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The ears are one of the most subconsciously noticed features of the face. Commonly, the eyes, nose, and smile are among the first things observed when meeting someone. However, the ears play a crucial part in the overall balance of your face, effectively framing the rest of your features. Misshaped ears can be the result of a couple sources. Injury, genetic predisposition, or a poorly-performed previous ear surgery can all leave you with ears lacking the position, shape, or proportion that you desire. An otoplasty is unique in its ability to be performed at almost any age. Protruding ears can be the subject of teasing and bullying in children who feel self-conscious about how they look. Ear surgery is usually more effective the earlier it is performed. Taking advantage of still-developing cartilage helps guarantee longer lasting results by reshaping the still-flexible ear tissue. Even mild distortions of the ears can be damaging to your self-esteem, no matter your age. Social situations, being able to wear your hair certain ways, and being photographed are all things you should never have to worry about doing. A successful otoplasty with Dr. Binder’s plastic surgery in Beverly Hills aims to make your life easier by shaping or sculpting your ears to better balance your face, restore self-confidence, and allow you to not think twice about taking part in common, daily activities.

The Procedure

Corrective ear surgery is performed under general anesthesia and usually takes no longer than two hours. For protruding ears, an incision is made behind the ear where cartilage is then sculpted and sutured to maintain the desired positioning. Yet another special benefit to an otoplasty surgery is its ability to be combined with other cosmetic facial procedures. Many patients choose to include this in conjunction with rhinoplasties and facelifts. Although, most commonly, patients desire their ears to be “pinned back” to avoid protrusion, deformed or disproportionate ears can be reshaped or altered in size to better fit your face as a whole. It is common to require a soft cast for the days following your procedure, but most post-surgical pain is minimal. The thin scar left from the incision is well hidden behind a natural crease of the ear.

Candidacy

Adults with no previous severe medical conditions and who generally lead a healthy life style are ideal candidates for this procedure. For children, it is generally recommended that they be at least 5 years or older, in relatively good health, able to follow instructions well, and are cooperative. With any candidate, having a thorough understanding of what you wish to change and realistic expectations only makes your procedure more rewarding.

How to Get Started

Dr. Binder’s cosmetic surgery in Beverly Hills is often considered the best option for solutions regarding the otoplasty procedure. Our office is dedicated to establishing proper communication with prospective patients. Contact us today to schedule a consultation for your revision rhinoplasty surgery in our Beverly Hills office.

For the most part, a scar isn’t bad if it’s small or in a location that’s easy to conceal. But when it’s not, you may wonder if there’s a way to treat it, other than hiding it under your clothes, that will make it go away or at least change how it looks. Here’s a look at some of the options available to you when it comes to reducing the appearance of those unwanted scars.

Scar Revision Surgery

Scar revision surgery is meant to minimize the scar so that it’s more consistent with your surrounding skin tone and texture. Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed; different in color or texture from surrounding healthy tissue; or particularly noticeable due to the size, shape, or location. Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely removed. Scar revision treatments include:

• Topical treatments—such as gels, tapes, or external compression can help in wound closure and healing, or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in healing of scar revision procedures.
• Injectable treatments—are often used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results. One form of injection therapy uses steroidal-based compounds to reduce collagen formation and can alter the appearance, size, and texture of raised scar tissue.
• Surface treatments—are most often used for cosmetic improvements of scars. These methods can soften surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of either mechanically removing the top layers of skin or changing the nature of tissue. These treatment options include: dermabrasion (a mechanical polishing of the skin), laser or light therapy (causes changes to the surface of the skin that allow new, healthy skin to form at the scar site), chemical peel solutions (penetrate the skin’s surface to soften irregularities in texture and color), and skin bleaching agents (medications applied topically to lighten the skin).

Scar Removal: Home Remedies

The human body is capable of taking care of scars and they tend to get lighter with time, but there are some home remedies that you can try to speed up the healing process, including: Aloe Vera—a natural scar removal remedy due to its anti-inflammatory and antibacterial properties. Apply aloe vera twice daily, but do not use on open wounds.

1. Peel the outer green cover off an aloe vera leaf and scoop out the gel-like substance.
2. Apply the gel on your scar and massage in circular motions.
3. Leave it on for about 30 minutes, then wash it off.

Olive Oil—is rich in vitamin E and helps keep the skin soft and moisturized. Repeat either of these remedies several times a day until you get the desired result.

• Apply some warm extra-virgin olive oil to the affected area and massage using small, circular motions. Wait 30 minutes, then wipe off the oil with a clean cloth. You can also leave the oil on your skin overnight.
• Another option is to mix a little lavender oil in some extra-virgin olive oil, apply it on the affected area and massage gently for a few minutes. Leave it on for 20 to 30 minutes, then rinse it off with lukewarm water.

