory. The patients themselves and their parents or guardians reported improvements in terms of anatomic aspect. For the psychological tests, improvements in almost all the assessed items were observed. In conclusion, psychological problems caused by anatomic deformities, such as prominent ears, can be improved by adequate corrective surgery. Psychological support is necessary for the patients.
Keywords Plastic surgery - Prominent ears - Psychological aspects
Note: The ears are 85% full growth at 3 years of age. So, children at the age of 5 before kindergarten can have their ears fixed. Prominent ears and cup ear deformity I commonly fix ages 5 to 10. When I was in India I had children of all ages with very difficult ear abnormalities. I have fixed many adults male and females with great success. Larry Weinstein MD FACS a board certified plastic surgeon in Chester, New Jersey.
Eyelash Reconstruction With Strip Composite Eyebrow Graft.
Annals of Plastic Surgery. 60(6):649-651, June 2008.
Kasai, Kenichiro MD
Abstract:
Eyelash hairs have certain unique properties such as parallel direction, limited length, and tapering, which makes eyelash reconstruction considerably difficult. Several methods for eyelash reconstruction have been reported. Among them, strip composite eyebrow graft is the most suitable because the properties of eyebrow hairs are very similar to those of the original eyelash hairs. A rich blood supply in the eyelid ensures a good survival of the graft. Careful selection of the donor strip harvesting site is critical for preserving a good direction of hairs. The thickness of the graft strip should be determined considering the optimal thickness of hairs being obtained. When suturing the graft strip to the recipient bed, the burying method is suitable for preventing the protrusion of the graft. A well-performed surgical procedure results in a postoperative outcome that closely resembles the natural eyelashes. Note: Eyebrow and eyelash reconstruction I have done with strip or individual hair follicle grafts. Larry Weinstein MD FACS Chester New Jersey board certified plastic surgeon www.drlarryweinstein.com www.docweinstein.com
Breast Reconstruction: Complication Rate and Tissue Expander Type
Aesthetic Plastic Surgery, 06/13/08
Background Limited literature exists regarding complication rates among women undergoing breast reconstruction and the association of these rates with tissue expander types (anatomic, round and Becker).
Methods A historical cohort study investigated all breast reconstructions performed at Hadassah Medical Center for 140 consecutive women. Analyses were performed using both logistic and Poisson regression multivariate methods.
Results At least one major complication occurred in each of the following groups: anatomic (41%), round (20%), and Becker (11.7%) (p = 0.015). Women reconstructed with anatomic expanders were at increased risk for at least one complication (odds ratio [OR], 3.96; 95% confidence interval [CI], 1.18–13.3; p = 0.026) and an average increase of 331% (95% CI, 102–817%; p = 0.0002) in the number of major complications.
Conclusion The results of this study suggest that integrated-valve expanders are associated with more complications than the distant inflation port. The benefits of an anatomic shape may perhaps be better exploited using devices with a distant port.
Keywords Breast reconstruction - Complication - Tissue expanders
C) 2008 Lippincott Williams & Wilkins, Inc.
Note: I have exclusively used distal fill ports for tissue expanders for over 20 years.
Larry Weinstein MD FACS Chester New Jersey board certified plastic surgeon www.drlarryweinstein.com www.docweinstein.com
Our mid-knife crisis: Why middle-aged men are turning to cosmetic surgery by BARBARA DAVIS -
Five months ago, 42-year-old Andrew Wadsworth checked himself into a private clinic, discreetly tucked away in a quiet street behind Harrods in London's Knightsbridge.
recalls 52-year-old car dealer, Dave Willcox, who lives in Torquay with his 47-year-old wife Josie.
'What on earth have you done that for? I would never have surgery, so undignified.'
say: 'You look so much younger!'"
Lots of people have commented on how good I look now. It has boosted my confidence at work in a graphic design firm, and in my social life. I feel like my old twentysomething self again.
Years ago people hit middle age and were considered 'past it' but not any more.
"I hated looking at photos of myself and avoided mirrors," recalls John, using words that have been uttered by most women.
Daily Record, LIFESTYLE section
Tuesday, April 16, 2002
Botulinum toxin is one of the most poisonous substances on Earth. But injected in purified, extremely small doses, it can be used safely to treat certain neuralgic disorders, by temporarily paralyzing muscles that cause involuntary spasms
The Food and Drug Administration approved that medical use of Botox years ago. But it is legal for doctors to use a prescription drug for other reasons – and two years ago, Botox suddenly became the rage among plastic surgeons and their customers eager for new ways to ease wrinkles.
