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The term facial reconstruction surgery conjures up images of pristine exam rooms and sterile equipment. While these perceptions are accurately evocative of the modern field of American plastic surgery, the procedures we know today actually go all the way back to the Civil War. While a myriad of advancements have been made in recent years, the earliest facial reconstructions occurred during a truly bleak time in our history, laying the framework for modern plastic surgery.

War Is Hell, Disease Is Death

While historians often focus on the impact of bullets and cannons when they tally the death toll of the Civil War, disease played a shocking role in making that number skyrocket. For every soldier killed on the field of battle, another two died from afflictions that couldn’t be treated by the medicines of the time. These diseases included typhoid, measles, diphtheria, and pneumonia. Pneumonia was the malady that claimed 18-year-old Private Carleton Burgan. A foot soldier for the Union Army, Burgan had a persistent cold that got progressively worse. His doctor attempted to alleviate the condition by treating him with calomel, a formula that contained mercury intended to flush Burgan’s system. Instead, the toxins in his medication ate away the soft tissue in the young man’s mouth, nose, and jaw. Burgan’s life was forever changed by the prescription of the mercury pills. His deteriorated flesh succumbed to facial gangrene, which spread from his tongue to his soft palate and cheek. Eventually, the infection spread to his right eye, leading to the removal of his right cheekbone to halt the life-threatening spread of gangrene.

The First Photo Documented Facial Reconstruction Patient

Burgan joined the ranks of thousands of Civil War veterans who were left disfigured and seemingly hopeless. But history would shine brightly on Private Burgan; he would not be yet another statistic. He would become the first documented facial reconstruction patient, a true benchmark in medical breakthroughs. Traumatized and unrecognizable after the surgery to remove his gangrenous tissue, Burgan turned to City Hospital surgeon Dr. Gurdon Buck, now considered the father of facial reconstruction surgery. Buck was the first to document “before and after” photographs of a reconstruction surgery, and it is through him that we have an idea of the capabilities of surgeons of this era. Because of the doctor’s intervention, Private Burgan, after several surgeries, was able to go on to enjoy a relatively normal life. In fact, Burgan thrived beyond the war years. He got married, had several children, and lived to be 71 years old. He passed away in the year 1915, just as another quantum leap in facial reconstruction innovation would revolutionize the field of plastic surgery.

Advancing Modern Facial Reconstruction: The World War I Years

The techniques used to save Carleton Burgan formed the building blocks of the surgical techniques used in modern day facial reconstruction surgery. The 20th century actually saw many advancements in facial reconstruction techniques, and just as with the case of Dr. Buck and Carleton Burgan, war necessitated this new round of breakthroughs. Dr. Harold Gillies established a visionary health practice in London during the First World War. He hired a team of nurses, surgeons and… artists? Dr. Gillies believed it would require a new set of aesthetics to repair the broken soldiers who had survived the horrors of the battlefield, so he brought in a sculptor named Kathleen Scott to join his efforts. Ms. Scott made casts of the injured young men’s faces to work from. Then, using flaps of grafted skin and sections of rib bones, the surgical squad rebuilt the fallen soldiers’ faces by working from the aforementioned casts. Together, the team made significant strides in jaw reconstruction and replacement that would ripple forward through time.