Lemon—can remove dead skin cells, promote the growth of new skin cells, and improve skin elasticity. Repeat this remedy once daily until the scar fades.

1. Apply some lemon juice on the affected area.
2. Wait 10 minutes, then rinse it off with warm water.

Honey—a natural moisturizer. Repeat this remedy daily before going to bed.

1. Apply some honey over the scar, cover it with a bandage, and leave it on overnight.
2. The next morning, wash it off with warm water.

Speak with Dr. Binder

If you decide that home remedies aren’t doing enough to fade your scars, then you should talk to Dr. Binder about the surgical scar removal options that might work best for you. With years of experience in his field, he as the expertise to help you make the right decision about how best to deal with your unwanted scars.

Living in LA in the winter months is basically the same as living there in the summertime. At least where your skin is concerned. Most people tend to think that once the sun goes away a little, they can stop protecting their skin from the sun’s harmful rays. But the truth is that the sun never really goes away. Winter skin care is just as important as summer skin care. Here are some tips on how you can properly look after your facial skin this winter, so that you can stay looking young and radiant.

9 Tips for Healthy Winter Skin

1. Cleansing—is an important routine to be followed all throughout the year. In the winter time, you can limit the number of times you wash your face from three times to two times. You can also alternatively cleanse your face with cold milk and cotton balls to cut down on the excessive dryness.
2. Scrubbing—avoid daily scrubbing as it may cause severe abrasion and make skin even drier. Try using a mild exfoliating scrub once or twice a week. You can also enhance your scrubbing experience by adding the following ingredients to make your innovative fruit scrub:
   1. 2 tbsp. mashed ripe banana
   2. 2 tbsp. of a mashed apple
   3. 1 tbsp. honey
   4. 2 dollops of your mild scrubMix all and go for gentle clockwise and counter-clockwise finer movements to scrub your face for two minutes; while washing off with warm water, ensure you pat dry with a soft towel.
3. Toning—is a must for all those who have aging and sagging skin concerns. Otherwise you can leave your pores open in winter for more oil secretion.
4. Moisturizing—is important for all skin types, not just those with very dry and flaky skin. You can indulge in natural moisturizing by using warm almond and extra virgin olive oil, and use it as a night massage routine. Alternatively, you can mix the oil with your normal cold cream and lotion, too.
5. Face packs—there are hundreds of ingredients in your kitchen that can be highly effective to make your skin become soft and supple in the winter season. Here are a few that you can make use of:
   1. Avocado face pack—use mashed ripe avocado on face for about 10-15 minutes before washing off with warm water. Apply a light moisturizer instead of toner.
   2. Banana face mask—take 4 to 5 tbsp. of mashed ripe banana and massage it on the face. Wash off after 10 minutes then massage your face with honey, in circular motions, for that extra moisturizing feel. Do so for at least 10 minutes before applying toner.
   3. Butter milk pack—use malai or fresh butter milk with a pinch of turmeric, letting it sit on the face for about 10 minutes, and then wash off with lukewarm water.
   4. Aloe Vera—can be used on the face as a moisturizer. It is the perfect way to relieve your face from dryness, while enhancing the texture by making it softer.
6. Keep hydrated—don’t forget that your skin needs hydration from the inside, out. A little warm water with lemon can be very refreshing and hydrating at the same time. Eating foods high in water content can also help hydrate your skin. Try watermelon, cantaloupe, apples, oranges, kiwi, and watery veggies like celery, tomatoes, cucumbers, zucchini, and carrots.
7. Sunscreen—isn’t just for the summertime. Winter sun—combined with snow glare—can still damaged your skin. Try applying a broad-spectrum sunscreen to your face about 30 minutes before going outside. Reapply frequently if you stay outside for a long time.
8. Hook up the humidifier—central heating systems blast hot dry air throughout the home and office. Humidifiers get more moisture in the air, which helps prevent your skin from drying out. Place several small humidifiers throughout your home so that they can help disperse moisture more evenly.
9. Ban super hot baths—the intense heat of a hot shower or bath actually breaks down the lipid barriers in the skin, which can lead to a loss of moisture. A lukewarm bath with oatmeal or baking soda can help relieve skin that is so dry it has become itchy.

Seek a Specialist

If you find that your skin isn’t looking the way that you want this winter, then you should consider seeking help from a professional. Book an appointment with Dr. Binder, so that he can help you figure out what surgical or non-surgical facial routine might work best for you.

It is evident that plastic surgery and cosmetic procedures have aesthetic benefits, but many of these procedures can have impacts on the health of patients, as well. One such procedure is blepharoplasty.