By formally approving a cosmetic use for Botox yesterday, the FDA cleared the way for maker Allergan Inc. to advertise the injections as a wrinkle smoother, potentially making it even more popular.
Dr. Larry Weinstein of Plastic Surgery Associates in
“I was reticent about using it initially because of the concern that botulism, or Botox, is derived from a bacteria which is potentially poisonous,” Weinstein said. “But in selected safe doses, it’s extremely useful to control forehead vertical lines, worry lines, crow’s-feet and deep vertical lip lines.”
Frown lines, those furrows between the eye-brows, typically are formed by excessive contraction of two forehead muscles. Injecting small doses of Botox into those muscles can weaken or paralyze them, thus temporarily improving the appearance of the wrinkles.
It is only temporary: In one study of Botox injections, the severity of frown lines was reduced for up to 120 days.
Botox should be injected no more often that once every three months, and the lowest effective dose should be used, the FDA cautioned.
“You must wait a minimum of three to four months between treatments because if you do it more frequently, people can have an antibody reaction to it, which makes the toxin ineffective,” Weinstein said. “The toxin has an effect for three, four or six months on some patients, and there may be a qualitative or quantitative effect of use over time. Eventually, the muscle doesn’t come back as strong.”
There are side effects, including headache, droopy eyelids, nausea and flu symptoms. Some patients – fewer than 3 percent in the study – also experienced face pain, redness at the injection site and muscle weakness. Those side effects were generally temporary but could last several months, the FDA warned.
Some of Weinstein’s Botox patients have found tension and migraine headaches have gone away after treatment, he said, adding that neurologists sometimes use Botox to treat such headaches. He’s never seen a patient with nausea or flu symptoms and only on one occasion did he have one with a droopy eyelid.
“Some people have an anatomical variant of the eye muscles,” he said, “so that when you try to control the muscles involving the crow’s-feet, the muscle that affects the eyelid is affected. It was recently described in one of the journals. I’ve only seen it once. It resolves. It goes away.”
Cost varies around the country but average about $400 a treatment, which is what Weinstein charges.
Analysts estimate Botox did $300 million in worldwide sales last year, with up to half that amount related to cosmetic use.
Featured in the Observer-Tribune, Thursday, May 9, 2002
By Phil Garber
Managing Editor
Dr. Larry Weinstein has been ironing out more wrinkles this year than ever before and it’s because of a newly approved drug made of the same material that causes deadly botulism.
But the drug is anything but lethal, particularly for the plastic surgery industry and the drug manufacturer who have seen profits skyrocket in the past months.
The drug is known by the trade name of Botox or botulinum toxin (BTX), marketed in the United States by Allergan of Irvine, Calif.
In past months, the drug has gotten increased attention by everyone from Hollywood stars who want to eliminate their laugh lines and to stop sweating to suburban women who attend area Botox parties.
Botox was first marketed about a decade ago as a muscle relaxant to treat crosses eyes and uncontrollable blinking.
Doctors have found that treatment with Botox can also eliminate laugh lines on the forehead and crow’s feet around the eyes. It also is injected into sweat glands to stop perspiration.
While the drugs has been used for such cosmetic purposes for several years, it could not be marketed for such use until last moth when it received approval by the U.S. Food and Drug Administration.
Successful Treatment
Carol Mozzone, 59, a patient account manager in Weinstein’s Chester office, is one of eight women in the office who have had Botox treatments.
The 15-miute procedure involves injection of a small amount of the drug into the lines between and next to the eyes
Each treatment lasts for about four months when the lines may begin to reappear and the treatment can be repeated. Each treatment costs about $400.
Mozzone has had “peels” when the skin is refreshed to remove aging lines; and she has had blepharplasty to eliminate sagging under the eyes. But she was most impressed with the Botox treatments.
“It definitely softens the lines,” said Mozzone of Bound Brook. “It looks great. It makes you brighter, less tired and not as old.”
Beverly Zagofsky, another employee and the wife of Dr. Weinstein, also has had the treatment. She said the physician has been using Botox for cosmetic treatment for about four years but business has boomed in recent months.