Another World War, Another Round of Healing

The vanguard work of Dr. Gillies made waves around the globe, and news of his accomplishments soon made their way to New Zealand. A young med student named Archibald McIndoe sought out the tutelage of Dr. Gillies, who was, in fact, a distant relative of his. McIndoe joined forces with Gillies and became a leader in the burgeoning field of plastic surgery in London during the 1930’s… just before the world was on the brink of another disastrous war. Just as technology advanced, so too did the weapons of battle. During World War II, many fighter pilots suffered from a phenomenon called “Hurricane Burn” – this was the result of jet fuel that had ignited during the heat of warfare. The traditional remedy for such disfigurements was tannic acid, which dried out the affected skin and caused additional pain and scarring to the already devastated victims. Dr. McIndoe saw a better solution. He noted that pilots who had been shot down at sea suffered less severe trauma, so he decided to treat his patients with saline rather than tannic acid. This resulted in speedier recovery, less pain, and overall more successful rehabilitation. But McIndoe wasn’t just a pioneer in the operating room (his work included the reconstruction of many soldiers’ hands in addition to his treatment of facial tissue damaged by burns); he also focused on his patients’ mental health post surgery. McIndoe encouraged those he had treated to form their own “Guinea Pig Club” – it was a support group intended to aid in the men’s reintegration into society following their harrowing experiences during the war. To honor his place in world history, McIndoe earned a knighthood in 1947. He then went on to help found the British Association of Plastic Surgeons (BAPS), an organization that later elected him its president. Various advancements over the years, and from all parts of the world, have led to the facial reconstruction techniques available today, and certainly, we can now do things at which Doctors Buck, Gillies, and McIndoe would be astounded by.

3-D Computer Imaging for Facial Reconstruction

Continuing with the trend of evolving technology, Dr. William J. Binder, considered as one of the founders of modern facial contouring, was the first to use 3-D computer imaging to develop facial implants for both aesthetic and reconstructive procedures. With the use of this technology, Dr. Binder can capture the minute details of a patient’s face and transpose those details into the implants, creating natural-looking and subtle results. In fact, these techniques are currently implemented by plastic surgeons around the world. As a leading surgeon who thinks in terms of 3-Dimensional concepts, Dr. Binder is always on the forefront of technology. Stay up to date with his blog for intriguing insight into the field of plastic surgery and facial reconstruction.

Migraines have the potential to severely reduce your quality of life. For some people, migraines are so bad that they are unable to work regularly, attend school or maintain normal adult responsibilities. There are a number of treatment options, but if you are not getting relief with the common ones, Botox can be used to effectively treat migraines. Dr. Binder pioneered the technique and has been using Botox for migraine treatment ever since.

Using Botox to Treat Migraines

Experts do not fully understand how Botox works to treat migraines. They believe that it might be due to relaxing the muscles in the area that can cause tension during contraction. It may also inhibit pain pathways. No matter the science behind it, Dr. Binder has used this technique to successfully treat or limit the migraines of several patients, and he continues to do so.

When Dr. Binder administers the Botox treatment, he makes the injections into specific areas to alleviate your migraines. These points typically include your temples, back of the head, upper back, bridge of the nose, your forehead and your neck. Dr. Binder will determine the best injection sites for you based on where your migraine pain is.

It can take 10 to 14 days for the Botox to take effect and start alleviating your migraines. On average, the injections can provide relief for up to three months. Some people will need two or more treatments, spaced 90 days apart, to start getting effective relief from their migraines.

A Simple Procedure with no Downtime

This is a simple in-office process, and you can go home shortly afterward. The first thing Dr. Binder will do is numb your skin to help reduce any potential discomfort. Once you are numb, your doctor injects a small amount of Botox into the pre-determined injection sites using a thin needle. Once the procedure is over, do not rub the injection sites. You can typically resume your normal activity level right away.

Possible Risks of Botox

The majority of people do not experience any serious side effects with these injections. Mild side effects, such as bruising, swelling, flu-like symptoms and headaches are common and temporary. While highly unlikely, the following are also possible if the Botox spreads elsewhere in the body:

• Excessive tearing or dry eye
• Vision problems
• Trouble breathing
• Muscle weakness
• Difficulty swallowing or speaking
• Bladder control loss

Gain Freedom from Migraines

Botox has become a rather popular option for treating migraines, especially in the last five years. With this versatile treatment, you can significantly increase your quality of life without the pain of nagging migraines. If you suffer from migraines and other forms of treatment haven’t alleviated symptoms,  contact us. Dr. Binder has successfully treated countless clients for migraines.

Rhinoplasty is a great way to change the profile of your nose or even improve your breathing, but it is a procedure that will require a prolonged healing period. You will spend several weeks in recovery, with the first 10 to 14 days being the most important. There are many things you can do to improve your recovery process so that you are more comfortable from day one.

