Author Archives: doctorbinder

Progress is rarely linear. We take several strides forward, then invariably step back. How else can we assess our trajectory and determine the best path toward our ideal outcome?

Every generation contributes to our collective betterment, but perhaps no group is more synonymous with progress than millennials. They grew up with the internet, pioneered social media, and thrive on information and innovation.

For these reasons, it is noteworthy when millennials opt for a classic approach over more recent methodologies. Since the advent and proliferation of Botox and fillers, the popularity of brow lifts plunged precipitously. Between the years 2000 and 2019, the procedure saw a 69% drop, due primarily to the convenience, safety, and effectiveness of injectables.

But now, the pendulum is starting to swing back the other way. Millennials love the results they receive from dermal fillers and neuromodulators, and now they want to put a ring on it. Brow lifts provide a more permanent solution to drooping skin and wrinkled foreheads, so the procedure is beginning to trend among the trendy.

Brow Lifts vs. Injectables

Let’s face it: we’re all sick of wearing masks. They helped slow the spread of COVID-19, but they also obscured your beautifully expressive lips and lower facial features. Masks directed our gaze upwards, emphasizing the eyes and their surroundings. Every wink and frown became amplified, and people paid close attention to every fine detail of the upper face.

The forehead is a breeding ground for wrinkles. Every time you make a facial expression, your musculature pulls at the skin, forming creases along the brow. There are many ways to address the wrinkling process. Botox halts the persistent contraction of specific muscles, allowing for a smooth serenity to encompass your expression. You can also get an added boost from facial fillers. These gentle serums bring volume to the skin, filling out gaps and smoothing creases from within. 

But some lax, redundant skin is too much for injectables to solve in a long-term manner. If you have sagging or heavy brows, a brow lift will work wonders for you. A brow lift procedure comes in two types: the endoscopic lift and the classic (coronal) lift. Although the endoscopic lift is a favorite for a number of reasons, the coronal lift has its unique advantages as well.

The Endoscopic Lift

The endoscopic lift is named after the procedure’s essential tool: the endoscope. This minimally invasive technique holds several advantages over the coronal lift, which was once the industry standard.

In any brow lift, the objective is to lift the skin surrounding the brow after it has begun to sag from muscle constriction around the eyes. With the endoscopic brow lift, small incisions about an inch long are made in the scalp above the hairline. Then, your medical team employs an endoscope (with a camera and light) to assist the surgeon in making the incisions. 

Once the doctor makes skillful, subtle incisions, he can gently separate the skin from the muscles and adjust it to create the appearance of a lift. The forehead is then secured with metal posts, which are removed ten days later.

Many patients opt for a simultaneous upper blepharoplasty procedure to complement the benefits of endoscopic brow lifts. Blepharoplasty is eyelid surgery engineered to remove subtle pockets of fat and excess skin. By performing an eye lift in conjunction with a brow lift, your doctor can achieve seamless results. After all, there is no magic border between the forehead and the eyelids; it is a holistic landscape of expression and radiance. 

The endoscopic procedure is quick, lasting about an hour and a half. Patients can expect to resume normal activities in ten days and recover completely in about three weeks. Overall, the procedure produces similar results to the classic lift, with less scarring.

The Classic Lift

The classic lift earned its title from its history of being the industry standard of brow lift surgeries. It involves a much longer incision, extending from ear to ear. This incision may also be made mid-scalp, following the skull to appear less conspicuous. This procedure removes a strip of skin, allowing the surgeon to lift and smooth the remaining skin.

A minority of coronal lift patients may experience alopecia: circular bald patches usually resolve after a few months. There is also a small chance of swelling, but recent advancements in the brow lift field have nearly eliminated this risk.

There is also postoperative pain associated with the classic lift, and the patient may experience prolonged numbness around the incision. This soon leads to itchiness, which may last for six months.