“We’ve done more in the last three months than all of last year,” Zagofsky said.
She said 80 percent of the patients are women who range in age from their 20s to their late 60s.
“I support anyone who wants to age gracefully,” said Zagofsky who has had wrinkles removed between her eyebrows and forehead. “But people are living longer and feeling active and they want to look like they feel.
“Why should we look older when we don’t have to?” Zagofsky asked.
Botulinum toxin injection was the top cosmetic procedure among the nearly 8.5 million cosmetic surgical and nonsurgical procedures performed in 2001, according to new statistics from the American Society for Aesthetic Plastic Surgery.
The society reported that more than 1.6 million BTX procedures were performed last year, an increase of 46 percent since 2000 and 2,356 percent since 1997.
That translates into huge profits for the Botox manufacturer, Allergan. In its latest filing with the U.S. Securities and Exchange Commission, Allergan reported sales of $221.2 million for the nine months ending on Sept. 28, 2001. It was a sizeable boos for the same period ending Sept. 2000, when sales were $172.8 million.
Botulism can cause a variety of illnesses produced by a certain class of bacteria but the compounds (toxins) produced by the organisms have been found to have therapeutic medical benefits.
Beginning in the 1970s and ‘80s, BTX was used in the treatment of conditions such as weak eye muscles, involuntary spasmodic winking, muscle spasms of the face and neck, as well as facial asymmetry from nerve paralysis, according to the American Society for Aesthetic Plastic Surgery.
Now, aesthetic plastic surgeons have found that the type of lines and wrinkles that respond best to BTX are those caused by the muscles- specifically those muscles that are repeatedly over-contracted during facial expressions such as frowning or squinting, according to the society.
Weinstein said Botox has “revolutionized the noninvasive technique of facial rejuvenation.
“I have found that Botox injections are effective in diminishing forehead wrinkles, glabellar frown lines, crows feet, vertical lip lines ad facial asymmetry,” said Weinstein. “It is easy to use, takes less than 10 minutes to administer, and is virtually painless when used with EMLA cream one to two hours prior to the procedure to numb the area.”
BTX blocks the transmission of impulses from the nerve cells to the muscle. This causes a temporary muscle weakening. By selectively interfering with the muscle’s ability to contract, thereby reducing excessive contractions, existing lines are smoothed out over time and future lines may be prevented, said the statement.
To date, no systemic complications associated with BTX have been documented. As with all biologic products, there is a rare possibility of an allergic reaction, said the statement from the American Society for Aesthetic Plastic Surgery.
Among the most common side effects are local numbness, swelling, bruising, or a burning sensation during injection. Headaches or nausea may also occur.
These are usually temporary and typically disappear within a few hours. Bruising and swelling may persist for several days, said the society.
There have been cases of mild to moderate drooping of one or both eyelids, which usually lasts about two weeks. These effects, or more serious problems, may occur as a result of inaccurate injection of the toxin, one of many reasons why the society says it is important to choose a board-certified physician with appropriate training.
Currently, there are no known long-term effects of repeated BTX injections, the society said.
In its statement following last month’s approval of Botox for cosmetic use, the FDA said clinical trials involving a total of 405 patients with moderate to severe lines were injected with Botox.
After 30 days, the great majority of investigators and patients rated frown lines as improved or nonexistent.
In these studies, the severity of the lines was reduced somewhat for up to 120 days for those patients who received Botox Cosmetic, said the FDA statement.
The FDA recommended that Botox be injected no more frequently than once every three months, and the lowest effective dose should be used.
Featured in The Star-Ledger Thursday, February 23, 2006
Morris Ledger
Morris Diary
By Paula Saha
Larry Weinstein’s flight landed in Calcutta, India, around 8 a.m. that first morning in early February. The plastic surgeon from Mendham started seeing patients two hours later, and by 1 p.m., he and the camp staff had seen 150 patients in all.
Four days later, Weinstein left India, having personally performed 52 cleft lip surgeries.
A cleft lip is a birth defect that leaves a separation between the two sides of the lips. In the United States, children born with cleft lips generally have them fixed within the first year of life.
But in the poorer regions of India, many people live with defects for several years, some well into adulthood.