Frozen Peas Instead of Ice Cubes

Since your face is not a flat surface, you want to use an icing method that will mold itself around your nose and face. A bag of frozen peas will mold to your face and they are lighter than a plastic bag full of ice cubes. This ensures more even icing and it is more comfortable.

Have Ginger on Hand

Nausea and vomiting may be common after this surgery. Since vomiting can create additional discomfort during the recovery process, you want to prevent it. Ginger tea or ginger ale can help to keep your nausea under control.

Sleep Elevated

When you are sleeping, put about two to three pillows below your head and neck. This puts your upper body at a 30-degree angle. This helps to reduce swelling and keep throbbing to a minimum.

Avoid Aspirin

Aspirin can thin your blood and encourage bleeding. Avoid any drugs that contain it. If you are taking blood thinners, talk to Dr. Binder to see if you would benefit from a temporary dosage adjustment.

Take Vitamin C

Vitamin C promotes healing, so it can encourage the healing process. Your surgeon can recommend the right dose so that you are getting enough to reap the benefits. This typically involves taking a vitamin C supplement, but eating foods that contain this vitamin is also helpful.

Stay Hydrated

You want to make sure that your nasal passages do not get dry and irritated. This can make your nose more tender and increase the risk of nosebleeds. Avoid overly dry environments and drink water throughout the day.

Nasal Taping

Taping your nose properly can help to alleviate the swelling faster. You must properly apply the tape and be very gentle since you have bones that are still healing. Dr. Binder can teach you the proper taping technique to ensure you do it correctly.

Be Sure to Keep Your Follow-Up Appointment

In addition to all of the tips above, you also want to make sure that you are following all of recovery advice laid out by Dr. Binder. Maintaining your follow-up appointments is also crucial to ensure your recovery is going smoothly. You should also take all necessary medications and protect your face from any trauma to ensure proper healing. If you’re considering rhinoplasty, Dr. Binder continues to produce expert, subtle and natural-looking results.  Contact us today to get started.

Revision rhinoplasty is the technical term for any nasal reshaping that is performed after an initial nose job has already been done. In many people’s minds, the idea of multiple nose surgeries conjures images of obsessed pop stars and other individuals who seem to never be satisfied with their appearance. Contrary to popular belief, however, recent studies have shown that most people seek revision rhinoplasty for concrete reasons and are satisfied with the results. Rather than seeking a third, fourth, or even fifth nose job, about 97% of patients who have revision rhinoplasty report satisfaction with their results and presumably do not seek further revision.

There are many reasons why a patient might seek a second nasal reshaping. Rhinoplasty is a delicate procedure that requires great skill and planning on the part of the surgeon. The underlying structure of the nose can be extremely complex and delicate to deal with. Further complicating these issues is the healing process itself. Even if a plastic surgeon takes all the necessary steps to create the nose the patient wants, in some cases the tissue heals in an unforeseen way, causing changes to the nose’s final appearance. When this happens, many patients seek a revision procedure to account for those changes that were not adequately foreseen by the original surgeon.

In other cases, revision rhinoplasty is sought by a patient because they are simply not satisfied with the results of the first procedure.  Although many doctors have an ability to provide patients a fairly accurate idea about the kinds of results they can expect, many people find that the nose they originally agreed to still has flaws. But some people, upon seeing the final result of their rhinoplasty procedure, decide that there are certain aspects that should have been addressed the first time around. The vast majority of these patients find that although the initial procedure was too conservative, the revision surgery now has a high degree of success to create a nose that is just right.

The most common reason for seeking a revision rhinoplasty procedure comes down to the experience of the surgeon, according to board-certified facial plastic surgeon Dr. William Binder. Rhinoplasty is the most popular facial cosmetic surgery performed in the United States each year, and it consistently ranks among the most popular cosmetic procedures overall. With so many individuals seeking rhinoplasty, it’s no wonder that many of the doctors performing this procedure are undertrained. There are a number of techniques employed during a nose job. However, novice surgeons may not be well-versed in many of the more complicated methods. The result is a nose job that utilizes inadequate techniques to achieve the end result. For example, many patients want to increase the projection of the tip of the nose. Most surgeons use a tip graft to achieve this. By itself, this procedure produces results that are neither natural nor satisfactory. In these cases, revision rhinoplasty performed by an experienced surgeon can be a great help in its ability to produce the desired result.