Blepharoplasty, also called eyelid surgery or an eye lift, is a procedure that removes excess skin by removing and relocating soft tissue surrounding the eyes, including fat and even muscle, in order to improve the appearance or resolve health issues. This is a serious procedure that can involve major changes to the eye area, but recovering from the procedure is relatively easy and usually only takes one to two weeks.

Aesthetic Benefits of Blepharoplasty

Cosmetic blepharoplasty is most often thought of as an age-reversing and revitalizing procedure. This procedure reduces under eye bags, sagging upper lids, and puffiness surrounding the eyes. This opens up the appearance of the eyes and gives a more alert, awake, and youthful appearance. It can also sometimes remove wrinkles and creases resulting from bags, sagging, and puffiness, and can remove or minimize the appearance of dark circles under the eyes. However, blepharoplasty cannot remove crow’s feet or improve the appearance of dark circles that are due to thin skin or hyperpigmentation of the skin.

Cosmetic eyelid surgery can be performed alongside other procedures for a more comprehensive revitalization or to address aesthetic issues that blepharoplasty alone cannot resolve. Crow’s feet and other types of wrinkles can be addressed with lifts, such as face lifts and brow lifts, or injected dermal fillers, such as Botox. Skin resurfacing treatments, injected dermal fillers, and custom facial implants and reconstruction can be used to improve the appearance of dark circles due to hyperpigmentation and fill in shadowy hollows under the eyes.

Health Benefits of Blepharoplasty

People don’t typically think of plastic surgery as having health benefits, and blepharoplasty is typically performed for cosmetic reasons. However, blepharoplasty, like many plastic surgery procedures, has health benefits, as well. These benefits extend to both the mental and physical health of patients.

Patients seeking eyelid surgery for health reasons can also have the appearance of the eye area improved at the same time, and may be eligible to have insurance cover the cost of the procedure.

Mental Health Benefits

Many plastic surgeries can benefit patients’ mental health by improving their self-confidence, and eyelid surgery is no exception. Not all patients will see improved self-esteem from plastic surgery, but patients who are highly dissatisfied with a particular aspect of their appearance that can be addressed by the procedure and have realistic expectations can greatly benefit.

People with high self-esteem are less likely to experience mental health issues, such as eating disorders, anxiety, and depression, among others. They are also more likely to have socially healthy and fulfilling lives. They are able to foster healthier relationships, are more comfortable expressing themselves, and form healthy and realistic expectations for themselves and those around them.

Physical Health Benefits

The improvements to mental health can have implications for physical health, as well. Eating disorders take a toll on the body, weakening tissue and making the person more prone to illness. People with high self-esteem are also more likely to take care of themselves, such as by pursuing a healthy exercise routine and making other healthy choices.

However, these are not the only ways that blepharoplasty can improve the physical health of patients. Many people have excess sagging of the upper lid that leads to obstruction of the upper portion of their field of vision. This can be the result of aging, physical trauma, or illness. Eyelid surgery can help correct this vision obstruction by eliminating the excess skin and displaced tissue, clearing the field of vision.

Dr. William J. Binder

Dr. William J. Binder is an experienced plastic surgeon based out of Los Angeles and is considered one of the world’s best plastic surgeons. He is double board certified, extensively published (largely in peer reviewed publications), and has 10 patents on medical devices and pharmaceuticals.

Whatever your reason for choosing blepharoplasty, you deserve the best possible surgeon. Contact Dr. Binder’s office today to schedule your consultation with one of the best.

What Causes Skin Pigmentation to Change? Aging affects our minds and bodies in a myriad of ways; some of these changes are monumental, but others are literally skin-deep. Over the years, our skin pigmentation naturally changes. These shifts may be merely superficial and aesthetic, but other permutations can be indicative of deeper health problems. The more you understand your skin tone, the better equipped you’ll be to fend off Father Time.

Sun Sun exposure is the primary cause of pigmentation alteration. Unless you live underground, you can’t escape the rays of our closest star, nor would you want to. The sun provides us with much needed Vitamin D, which is absorbed through the skin and helps maintain the health of the skeletal system, various organs, and cell cycles. In small doses, the sun produces a gorgeous tan and cute freckles, but the long-term effects are less desirable. Sun exposure can cause the development of dark spots and keratosis, which can develop into skin cancer. A staggering 80% of instances of skin cancer appear on the face, head or neck; these are the exact areas that endure the most sun exposure. Skin cancer has serious implications for both your health and your appearance.

Skin Damage/Scar Tissue A skinned knee might be nothing to cry about, but repetitive and persistent skin damage can have a permanent effect on your overall pigmentation landscape. We all suffer the occasional scrape, cut, pimple, or abrasion; these are the marks of a life fully lived. How we treat these injuries, however, ripples across our complexion for years to come. Scar tissue causes a lack of pigmentation, so the treatment of a wound is vitally important to minimize the damage before it sets in. Disinfecting a cut prevents infection and further complications; antibacterial salve is the front-line soldier in your war against scar tissue and further skin damage.

