SURGERY in Boston
Innovative surgery customized for each patient
Dr. Michael Yaremchuk
Chief of Craniofacial Surgery
at Massachusetts General Hospital
Clinical Professor of Surgery
at Harvard Medical School (part time)
Dr. Yaremchuk is currently a Professor of Surgery, Part Time, at the Harvard Medical School, the Program Director for Harvard's Plastic Surgery training program, and Chief of Craniofacial Surgery at the Massachusetts General Hospital. He is known as an innovator and teacher who uses state-of-the-art techniques and knowledge to care for his patients.
Dr. Yaremchuk received his M.D. from the Columbia College of Physicians and Surgeons and his B.A. degree from Yale College.
Dr. Yaremchuk's expertise as a plastic surgeon is recognized both nationally and internationally. Patients come to Boston for his care from all over the world.
In addition to surgery of the face and facial skeleton, he practices a full range of cosmetic surgery including liposuction, breast augmentation and fat grafting. His care of patients referred to him with facial deformities created by unfortunate cosmetic surgery has been reported in many national and international magazines including Harper's Bazaar, Self, British Glamour and Allure magazines, and featured on the E! network and the Today Show.
Dr. Yaremchuk frequently provides commentary on plastic surgery topics for a blog at The Huffington Post. In the foreword he wrote for the latest publication of friend and colleague Jamieson Dale, Chasing Beauty, he has provided his thoughts on how to know plastic surgery is the right decision for you and what can be done to best ensure attaining a desired result.
Dr. Yaremchuk has authored four textbooks, more than 40 book chapters, and over 100 scientific articles.
His most recent book, "Atlas of Facial Implants", was awarded an Association of Medical Illustrators Award for surgical atlases.
Recent BooksYaremchuk, MJ. Atlas of Facial Implants. Philadelphia: Saunders-Elsevier, 2007
Hazani R, Mrad A, Tauber DM, Ulm J, Yan A and Yaremchuk MJ: Clinical Diagnosis in Plastic Surgery. :Cham, Springer, 2015
Recent Book ChaptersYaremchuk, MJ.Alloplastic Craniofacial Implants. Current Reconstructive Surgery, Serletti et al eds. McGraw – Hill, New York, 2013. Chapter 3.
Yaremchuk, MJ. Chapter 15. Midface Skeletal Augmentation and Rejuvenation.Neligan, Ed. Plastic Surgery, Elsevier - Saunders, 2013.
Dr. Yaremchuk has a national and international reputation as both an expert clinical surgeon and an educator. He has received numerous awards and honors in the field of plastic surgery. Dr. Yaremchuk lectures nationally and internationally to share the breadth of his knowledge with his plastic surgery colleagues. Countries where he has lectured as a visiting professor include France, England, Germany, Italy, Spain, Belgium, Brazil, Argentina, Chile, Japan, Korea, China, Australia, Taiwan and Russia.
In 2013, Dr. Yaremchuk spoke in Brazil, Australia and Russia about his techniques for facelift, blepharoplasty (eye lift), rhinoplasty and implant surgery, and he was honored as the Borckaban lecturer by Turkey’s premier plastic surgery organization. In 2012, in addition to his international invitations, he was the visiting professor at 10 major US medical centers.
In 2015, Dr. Yaremchuk demonstrated his techniques for facelift and facial implant surgery at the Facial Aesthetic/Oculoplastic Surgery and Rhinoplasty Course in Coventry, England.
Dr. Michael YaremchukSpeaking Engagements
Dr. Yaremchuk has received a multitude of invitations to lecture at premier medical conferences and at some of the best medical universities all over the world. He was a visiting professor at 10 major US medical centers in 2012. In 2013 he traveled to speak at engagements in Brazil, Australia, Turkey and Russia.
Recognition of his skills is evidenced by his listing in "Best Doctors in America" and "Who's Who in America." Dr. Yaremchuk has been recognized numerous times by Boston Magazine as one of the area's best plastic surgeons.
He has been invited as the Visiting Professor to many universities and surgical societies throughout the world.
Dr Yaremchuk's Mission Statement
My goal is to impact the facial balance. I use the ideal facial blueprint – using anthropometric measurements, science, elements of nature and rational thought. I use proportion of parts and elements of
symmetry to guide my work with each individual patient. With this repertoire, imperfect features or faces can be reconstructed or rejuvenated to make a balanced whole.