Classic Brow Lift vs. Endoscopic Brow Lift

Some surgeons express doubts regarding the longevity of endoscopic brow lifts. The method may not produce the long-lasting results associated with the classic lift approach. This is due to the fact that endoscopic lifts merely shift the skin upwards without removing redundant skin, leaving a chance that the skin may resettle over time. 

According to one extensive survey of 628 endoscopic brow lift procedures, patient satisfaction was high. In fact, 70% of respondents indicated positive results, but their surgeons still hold an affinity for the classic lift approach. Only half of the physicians surveyed were satisfied with the long-term benefits of their endoscopic lifts, expressing a desire for more enduring results after five years.

The endoscopic lift also shifts the hairline upwards, thus making the classic lift a better option for people with thin tissue or a receding hairline.
When deciding which brow lift procedure is right for you, schedule a consultation with Dr. Binder. His vast expertise ensures that he can answer any surgical questions or concerns you may have.

Beauty is a snapshot in time. The way your skin looks at a given moment is fleeting; it evolves and matures every hour of every day.

The dynamic nature of skin regeneration presents both opportunities and challenges. On the bright side, cells replenish and help your complexion maintain a healthy glow. But when the body begins to age, these regenerative properties slow down. By thoroughly understanding the ways in which skin forms and heals will guide our collective efforts to keep you looking and feeling your best.

WHAT IS SKIN RESURFACING?

Complexion is a story of two realms: superficial and subdermal. Let’s focus on the latter first. Under the skin’s surface, a complex network called the extracellular matrix (ECM) provides structure and support to a person’s features. 

One of the most prevalent compounds in the ECM is collagen. This protein generates growth, allowing new cells to flourish and replace dead and damaged skin. But as we get older, we produce less and less collagen.

In our later years, the skin reflects this shift in collagen levels. Wrinkles emerge, age spots linger, and the skin takes longer to repair itself in the event of breakage and splits. To resurface the skin as efficiently as possible, we may need to give the ECM medical boost every so often.

There are many ways in which a skilled physician can stimulate collagen production and bring vigor back to your complexion. The exact procedure(s) that works best for you will depend on several factors. Your skin tone and general health status will help determine which treatment is right for your aesthetic journey.

CHEMICAL PEEL OPTIONS

It’s time to face facts: dead cells peel away every time we wash our skin. It is a natural process, but it can be nurtured and amplified with a safe resurfacing strategy.

Chemical peels are procedures in which a licensed professional applies a carefully balanced compound to the skin for a precise length of time. Once the serum has reached a determined depth, your doctor will gently rinse off the chemical mixture, signaling your body to take over and replenish the affected skin.

The depth of your peel will depend on your cosmetic goals. If you have fine lines that you wish to tighten and smooth away, then a superficial peel may be ideal for you. On the other end of the spectrum, deep peels penetrate persistent creases and dark spots. To achieve your individual needs, your practitioner will utilize a bespoke blend of chemicals.

Glycolic peels are the lightest level of chemical resurfacing procedures. They are ideal for minimizing mild imperfections and textural inconsistencies.

Delving further below the surface, trichloroacetic acid (TCA) peels target splotches and discoloration, known as hyperpigmentation. In approximately five or six days, the outer layer of skin damage will flake away, revealing a healthy, youthful complexion.

The deepest peels available are formulated using a phenol compound. Phenol peels must only be administered seldom since they require up to two weeks of recovery time. Individuals with darker skin types may not be eligible for deep peels, so please consult with your aesthetic team to discuss the types of peel you desire.

LASER RESURFACING TREATMENTS

Technology is illuminating the way to new and innovative enhancements. One of the most brilliant techniques in our cosmetic toolkit is laser skin resurfacing.

By carefully swathing an area of dull, damaged skin with a concentrated energy beam, we can accomplish several goals simultaneously. First, the CO2 laser eradicates dead cells on the surface that may obscure one’s radiance. Meanwhile, the technology penetrates the dermis, where collagen activates and flourishes to create continued skin health.

Due to the highly delicate nature of laser resurfacing, you must only trust the procedure to a skilled, experienced professional. If you leave it in the hands of a non-licensed provider, it can lead to scarring, discomfort, and further damage.

