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From Skin Surface to Structure
Dr. Scott Spiro is celebrating his 30th year in the private practice of plastic surgery
The northern New Jersey practice of Dr. Scott Spiro stands out as a destination for patients from across the United States and beyond. Drawn by his expertise and artistry in plastic surgery and celebrated for numerous accomplishments as an award-winning artist and plastic surgeon, Dr. Spiro harnesses his knowledge and skill, along with his artistry, in his comprehensive approach to facial rejuvenation, which he calls “from skin surface to structure.”
When it comes to the surgical management of the aging face, Dr. Spiro channels his “Surgeon by Trade, Artist at Heart” motto to deliver natural and individualized outcomes. “Facial aging is complex,” he says. “We now recognize that facial aging begins much earlier in our lives than previously thought.”
Dr. Spiro performs his signature facelift, a hybrid combination of a High SMAS Deep Plane face and neck lift that focuses on maximally restoring youthfulness to the face and neck while addressing skin laxity and deep tissue tightening characterized in aging by sag and volume loss.
“I frequently combine multi-site fat grafting to restore volume throughout the face in microdoses to avoid overfilling.” The temples, cheeks, lid-cheek junction, marionette lines, nasolabial folds, and lips undergo atrophy as well as age-related laxity and deflation. Small-volume fat grafting within face and neck lift procedures helps restore youthfulness in a balanced and natural manner.
Addressing eyelids, fat bags, eyelid muscle orbicularis resuspension, temporal lifts, and full foreheadplasty and brow lifts are employed as needed to achieve optimal outcomes. “I pay close attention to the jowl region,” Dr. Spiro explains. “I lift and rotate the deep tissues in the face while simultaneously tightening the neck from both the back and the front. This three-point approach maximizes jowl tightening.”
This structural restoration forms the foundation of his surgical philosophy.
A Collaborative Approach to Facial Aging
Advanced skincare protocols at Spiro Plastic Surgery improve tone, texture, and overall skin quality.
Recognizing that facial aging affects both structure and skin quality, Dr. Spiro has brought together additional key components into his comprehensive facial aesthetic vision.
His Nurse Practitioner, Mikayla Barbarossa, is a seasoned, well-trained, and highly skilled injector and laser specialist. Skin Care Specialist Rebecca Pierce provides a foundational, comprehensive approach to skin care of the aging face. Patients do not need to be surgical candidates to benefit from the advanced services offered within the practice.
The team collaborates closely to remain cutting edge while delivering reproducible and safe outcomes.
“We now have a greater understanding of aging,” Dr. Spiro says, “and addressing skin aging starting in our early thirties and even late twenties allows us to age more slowly.”
Building the Foundation: Skin Health Before and After Surgery
Rebecca provides a sophisticated approach to skin care that enhances both non-surgical and surgical outcomes.
She offers facials, SkinPen microneedling, medical-grade chemical peels, and DiamondGlow treatments. These treatments are often strategically stacked within a single session to optimize results.
Helping to optimize the skin’s ability to heal itself and create a clean, hydrated, receptive surface before surgery is imperative. Skin care treatments strengthen the barrier, improve circulation and oxygenation, support lymphatic drainage, reduce swelling, and enhance hydration.
“Skin care treatments optimize the canvas that heals over what is done surgically,” Rebecca explains. “When the skin is healthier before surgery and supported after surgery, you heal faster, with better scar quality, more even tone and texture, and longer-lasting, more natural-looking results.”
Microneedling and Dermal Strength
Consistent skin maintenance is key to preserving results achieved through both surgical and non-surgical care.
Rebecca offers SkinPen microneedling to stimulate collagen and elastin and strengthen dermal structure. For optimal results, microneedling should begin three to four months before surgery with a series of three treatments spaced four to six weeks apart.
Before surgery, microneedling creates a stronger dermis and improves tissue quality for incisions and closures. After surgery, it can improve skin thickness, texture, and color.
Long term, continued collagen stimulation remains important as natural collagen loss progresses with age.
Medical-Grade Chemical Peels
SkinMedica medical-grade chemical peels help stimulate collagen, improve sun damage and uneven pigment, and increase cell turnover.
Before surgery, chemical peels even skin tone and reduce pigmentation issues that may worsen after surgical trauma. After surgery, they refine texture and discoloration.
“The best results of surgery are found with the right combination and timing of skin care treatments,” Rebecca says. “Before surgery, weeks or months of planning to strengthen, hydrate, and normalize the skin are essential. After surgery, the focus should be on protecting the barrier and reducing inflammation.”
DiamondGlow and Advanced Facials
DiamondGlow treatments and advanced facials improve circulation, support lymphatic drainage, and strengthen the skin barrier so it functions properly. This is critical for wound healing.
DiamondGlow treatments may be performed before and after surgery and are frequently stacked with other modalities for enhanced outcomes. DiamondGlow is particularly beneficial following LaseMD Ultra, as the laser brings pigment to the surface and the DiamondGlow exfoliates rough texture while infusing hydration back into the skin.
SPF remains essential for maintaining results across all treatments.
Laser Technology and Strategic Stacking
At Spiro Plastic Surgery, treatment plans are customized to enhance each patient’s unique features.
Mikayla offers advanced laser treatments including LaseMD Ultra and Mosaic 3D, which address texture, tone, and pigmentation. These lasers may be used separately or combined in a sophisticated approach.
Mosaic 3D and LaseMD Ultra can be enhanced with chemical peels between sessions, typically two weeks after laser treatment and two weeks before the next session.
“Our lasers enhance surgical outcomes by addressing texture, tone, and pigmentation,” Mikayla says. “As we continue to age, we continue to lose volume in our face.”
Injectables, Volume Restoration, and PRF EZ Gel
Mikayla is at the cutting edge of non-surgical restoration, including HA fillers and PRF EZ Gel. HA fillers are often used in patients who have had a facelift but are experiencing volume depletion due to ongoing aging or life events such as weight change or menopause.
PRF EZ Gel is a natural volume enhancer composed of 100 percent autologous biostimulators that support collagen production for long-term skin health and modest volume replacement.
Most patients require multiple modalities to address aging concerns. This is where the process of stacking treatments becomes important. Stacking simply means using multiple services in one visit to achieve a specific goal.
Whether combining LaseMD Ultra with PRF EZ Gel or pairing DiamondGlow with microneedling and PRP, the practice remains committed to delivering sophisticated outcomes within strict safety guidelines.
Returning to Structure
While non-surgical care enhances and preserves results, structural aging often requires surgical intervention for optimal restoration.
The High SMAS Deep Plane face and neck lift remains the cornerstone of Dr. Spiro’s approach. By lifting and rotating deep facial tissues while tightening the neck from both the front and back, he restores youthful contour while maintaining natural anatomy.
It is this integration of structural correction and surface optimization that defines the “from skin surface to structure” philosophy.
In Dr. Spiro’s words, “Whether you are a young person who wants to slow aging, a middle-aged patient who is not ready for surgery, or a patient who would benefit from surgery, we have a solution here at Spiro Plastic Surgery.