Plastic surgery procedures
Dr.Yaremchuk’s facelift technique results in a younger and natural, but not “done," look. The surgery is done in a deeper plane which results in a full-thickness
Blepharoplasty, or eyelid surgery, can fix bags, dark circles, droopy eyelids, and tear trough issues. Dr. Yaremchuk employs several techniques in his eyelid surgeries to restore youthful contour and dimensions to the eyelids.
Rhinoplasty, both primary and secondary, is a large component of Dr. Yaremchuk’s practice. He uses both open and closed techniques as appropriate for the individual needs of the patient. Rhinoplasty can address droopy tip, bulbous tip, dorsal hump, hanging columella, and wide nostrils, among other concerns.
Dr. Yaremchuk employs his knowledge and experience with craniofacial surgery and biomaterials to create new facial skeletal contours. Using facial implants he can mimic the facial appearance obtained with more extensive facial skeletal surgeries. Dr. Yaremchuk custom carves all facial implants from basic shapes - many of which he has personally designed.
Neurotoxins, fillers & fat implants
Dr. Yaremchuk has extensive experience in the use of neurotoxins, fillers and fat injections, which all have roles in facial rejuvenation and facial contour enhancement. Whether as alternatives or complements to surgical options, these non-surgical interventions can help to refresh and rejuvenate your look.
Dr. Yaremchuk has extensive experience in breast augmentation and reduction surgeries. He routinely reconstructs breasts immediately following mastectomy procedures to minimize patients' experience of breast loss. Liposuction and abdominoplasty are significant portions of Dr. Yaremchuk's cosmetic surgery practice.
Before & after examples of cosmetic surgery
This patient underwent facelift, blepharoplasty and midface lift.
This patient underwent computer designed (CAD/CAM) jaw implants to correct post orthognathic surgery jaw irregularities.
This patient underwent facelift with small chin and mandible implants to improve neck contour.
This patient underwent tertiary rhinoplasty including paranasal augmentation.
This patient underwent lower lid blepharoplasty using the arcusmarginalis release and fat transposition
This patient was self-referred for reversal of a previous browlift by lowering the hairline and brows; correction of scleral show with a midface lift, bridge of bone canthopexy and infraorbital rim augmentation
Photo gallery of the facility
"Everybody tells me that even after 2 years I have the best facelift they have ever seen. I know many of my friends and acquaintances have gone to see you. I hope some have actually gone ahead with the surgery. It makes such a difference in one's life."
"I just wanted to thank you very, very much for the incredible results I already see from my surgery last week... The results look so natural. I'm so happy!"
"It is as much a blessing as a relief to have you as my surgeon. Your peerless skill is matched only by your immense kindness and compassion. Thank you or all you do for me and for countless others. You have clearly devoted your entire life to our care, and we are all the better for it."
"There really is no way for me to adequately explain the feeling of incredible gratitude I have for your help last week… I shall always remember the compassionate assistance you showed me."
Long associated with the pursuit of vanity, cosmetic surgeons are finding new ways to help disease and accident victims look ‘normal’
By Raja Mishra, Globe Staff
One morning five years ago Jennifer Davis awoke to find her eye bulging out. She was at her mother’s house in Hingham. She rolled out of bed, walked to the bathroom, and casually glanced at the mirror
“It scared the hell out of me,” she said
Her eyelids were fully opened. Her eyes popped forward as if she’d just been mortally frightened or had glimpsed some impossible sight. She rubbed her face. The eyes refused to budge. She could scarcely fathom what was happening, not to mention what could possibly cause a person to slide into bed without a worry and awaken with a different face. Jennifer Davis could not see Jennifer Davis in the mirror..
“It changed my face completely. I was looking at a stranger.” Said Davis, now 32.
“I look at the plates I used in the early ‘90s and they almost look primitive,” said Dr. Ed Luce, chief of plastic surgery at university Hospital of Cleveland and president of the American Society of Plastic Surgeons.