DERMABRASION

Whether we mean to or not, we are sometimes harsh on our skin. Itching, picking, and daily abrasiveness deteriorate our glow. But perhaps the worst culprit of skin damage is sun exposure. Every time UV rays make contact with our complexions, it has an impact.

Sunburns, acne, and other wounds require healing. The skin patches itself via a process called epithelialization. Lower levels of skin create healthy new cells that rise to the surface to repair visible damage. Epithelialization takes time, however, and when it is rushed, it is noticeable. When collagen surges to fix a broken area of skin, it appears discolored or “tough” in texture. This is scar tissue.

But a medically guided epithelialization procedure can prevent scar formation and promote vibrant, gorgeous skin. Dermabrasion is one such procedure. Your doctor begins by administering a mild anesthetic to ensure comfort and safety throughout the session.

Once you are sufficiently comfortable, your skin is treated with a device that brushes away dead, discolored skin along the surface of your complexion. The depth of your dermabrasion session will depend on your goals and needs. Your doctor will meticulously work down through the layers of your skin to remove any unwanted blemishes and unearth your best attributes.

YOU DO YOU

Enhancement is not a “one size fits all” endeavor. Each of the procedures described above is customizable, so you will receive the treatment contoured appropriately to your skin. 

The recovery time associated with these techniques varies according to depth and duration. A light chemical peel, for example, requires less downtime than a comprehensive laser resurfacing session.

To prepare for your visit, chat with one of our friendly, knowledgeable staff members. We can’t wait to explore your skin resurfacing options with you! Call (310) 858-6749 to reach our Beverly Hills offices.

Cosmetic enhancement is the art of symmetry and balance. Sometimes, nature gives us too much bulk in some areas and not enough in other areas. A skilled surgeon can bring these two extremes into harmony through the science of fat transfer, also known as fat grafting.

Fat grafting is the process by which fat is removed from one portion of the body via liposuction, then liquefied by a process of straining and spinning, and finally surgically added to the body elsewhere. Traditionally, this process was used to fill out irregularities in the skin’s surface during procedures such as natural breast augmentation and Brazilian butt lifts. Now, however, fat grafting is becoming more and more important to facial plastic surgery.

Fat grafting is also used for facial reconstructive surgery and is now frequently used in other cosmetic facial plastic surgery techniques.

FACIAL FAT GRAFTING APPLICATIONS

Fat grafting can be used as an alternative to more traditional facial implants, with the added benefit of removing fat from less desirable locations. Using this technique, a surgeon can create a more natural facial profile, rebuild facial deformations, and repair tissue damage. Imperfections such as radiation damage from cancer treatment, birth defects, and damage resulting from prior surgery or trauma can now be treated with fat from a patient’s own body.

Facial fat grafting can also be used to augment the results of a facelift, which is becoming an increasingly popular technique used by plastic surgeons. According to a study in which 300 members of The American Society of Plastic Surgeons were polled, 85% of the surgeons polled used fat grafting during facelifts.

According to the study, these surgeons found that injecting fat from the patient’s body resulted in a more rounded and fuller appearance in the face. This result is especially beneficial when performing a facelift to improve upon cheeks that appear gaunt or sunken.

SUPPLEMENTING FACIAL RECONSTRUCTION SURGERY

In recent years, fat transfer has become a valuable tool in restoring facial structure and splendor. There are many reasons why patients may need to bring harmony back to their appearance. These causes include Parry-Romberg syndrome and other such deformities.

Traditional reconstructive surgery employs the flap technique to address the loss of tissue in a given area. Two flaps of skin are skillfully joined to cover the affected facial feature, smoothing it over for aesthetic enhancement. Some grafting techniques transplant skin from other body areas for application to the face if there is insufficient material on the face itself.

Regardless of the flap technique required to achieve facial reconstruction, fat grafting can aid the procedure. By supplementing skin with lipids, your surgeon can round out your look and bring volume to gaunt, slack areas of the face.