That is where Sharadkumar Dicksheet comes in. Dicksheet is a longtime friends of Weinstein’s. Since 1968, Dicksheet has been holding free plastic surgery “camps” to perform surgical procedures to which many poor Indians would not otherwise have access. Weinstein has taken part in camps before, the last one in Jaipur in 1993. At the time, his son Joshua was in his early teenage years, and his father promised that someday, they would go to India together.
Today, Joshua Weinstein is a Boston University film school graduate, and his current project is a documentary of Dicksheet’s work. Father and son plan to return to India again next year to follow up on all their patients.
This work was, in some ways, very different from the daily cosmetic surgeries Weinstein performs as part of his Chester and Summit medical practice. There, he spends most of his time helping men and women who are unhappy with the way they are aging, or the proportion of their physical bodies.
He is not, he says, someone who walks down the street silently assessing how to perfect each passerby. But, he said, if someone is unhappy with their appearance, he likes to be able to help them.
“In this country, we’re a very youth-oriented society,” Weinstein said. “To be able to help these people feel good about themselves is a blessing.”
His ability to help patients in India, he said, is also a blessing. Weinstein did not even know how many surgeries he was performing a day, but when he finished, he learned that he had done 52 in all – one “mitzvah,” or good deed, for every week of the year. “I’m always excited when people come to me with any problem that I can help them with,” he said.
One of the real joys of the work in India, Weinstein said, is working with his friend, Dicksheet, who has been nominated for the Nobel Prize numerous times, and won a prestigious international medicine aware recently from the American Medical Association. A serious car accident left the 75-year-old man in a wheelchair, and he has survived two heart attacks and larynx cancer. Yet he continues to work.
“He has sat at a table for as long as 10 hours for surgery,” Weinstein said. “To work with a man like that. He’s really a testament to the human spirit.”
Healthier Living Newsletter 1st Quarter 2005
Hackettstown Community Hospital: A Member of Adventist Healthcare
Begin the New Year Looking Younger
Today, attractive alternatives are available for minimally invasive facial rejuvenation. Tailoring the procedure for the right circumstances, physical findings, patient concerns and health of the patient is Dr. Larry Weinstein’s specialty. Dr. Weinstein, a board certified plastic surgeon, uses a balanced approach to achieve consistent safe and natural improvements.
As people age, the effects of gravity exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck.
A face-lift (technically known as rhytidectomy) can’t stop the aging process. What it can do is “set back the clock,” improving the most visible signs fo aging by removing excess fat, tightening underlying muscles, and re-draping the skin of your face and neck. A face-lift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery or nose reshaping.
“I always concentrate on the areas that can be fixed with minimal invasive plastic surgery. When I check position, I look carefully at the anterior hairline. I find in the aging patient, both male and female, that a receding hairline is common. I will offer an anterior hairline approach for brow elevation in those patients with a receding hairline. This anterior hairline technique allows the hairline to be brought forward, while elevating the brow and correcting glabella (worry lines) furrows. I always preserve the widow’s peak to obtain a natural results.”
“When performing a face-lift, I want the wounds to be barely visible. Women are often concerned that if the wind blows their hair up, there will be visible scars,” Dr. Weinstein added.
The best candidates for a face-lift
The best candidate for a face-lift is a man or woman whose face and neck have begun to sag, but whose skin has some elasticity and whose bone structure is strong and well defined. Most patients are in their forties to sixties, but face lifts can be done successfully on people in their seventies or eighties as well. A face-lift can make you look younger and fresher, and it may enhance your self-confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth.
Before you decide to have surgery, think carefully about yoru expectations and discuss with your personal physician. To reach Dr. Weinstein, call 
(908) 879-2222
.
Press Release: May 13, 1995
Dr. Larry Weinstein gave a 30 minute scientific presentation on “Patient Selection and Laser Treatment”, to the Plastic Surgeons of the Society of former residents of Plastic and Reconstructive Surgery of Kings County Hospital Center, Downstate University Medical Center, University Hospital Center, Newark and Long Island Plastic Surgery group.
He covered many aspects of current Laser therapy. His preliminary work utilizing the Medlite Laser for pigmented lesions, vascular lesions and tattoo’s were significant. He exhibited pre and post operative photographic documentation of LASER treated patients.
Dr. Weinstein stated, “The Candela Laser can be extremely effective for flat red vascular lesions of the face and body. Most effective treatments can be achieved on arterial telangietasias and port wine stains.”
The CO2 Laser is currently available for use for rhydities, (aging face lines) of the periorial area with excellent results.
