Dr. B. Aviva Preminger 


By Dr. B. Aviva Preminger 

The term plastic surgery usually brings to mind the big stuff: facelifts, breast surgery, tummy tucks, and liposuction. While that is certainly a big part of what plastic surgeons do, sometimes it’s the little changes that make people happy. Here are some common concerns that we can easily tackle.

Stretched or torn earlobes. Classically, this happens from wearing heavy earrings. However, many people with this problem never did. Torn earlobes can also happen from sleeping with earrings or from too much pressure on the earlobe. The earrings either catch on something, creating small tears and allowing the hole to stretch, or many women wear their earring backs too tight because they are afraid of losing them. This is particularly common with diamond studs. Once the hole begins to stretch, it generally gets worse with time. I see women who lose expensive earrings because they literally fall through the enlarged hole, or sometimes the earlobe tears completely.

The problem is a relatively easy fix but not as easy of a fix as some think. It requires a little bit of advance planning to allow the earlobe to heal. I say this because women commonly come to me a few weeks before a family simcha, and sometimes there just isn’t enough lead time to get the job done. To the surprise of some, the stretched-out holes cannot simply be sewn back together. I explain this to people by telling them to imagine sewing two fingers together. They would not stick. In order to repair a torn earlobe, the hole needs to be recreated and the front and back of the earlobe repaired. The procedure is performed with local anesthesia only. It’s basically less painful than a trip to the dentist, and earlobes are surprisingly not sensitive! The stitches must remain in place for a week and then an additional five weeks need to pass before the earlobes can be re-pierced. It is also important to note that the new piercing cannot be placed in the exact same location as the old one or it will be more likely to tear again.

Fine lines, loss of volume, and brown spots. These problems affect us all as we start to age, and are sometimes a result of genetics, sun exposure, or an expressive face. The first lines that most of us start to see are on our foreheads. There are actually two sets of lines in this area—the horizontal lines that appear from raising our brows, and what I call “11” lines. Many find the “11” lines concerning because they can make us appear angry. Both of these sets of lines have a relatively painless solution: Botox. It’s injected with a very small needle after placement of a topical anesthetic cream. It can take up to a week to work.

Many people ask me if it is addictive. My response is that it is, only in the sense that you will like the way you look, and you will then want to continue doing it. Unfortunately, the results are not permanent and the procedure needs to be repeated every 3–6 months. With time, the forehead muscles weaken from repeated Botox, and less is needed with less frequency. Botox also works great on the fine lines around the eyes that we call crow’s feet.

For smile lines around the mouth, filler is recommended. The most common filler is made of hyaluronic acid, a compound naturally occurring in our tissues that diminishes with age. The injection is not permanent but lasts longer than Botox—six months to a year—and is reversible (can be dissolved) if you don’t like it. It also works well to fill in dark circles in the lower eyelid area and restore volume to the cheek area.

Many women also complain of “smoker’s lines” around the mouth even if they never smoked. This problem can be addressed by a combination of Botox, filler, and laser resurfacing. Fractionated CO2 lasers commonly known as “fraxel” help with fine lines, and IPL lasers with minimal to no downtime can help eliminate brown spots. Skin peels are particularly helpful for dull skin as they help shed dead skin cells and brighten. I prefer to use a series of gentle peels that can provide results without downtime.

From big to small concerns, there are so many tools in the plastic surgeon’s toolbox, many of which are non-invasive to minimally invasive. The key is communicating what you are trying to achieve, explaining your personal limits/constraints, and making sure that the physician you are meeting with understands your goals. Sometimes a small change can make a big difference!

Dr. Preminger is an Ivy League-educated, board-certified female plastic surgeon specializing in cosmetic and reconstructive surgery of the face, breast, and body. Dr. Preminger has expertise in a wide range of cosmetic and reconstructive procedures and has lectured and published extensively. She is in private practice in New York City and Long Island. To schedule your free consultation, call 516-218-6808.


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