Fat transfer has proven wonderfully effective for patients who have undergone cancer removal from the head and neck. Healthy fat cells can be removed from one body region and placed delicately in the area where problematic lumps have been removed.

SKIN REJUVENATION

On the topic of cancer treatment, fat grafting offers a helpful set of benefits to those battling the condition. Radiation sessions can take their toll on skin health. Peeling, thinning, and darkening are pretty common in cancer survivors due to the potency of radiation treatment.

Fat grafting can alleviate some of the symptoms mentioned above. Your doctor uses purified adipose tissue from elsewhere on your body to rejuvenate and replenish your natural glow.

A LIFTING EFFECT

One of the residual benefits of fat transfer to the face is its ability to create a lifting dynamic to sagging features. Cheeks, brows, and other subtle structures can significantly boost their profile with a minimal amount of injected fat.

Grafting is an excellent supplement to surgery because the two disciplines address your various needs. Surgery removes ptotic (dropping) tissue and erases redundant skin. Meanwhile, fat transfer bolsters your natural contours, propping up your ideal lines and curves. 

The right fat transfer approach can diminish nasolabial folds, crow’s feet, perioral lines, and other unwanted creases either with or without the need for a more invasive procedure.

AN EVER-EVOLVING TECHNIQUE

One certainty when it comes to fat grafting is re-absorption. Your body will process some of the cells transferred to the desired area and eliminate them naturally and gradually. However, medical science is advancing every day to minimize the loss of transferred fat and maximize your results.

Experts are constantly finding new ways to salvage healthy cells and nurture them as they are transplanted to facial contours. The study of stem cells and platelet-rich plasma (PRP) continues to raise questions and illuminate opportunities in the field of fat grafting.

Please be advised that you should not trust fad techniques or quick fixes regarding your health. Experimental procedures are just that: experimental. More research is required regarding the effectiveness and safety of stem cell therapy and PRP treatments. You are nobody’s test subject. It would help if you only embarked on a procedural strategy after its benefits have been well proven and deemed applicable to your case.

The process of maneuvering healthcare advances can be complicated, which is why you require an innovative leader in the field of cosmetic surgery to explore your best options. Enhancement is marvelous, but safety is a must. The right fat transfer procedure can bring your appearance from the here and now to the bright future that awaits you.

AN INCREASINGLY POPULAR TECHNIQUE

Fat grafting is one of many tools that a plastic surgeon can implement. Whether used for cosmetic purposes or medical purposes, one thing is certain: fat grafting is becoming increasingly popular and essential to facial plastic surgery.

If you would like more information on facial plastic surgery techniques or considering the procedure, reach out to Dr. Binder, a leading plastic surgeon, and innovator in the field. Call (310) 858-6749 or contact us online to schedule your consultation.

Your skin has many talents. It is a guardian, a tactician, and a doctor. Skin protects you from the elements while providing a vital sensation that helps you experience the world around you. And when you suffer a wound, the skin heals itself…to a degree.

Broken skin sends a signal to the body to seal the area. Collagen rushes to the site and rapidly forms new flesh, but this skin may not match the look and feel of its surroundings. That’s what we know as scar tissue.

But not all scars are created equal. In order to minimize the appearance of scarring, we must assess several factors, including skin tone, severity, and the nature of the scar itself.

Types of Scars

There are several scar tissue varieties, but the most common types fall into two major categories: hypertrophic and keloid. Hypertrophic scars have a red hue and tough texture but generally lay flush against the plane of the skin’s surface.

Keloids, on the other hand, extend well beyond the parameters of the original wound. They are raised approximately 4mm or more above the surface and are more persistent than hypertrophic scars. Individuals with darker skin types are more vulnerable to keloid scarring.

It is important to discuss your unique complexion, healing patterns and aesthetic goals with a skilled medical professional to determine the best course of action for scar treatment.

Surgical vs. Non-Surgical Scar Revision Techniques

As detailed above, collagen is both a virtue and a complication. When collagen forms too hastily, it has a fibrous consistency synonymous with scar tissue. To counteract this dynamic, collagen injections can supplement the skin and minimize the persistence of certain scars.