These new tools, as well as many advances borrowed from cosmetic surgery, have made reconstructive surgeons increasingly able to deal with a variety of rare deformities that include Davis’s problem, disfigurement from World War II shrapnel and birth defects resulting from maternal drug use. No manual or textbook exists for these cases. They require a pastiche of new techniques and a healthy dose of improvisation.
After staring at the mirror in disbelief, Davis and her mother rushed to Beth Israel Deaconess Medical Center and got an answer: Graves’ disease. A defect in Davis’s immune system caused the production of an antibody that attacked the muscles around her eyes, causing them to swell overnight thus forcing her eyes out of their sockets. It was rare but not unheard of.
Davis’s eyes took on an abnormal look because of swelling in the fat that lined her eye sockets.
Putting eyes in their Place
Graves Disease causes swelling in the intraorbital fat tissue that lines the eye socket, pressuring the eyeballs until they bulge out or even become paralyzed in extreme cases. But a new reconstructive surgery technique restores a normal appearance by widening the eye socket.
Eyeball bulges out as intraorbital fat tissue
The surgeon drills through two bones near the eye-the lateran wall and the medial wall- allowing the intraorbital fat to spread out from the socket, causing eyeball to recede
Denote interaorbital fat
Starting that day. Davis’s life would fall apart and her only hope of a normal existence would come from an unlikely place-plastic surgery.
Three weeks ago, the US Food and Drug Administration generated headlines by approving botox injections for temporary relief from the vertical frown lines that develop between the eyebrows with age. Month’s earlier, Fox News anchor Greta Van Susteren stimulated national chatter by undergoing botox treatment, then reappearing on air with a significantly altered look
But many plastic surgeons cringe at the popular impression they cater to the vanities of the rich. There is indeed a more serious side to the field reconstructive plastic surgery – that has made significant leaps in the past decade. Engineering advances have allowed reconstructive surgeons to use increasingly light and strong titanium plates and screws to repair deformities arising from bone problems.
New laser technology and surgical tools now allow them to remove even the most grotesque scars and tumors. Artificial cartilage and a variety of new implants have made post-mastectomy breast reconstruction once rare and complex, almost standard. The pace of improvement over the last decade, say the surgeons, has been steady.
Suddenly, it made sense. Davis for several years had had hyperthyroidism where an inherited defect in her immune system caused it to make antibodies that attacked and over stimulated her thyroid. A radio-iodine procedure a year before plus a daily prescription drug kept its symptoms weight loss dysfunctional leg muscles – in check.
The same immune system defect was causing her eyes to bulge said her doctors, a clear sign of Graves’ disease In fact, her hyperthyroidism,
they said was a product of Graves’ disease. One of every 1,000 people annually are diagnosed with it, mostly young or middle-aged women. There is no cure, though some of the symptoms can be alleviated with medication and treatment as Davis’s had been.
Her doctors, however said they could do nothing to stop her eyes from bulging. So, she walked out of the hospital and began the painful process of revealing her new deformity to the world.
First came her closest friend, her brother. “What happened?” he exclaimed.
Then came her boyfriend of two years. He refused to comment much on it, she remembered, saying that it would soon go away. She took that as a bad sign. Her colleagues at Provant Inc.. a Boston-based human resources consulting firm, were stunned then supportive though she often caught them staring.
But strangers were the worst.
‘I’d be sitting in a restaurant and people next to me would make some joke out loud about a deer caught in headlights, as if I couldn’t hear it, even though I was sitting right there,” she said “And little kids would point at me and ask, Mommy, what’s wrong with her?”
“Davis wore sunglasses whenever possible. After a year, her boyfriend left her.
“Everything around me fell apart,” she said.
Her life continued that way for two years. And then in summer 2000, Dr. Michael Yaremchuk called. The Massachusetts General Hospital plastic surgeon had actually seen Davis briefly two year ago but decided his abilities.
But now, be thought he could help. Graves’ Disease eye bulging lessens slightly after several years. Yaremchuck had determined that Davis’s condition was at a point where a rare plastic surgery procedure might help.
Yaremchuck, who also has a private cosmetic surgery practice, has special sympathy for patients like Davis. His text books are filled with photos of them. One patient accidentally drove his car underneath an 18-wheel rig. The entire left side of his face was shaved off, an omelet of misplaced facial structure and scar tissue. His “after” photo shows an almost-handsome man with only a single visible scar along his chin.