Revision rhinoplasty procedures are usually successful for a number of reasons.  Patients who had prior nasal procedures have the knowledge and benefit of their own experience to better understand the outcome of the surgery.  They know what they want and have a much better idea about the kind of results that a nose job can produce. They can discuss their goals and the problems of their last procedure with the new surgeon, allowing her or him to make the necessary adjustments to achieve the patient’s ideal results. Finally, patients tend to be more selective the second time around and avoid the discount surgeons who led them to seek revision in the first place. Rather than obsessive plastic surgery addicts, these patients are shrewd consumers with the benefit of hindsight. It’s no wonder that so many of them find that, when it comes to rhinoplasty, the second time’s the charm.

According to the latest study from the American Society of Plastic Surgeons, nearly a quarter of a million rhinoplastyprocedures were performed in the United States last year, about the same number as the year before. That made it the most popular facial cosmetic surgery, which begs the question: why is rhinoplasty such a popular procedure? Although every individual has his or her own reason for seeking this procedure, the enduring popularity of rhinoplasty can be traced to a number of reasons. Reconstructive nose surgery dates back thousands of years to ancient India, where physicians would repair damaged noses using a variety of techniques. Today, people still seek rhinoplasty to surgically repair damage to the nose. Usually, this is because of an accident that has caused a nasal fracture. In cases like these, nose surgery can be used to correct functional issues and restore the appearance of the nose. However, at least as many people (if not more) seek rhinoplasty for purely aesthetic reasons. Concern about the appearance of one’s nose is nothing new. The nose is the central focus of the face, the most prominent feature in many people’s minds. If you feel your nose is too large, too flat, hooked, etc., rhinoplasty can be used to give you a nose that more closely resembles your ideal. In many instances, correcting this one facial feature can have the most dramatic impact of any facial cosmetic procedure. But the importance placed on the appearance of the nose isn’t the only reason for the popularity of rhinoplasty. Among cosmetic procedures, rhinoplasty is quite affordable. For many patients, the idea of plastic surgery is appealing, but cost can be a barrier. Having one affordable procedure to greatly enhance your appearance is an appealing prospect for many of these individuals. In addition, financing options are usually available for most patients. Another reason for the popularity of cosmetic nose surgery is the relative ease of the procedure, at least for the patient. Although a good nose job  is a sophisticated procedure for the surgeon to perform well, it is less invasive than other cosmetic surgeries.  The incisions used are typically small and the recovery period is relatively short, especially compared to a procedure like a facelift. A facelift can be a larger surgery and more invasive than rhinoplasty, with a longer postoperative recovery. Older techniques focused on reducing the size of the nose by removing tissue, usually from the bridge of the nose or the tip. But new methods have opened the door for people from all ethnic backgrounds, further increasing the popularity of this procedure. Doctors can now augment noses to give them a greater projection, reduce nostril width, and generally reshape noses that were once difficult to operate on.   Recently, ethnic rhinoplasty has become an important subject that is currently being taught in academic institutions and is becoming increasingly more popular throughout the world.  Instead, the emphasis has shifted to fashioning noses that work harmoniously with the patient’s existing facial features to create an overall improvement in appearance. Perhaps the most important factor in the enduring popularity of structure rhinoplasty is the great and enduring results that are typically achieved. Surgeons like to talk about the “predictable” results that the vast majority of patients experience. Advances in rhinoplasty techniques have allowed plastic surgeons to give their patients the noses they want, resulting in an extremely high level of overall patient satisfaction. When it comes to improving your appearance, who wouldn’t want to use a procedure that is likely to produce the best, most noticeable results?