Another injectable solution is the use of dermal fillers like Restylane or Juvederm. These compounds can add fullness to divots or other inverted scars, bringing an even tone and texture to the area. Steroids may also be injected into the area to alleviate the itching and redness associated with scar tissue.

To address the scarring on a surface-level approach, your doctor may apply silicone gel sheets. Alternately, you may opt for pressure therapy, which requires several months of faithful usage to deliver noticeable results.

Laser skin resurfacing is a more comprehensive approach to scar revision. By heating the cells beneath the fibrous tissue, the CO2 beam encourages healthy new skin to form, replacing the unsightly scars that appear on your complexion.

Cosmetic surgery techniques have made incredible progress in the realm of scar revision. Your surgeon can literally excise scar tissue and suture the incisions back together with an eye for contouring and seamless functionality. For example, the elliptical, W-plasty and Z-plasty approaches are three variations on the same basic concept. The doctor works with the movement of your skin, assessing which incision shape will be the least noticeable.

For example, Z-plasty (as the name suggests) creates a zigzag incision that breaks up the stark, linear manifestation of a scar. Your skin is allowed to heal in several dimensions simultaneously, downplaying the original protrusion and dissipating the scar tissue in various directions. 

If your skin is struggling with scars that constrict your movement and expressions, your surgeon may recommend tissue expanders. These devices encourage your skin to flourish, overpowering scar tissue that pulls at your complexion.

The exact procedure that you require will depend on several factors. Before choosing between the surgical and non-surgical options outlined in this article, you must step back and take a holistic snapshot of your aesthetic landscape.

Careful Considerations

Scars affect everybody in different ways. The darkness of your skin, for example, will influence the type of scar tissue you develop (keloids vs. hypertrophic). But the proper scar revision technique must also consider the placement of a wound, the age of the patient, and the depth of the scarring.

One concept to keep in mind is that of relaxed skin tension lines (RSTL). When you look at scar revision under a microscope, you may think about your skin as it stretches, heals, and reforms. But we spend most of our time in a more calm state. When skin is relaxed, it has an entirely different vibe than when it is flexing and posing.

Take a casual look in the mirror. Does your scar stand out due to how rigid and straight it appears? That’s because it doesn’t have the same flexibility as the skin you have developed over the entire course of your life. Those relaxed skin tension lines define who you are, and scars get in the way of your resting best face.

A successful scar revision procedure will consider how you behave daily, not just how you will look in the clinic under certain lighting. We want you to be satisfied with your skin in the long term and under a bevy of scenarios.

From smiles to surprises and everything in between, your skin is a reactive gem. It demands individualized attention, and scar tissue is a facet of your complex complexion. Revision procedures are tailored to your ultimate goals, so be sure to discuss any and all medical needs with your physician before embarking on scar treatment.

Managing Expectations

Once the skin is broken, it can never magically go back in time to its perfect, unblemished status. That said, we can work with the skin to ensure it shimmers and glows at its optimum levels.

Realistic expectations are essential to cosmetic improvement. Scarring is natural because it is part of your healing process. Medical science is geared towards amplifying this process, but it can never replace your body’s own capabilities. Doctor Binder is an expert in the field of aesthetic enhancement because he respects and understands the skin. To benefit from his unparalleled expertise, contact our Beverly Hills office. 

Confidence is like beauty; they both originate from within and then project outward for the whole world to appreciate. It is vital to understand the dynamics of interior and exterior forces if we want to assess the best ways of maintaining your most attractive qualities.

The analysis of superficiality vs. depth is more than just a metaphor. We must treat the skin on its surface and below it simultaneously. After all, fine lines form along many planes of our complexion, so we need to eradicate them on multiple levels to fight the aging process comprehensively.

Botox and facial fillers work together (or separately) to enhance the skin and embrace your youthfulness. To learn which products are best for your brilliant skin, let’s get to the root of your aesthetic issues.