“People associate plastic surgery with Hollywood and face lifts” he said “They think it’s solely devoted to enhancement. But that’s only part of it.”
The current renaissance in reconstructive plastic surgery started in the late 1980s. Swiss orthopedic surgeons had started using steel plates to steady bone fractures allowing patients mobility.
Reconstructive surgeons saw an opportunity to treat a staple of their practice-jaws broken in first fights. They had long used wire to repair jaws. But wires often stretch disrupting jaw alignment.
“What plastic surgeons are really good as it taking technology from other fields” said Dr. Daniel Del Vecchio, a plastic surgeon at Tufts New England Medical Center, whose caseload is dominated by reconstructive cases.
Surgeons like Del Vecchio began taking postmedical-school courses on the new techniques, and by the early 1990s, plates and screws were the standard tools of the trade.
“The plates and screws have really made treatment of these patients easier.” Said Dr. Gregory A. Antoine, chief of plastic surgery at Boston Medical Center
Surgeons say there’s a clear difference between cosmetic and reconstructive cases.
Surgeons say there’s a clear difference between cosmetic and reconstructive cases.
“Both patients have self-gratification in mind but at different levels” said Antoine. “One is a Little more out of vanity and the other is really because of a major life change.”
Certainly, health insurers recognize the difference: They pay for reconstruction but not for most cosmetic work. Surgeons use a specific scale to draw a distinction between the two. The field has cataloged the size shape and placement of every facial structure for every ethnicity. Patients with feature two or less standard deviations or steps away, from the norm are cosmetic patients. But those in the third and fourth deviations are considered deformed. Davis fell in the third deviation. But the untrained eye can easily spot deformities..
“A deformity is basically whatever looks funny,” said Yaremchuk.
In September 2001, Davis checked into Mass. General Reconstructive surgery is usually a major medical procedure, and this was no exception Yaremchuk began with an incision above Davis’s right ear. He drew the scalpel up the side of her head, across the top of it and down to the other ear. Then he peeled her face down-standard during facelifts.
The goal was to widen her eye sockets. Using a high-speed electric drill, he burrowed cavities into the left and right walls of each eye socket, careful not to damage any part of the organs. The eyes began sinking back in.
Then he took two S-shaped hard plastic implants about the size of matches and nailed them to the top of her cheek bones, just below the eyes. This would make her cheek’s project.
Finally, he ripped each cheek mass from the skull. A tiny titanium screw was placed in each in each temple, just to the side of her eyes. Using sutures, Yaremchuk tied the cheek mass below to the screw above, anchoring the cheeks higher on Davis’ face.
He put her face back on, stitched close the head cut and seven hours later, it was done.
Davis’ eyes were stitched shut. She awoke to blackness and assumed a surgical mishap rendered her blind. A nurse calmed her. Four days later, the stitches came out. The hospital staff brought in a mirror.
“It was amazing,” she said.
Her face puffed with swelling. But it was her face.
“I kept wondering if my eyes were suddenly going to pop back open,” she said.
Her eyes were not as narrow as they once were. She looks like a woman with big eyes – but normally big eyes or, as surgeons might say, eyes less than two standard deviations from the average.
Davis’s eyesight remained perfect; the surgery was a complete success. It would take almost a year, however, to regain full feeling in her face. The only external scarring was on her scalp, and hair would soon cover it. The procedure in a sense cured her only remaining symptom of Graves’ disease.
“I viewed plastic surgery as a way to make someone 50 look 40,” she said. “I didn’t think they treated serious illness.”
She began dating again. Her confidence surged back. But there was always a voice, established during three years of shame, that asked; “It someone looking at me?”
“I just got over that a few weeks ago,” she said during a recent interview at a Waltham restaurant, seven months after her surgery.
During the three years Davis’s eyes bulged, she concluded Americans were overly judgmental and society was disgustingly superficial. In fact, when Yaremchuk told her the surgery would be possible, she considered passing on it. After all, she’d come to feel that external appearance was secondary. It seemed ironic to undergo such a severe medical ordeal in order to repair it. In the end, a single concern, shared by most reconstructive surgery patients, convinced her .
“I needed,” she said, “to fit back into society."