Plastic Surgery of the Face

You might be surprised to learn that the “plastic” part of plastic surgery doesn’t have anything to do with being artificial or using a plastic manufacturing material. In the 1830s, the term “plastic surgery” was popularized in reference to the Greek word “plastikos,” which means “fit for molding.” Thus, plastic surgery is a field which covers a variety of procedures that are designed to improve patients’ form and function, not a literal reference to plastic. As I see it, the three primary fields within plastic surgery are aesthetic surgery, reconstructive surgery, and hand surgery. While plastic surgery requires extensive knowledge, precise technique, and a delicate touch, it also requires an artistic sense.

Facial plastic surgery is a special interest of mine. Common facial conditions I treat are:

Problems of Facial Skin: Facial issues can include acne, skin cancer, and wrinkles. For each of these problems, preventative care is most important. Avoiding sun exposure is best achieved with wide-brimmed hats and sunscreen. A good skin care regimen is foundational. I treat acne scarring and fine lines with micro needling, chemical peels, and dermabrasion. Early facial skin cancers are addressed topically while advanced facial skin cancers are treated with surgery. Hollow cheeks and thin lips are treated with hyaluronic acid injections. Forehead lines and crow’s feet are treated with neurotoxin. Surgery is usually reserved for more significant problems. I use surgical lifts of the face, neck, and brows to help patients look and feel their best.

Problems of Eyelids: The eyelids can be afflicted by blocked vision, loose skin, fat pockets, and dark circles. Many patients are referred to me with obstructed vision from loose skin and muscle of their upper eyelids. Unfortunately, this problem has a significant genetic component and generally worsens with age. The only cure for this is surgical removal of the extra skin and muscle (upper blepharoplasty), which helps patients see better, look smoother, and appear more awake. When treating the lower eyelids, I help smooth the skin of the eyelid, correcting fat pockets and dark circles.

Problems of the Nose: Nasal issues include difficulty breathing, broken nose, crooked nose, dorsal hump, misshapen tip, or prominent tip. I see many patients with difficulty breathing and concerns about nasal shape. Of course, not every person with difficulty breathing needs surgery. When I see athletes with broken noses right after the injury, we can usually set the nose to its original shape without a surgical incision. However, in many cases, surgery is needed. Whether rhinoplasty is cosmetic or functional, I adhere to reliable plastic surgery principles to help my patients achieve their desired outcome.

Plastic Surgery of the Hand

The field of hand surgery is one of the most recently established medical subspecialties, born out of necessity during World War II. Every board-certified plastic surgeon is now trained in hand surgery. My practice involves treating conditions from the elbow to the fingertips. Hand therapy is essential after hand surgery, as people who follow their rehab instructions do very well. Common hand conditions I treat are:

Carpal Tunnel: Carpal tunnel syndrome is caused by a pinched nerve at the wrist. Typical symptoms include numbness and tingling of the thumb, index finger, and middle finger. Nerve pain wakes patients up at night, and they may also experience thumb weakness and pain. Injections and splinting can help, but surgery is the only cure for most patients. I offer endoscopic carpal tunnel release for a smaller, more convenient incision and an even faster recovery. A nerve at the elbow can also be pinched, causing cubital tunnel syndrome. This is also treated with surgery.

Trigger Finger: Trigger finger occurs when finger tendons become caught by a pulley where the finger joins the hand.The finger will become stuck in the palm in a flexed position. Sometimes the other hand must help move the finger back into extension, which causes a painful popping sensation. The first line of treatment for this condition is steroid injection, which is effective for most patients. Surgery is reserved for people whose symptoms do not respond effectively to injection.

Finger and Wrist: Hand arthritis is very common. I treat all forms of arthritis of the hand including wrist, hands, and fingers. One of the most common conditions is thumb arthritis, where the base of the thumb becomes painful with daily activities. It can be debilitating. We start with injections, splinting, and therapy for thumb arthritis. Surgical correction of thumb arthritis is a highly effective and reliable cure.

Fractures: We use our hands for work and play, which is why injuries are so common. I treat many wrist, hand, and finger fractures. Some fractures can be treated with splinting or casting alone, but others require surgery with pins or tiny plates and screws.

Tendon and Nerve: Tendons connect our muscles to our bones so that we can move. Injured tendons must be surgically repaired. Similarly, nerves connect our brain to our muscles and skin so we can move and feel. Injured nerves must also be surgically repaired.

Bumps and Cysts: Just like other parts of the body, the hands can be afflicted with various benign and malignant tumors. Lipomas, skin cancers, dupuytren’s disease, and other conditions are all cured with surgical excision and reconstruction.

Whether a patient is a laborer, gardener, quilter, or athlete, we can care for all their hand surgery needs. If you have a hand problem, ask your doctor for a referral to my office. Sometimes all a patient needs is something as simple as an injection or hand therapy. We work emergencies into the schedule all the time. Surgery is reserved for patients who truly need it. It’s a privilege to provide plastic surgery of the hand for the community. No need to travel for high-quality hand surgery, we are right here at home.

JCMG Plastic and Reconstructive Surgery

JCMG Plastic Surgery is designed to meet the plastic, reconstructive, and hand surgery needs in central Missouri.Dr. Steffen and his team of nurses and estheticians see patients at their JCMG office, and Dr. Steffen performs surgery at the JCMG SurgeryCenter, SSM Health St. Mary’s Hospital, Capital Region Medical Center, and the CMMP Surgical Center. Commonly performed surgical procedures include facial skin cancers, blepharoplasty, rhinoplasty, facelift, facial fracture surgery, breast reconstruction, mommy makeover, abdomino-plasty, carpal tunnel, thumb arthroplasty, and fracture surgery of the hand and wrist.

Caleb Steffen, MD JCMG Plastic and Reconstructive Surgery
1241 W. Stadium Blvd., JCMO (573) 556-7722 | jcmg.org