Caution was expressed by Dr. Weinstein in the use of the new CO2 Lasers for Dermabrasion purposes. He explained alternative techniques of therapy for problems such as rhydities which included chemical peels and fat injection. Current laser technology has enabled Laser therapy to be more effective with less scarring which has resulted in greater patient satisfaction.
Dr., Weinstein was elected Vice President of the society for the 1995-1996 business year at the societies business meeting.
Dr. Weinstein is a local Plastic Surgeon in Chester, New Jersey, with surgical privileges at Morristown Memorial, Overlook, St. Barnabas and Hackettstown Community Hospital.
Press Release: April 26, 1995
Wednesday, April 26, 1995 at 7 p.m.l EST, Hackettstown, NJ.
Audience held spellbound during presentation by Dr. Larry Weinstein
Audience held spellbound during presentation by Dr. Larry Weinstein on plastic surgery and the battle of the bulge. Topics pertaining to diet, exercise and plastic surgery were discussed. Although, suction assisted Lipectomy or Liposuction has been advocated by many as a simple type of technique for removing fatty adipiose tissue, Dr. Weinstein felt strongly this technique should be utilized only for patients with fat or adipose deposits resistant to exercise and diet.
Multiple examples of patients who had adipose tissue which were resistant to exercise and diet were shown including:
Patient #1) A weight lifter who was unable to lose his love handles on the sides of abdominal wall
Patient #2) An exercise instructor unable to lose thighs.
These fatty deposits gave both of their bodies cosmetic disproportion which was alleviated by suction assisted Lipectomy.
Patient #3) Abdominoplasty “Tummy tuck” is utilized for correction of excess abdominal skin and/or fascial laxity. The saggy baggy stomach syndrome is alleviated by removal of skin, fat and tightening the muscles of the abdominal wall.
Dr. Weinstein advocated a low fat diet avoiding fatty foods such as olives, french fries, sausages, oils, fatty dressings, cooking in oil, cookies, cakes, ice cream, candy, etc.
Eating fish versus: Chicken, red meat and pork products, as fat content is least in fish and greatest in pork products.
Dr. Weinstein advocates 20 minutes of cardio exercise daily, and weights three times a week.
Other patients presented included a young woman who requested a Rhinoplasty was noted to have a very small chin and baggy lower eyelids. She had Rhinoplasty, a lower lid Blepharoplsaty, and Chin Augmentation for a much improved profile. She adjusted well to the changes which gave her a brighter, younger look and better feelings about herself.
Press Release, Philadelphia
NOT JUST FOR WRINKLES: BOTOX COULD PLAY KEY ROLE IN PAIN CONTROL DURING BREAST RECONSTRUCTION
PHILADELPHIA- Botox, a household name for wrinkle reduction, could be assuming a new rule as a pain reliever. In a study presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2004 conference in Philadelphia, women injected with Botox in the pectoral muscles following the surgical removal of their breast experienced significantly less pain and shorter hospital stays.
“As surgeos, our top priorities are the safety and comfort of our patients,” said Larry Weinstein, M.D., ASPS member. “We are always searching for ways to decrease pain for breast reconstruction patients and found that using Botox after surgery significantly decreased the pain and discomfort they experienced.”
The study examined women who had mastectomies, followed by breast reconstruction patients and found that using Botox after surgery significantly decreased the pain and discomfort they experienced.”
The study examined women who had mastectomies, followed by breast reconstruction with tissue expanders. The tissue expanders, balloon like devices, were placed beneath the pectoral muscle and slowly inflated to allow time for the tissue to stretch and ultimately accommodate a breast implant.
Unfortunately, tissue expansion causes muscle spasms and additional pain. By injecting the muscles with Botox, the spasms, pain, ad discomfort significantly decreased.
“In this study, Dr. Julio Hochberg found patients who received Botox injections used 89 percent less morphine in the first 24 hours after surgery, had their hospital stay reduced by one day, and required three fewer physician visits than the control group to achieve the targeted tissue expansion before placing the breast implant.” Said Chester, NJ Plastic Surgeon, Larry Weinstein, M.D.
“Many general surgeons could clearly see the relief patients received when administered Botox to the affected muscles.” Said Dr. Weinstein. “Now many surgeons are using the injectable for their own patient to help manage pain after certain surgeries of the chest and abdomen.”