What Causes Wrinkles?

Skin is amazingly pliable. It stretches and contracts with astounding flexibility, but every complexion has its limits. After years of push-and-pull, the skin has trouble “bouncing back” like it used to in our younger years.

There are many reasons why lax skin develops creases. One of the main causes of wrinkles is the depletion of proteins like elastin and collagen in aging bodies. When we produce less of the supportive materials that prop up our skin, it slowly collapses. As skin hangs farther and farther away from its underlying muscle and soft tissue, the complexion puckers noticeably. 

Another root cause of fine lines is muscular contraction. Every time you wink, laugh or frown, your skin reacts. The repetitive motion of facial muscles creases skin, creating etched lines around the eyes, mouth, and nose. In order to halt the spread of unwanted wrinkles, we must identify the muscular activity that is exacerbating the aging process and relax them at their source.

Stop the Tug-of-War

Botox is a miraculous compound that eases muscular tension, ushering in a new age of placidity and smooth skin. The way it works is complex yet comprehensive. When your nervous system sends a signal to your facial muscles telling them to contract, your muscles follow their orders. 

By disrupting this signal, Botox allows you only to show the emotions you wish to convey rather than every involuntary twitch and cringe that persists on your face. Botox blocks the release of acetylcholine at the neural junction. This reduces the stretching and stress on your skin at the point of injection.

Even though the results of Botox are profound, they only take a short amount of time to take effect. Your skin may begin to show improvement in as little as 24 hours after an injection session, or they may take up to two weeks to integrate with your appearance. 

Enhance Your Skin from Within

Dermal fillers are similarly efficient in their activation. Restylane and Juvederm, for example, produce immediate results that only get better over the course of one to two weeks. During this time, the filler of your choice mingles with the natural substructures of your skin, bolstering their strength and preserving their youthful contours.

The active ingredient in Juvederm and Restylane is hyaluronic acid, also known as hyaluronan (HA). The human body naturally produces HA, so facial fillers formulated with this compound are safe and effective. When your doctor gently injects HA below the skin, your complexion radiates its ideal fullness and hydration. Indeed, HA molecules bind with water, cradling moisture and delivering an enduring glow to its recipients.

Hyaluronan is part of the extracellular matrix (ECM), a network of scaffolding that gives skin its signature shape. When HA is added to sagging, sallow skin, the results are transformative. 

Think of a balloon that has lost its air. The surface is withered and wrinkled. But when you inflate it, it enjoys a healthy sheen along its surface. Your skin is like that balloon, and hyaluronic acid is the air that is necessary to bring radiance and volume back to your appearance. 

Fillers and Botox: Better Together

There are significant advantages to each type of injectable. Fillers add fullness to areas like the cheeks and chin to add definition where it is most needed. On the other hand, Botox is most often administered along the upper face to reduce forehead wrinkles and glabellar lines (the “11” shaped creases that arise between your eyebrows). 

But the variability of enhancement compounds extends beyond the face. Botox, for example, can help alleviate the stringy, taut lines that appear along the neck. Most people focus their attention above the jawline, but the neck is one of the most prominent places where aging first manifests itself. By easing the tension along the lower face and neck, you can give your face the pedestal it deserves.

Fillers can also help turn back time in places other than the facial region. When the skin along the hands loses its fullness, it can appear skeletal and gaunt. A smart filler strategy rounds out hands to their proper dimensions. 

If you struggle with both persistent muscular contractions and deflated features, you can benefit from a combination of Botox and fillers. The formulas complement one another beautifully when injected by a skilled, knowledgeable professional.

Comprehensive Improvement

When you want to look and feel like your best self, you don’t merely want to plump or perk one area. It would help if you had an overall boost that lifts your profile along with your confidence. Doctor William J. Binder understands the complexities and opportunities of the injectable realm.

To schedule an appointment with the most accomplished aesthetic thinker on the west coast, contact our Beverly Hills office today. We’ve got the formula for success, and we’re eager to share our expertise with you.