Disorders In addition to sun exposure and skin damage, there are several disorders that can cause changes in the pigmentation of our skin, either permanently or temporarily. Some afflictions only affect your skin tone, but other changes in pigmentation are warning signs of a more insidious health issue. The skin is the largest organ in the human body; when it speaks, you should listen. Contact a doctor if you experience any unusual, unexpected, or unexplained changes in the pigmentation of your skin.

Melasma Pregnant women undergo massive hormonal changes that often manifest themselves in skin tone transformations. This “mask of pregnancy” is clinically known as Melasma, aka chloasma. It’s a hyperpigmentation of the skin characterized by the development of brown epidermal splotches, particularly in the facial area. For some women these spots fade after pregnancy, but for others, the change in pigmentation is permanent. Men can also experience Melasma, though it is much less common for men than women. The condition can be treated with prescription creams or cosmetic treatments. Sun exposure can exacerbate this condition, so those who experience it should exercise extra precaution to avoid overexposure to UV rays.

Addison’s Disease Addison’s disease, a disorder characterized by an underactive adrenal gland, is another (yet more rare) cause of hyperpigmentation. This disease is a serious health condition that can lead to impaired kidney function and dangerously low blood pressure. With proper treatment, however, most people with Addison’s disease are able to live a normal life. Addison’s disease affects only 1 in 100,000 people, but can strike at any age. One side effect of Addison’s disease is the development of dark splotches and freckles. These can appear anywhere on the body, including the gums, but are most common on places that get frequent sun exposure, like the face and hands.

Vitiligo Vitiligo is distinct from the aforementioned disorders in that it causes hypopigmentation, or the loss of pigmentation, rather than hyperpigmentation. Vitiligo is an autoimmune disease that causes white patches to appear across the body and/or face due to damage to the pigment-producing cells. Vitiligo cannot be cured, but the spots can be treated with laser treatments and corticosteroid creams.

Albinism Our skin, hair, and even eyes are given their signature tone from melanin, a pigmentation agent produced by most human bodies. In rare cases of albinism, however, those affected produce little to no melanin. This may give skin a pale hue and make skin even more sensitive to the harmful effects of sunlight than most people. Albinism can undergo a subtle shift during the teen years, when pigmentation sometimes increases, but other cases never result in the melanin production present in the average human body.

Just as some ailments can cause changes in the skin, so can some treatments, such as certain antibiotics, antiarrhythmics, and antimalarial drugs, which can all cause hyperpigmentation.

Correcting Pigmentation Changes Changes in skin color can be frustrating and visually unappealing, even if they aren’t associated with a larger issue. Fortunately, a cosmetic surgeon skilled in cosmetic skin treatments can help to minimize or even eliminate the appearance of discoloration.

Dr. William J. Binder is located in Los Angeles, but he is known the world over as one of the industry’s leading plastic surgeons. He has the skill and resources to not only evaluate and treat your pigmentation changes, but to make the process as easy and stress-free as possible. If you’re sick of living with skin discoloration, contact Dr. Binder’s office today to schedule a consultation.

It goes by many names: beauty mark, patch, spot, birthmark, etc. But for the sake of clarity, let’s call it what it is: a mole. It could be harmless or it could be the warning sign of something more serious. Do you have any suspicious moles that you’ve been secretly fretting about? Are you worried that your mole might be cancerous? Since most skin cancers start in irregular spots, it is important that you check your skin every few months. Ask your partner or physician to help you assess areas of the body that you can’t see yourself.

Know Your Stages 

Let’s start with the good news: the sooner you identify a cancerous mole, the better your chances are to avoid more serious health concerns down the road. For example, patients with a Stage One prognosis have higher odds of beating cancer than those with a Stage Four assessment. Before moving on, let’s define these terms. STAGE ZERO - This diagnosis means that there are no cancer cells detected yet, but the presence of abnormal pre-cancerous cells that must be monitored. STAGE ONE - The earliest stage of cancer growth, this phase is typified by the fact that the affected cells are all contained in one finite area of the body. STAGE TWO - This is when cancer has spread to adjoining regions of the inception point. STAGE THREE - As cancer spreads further, it could infect your lymph nodes or other sensitive tissue matter. STAGE FOUR - At this point, cancer has metastasized and branched out to various parts of the body, making its eradication more complicated.  But complicated doesn’t mean impossible, so let’s focus on the positive and work together to fight cancer before it spreads. Here’s how to determine whether or not your moles may be cancerous. Types of Moles and How They Look

• Normal mole—is a harmless spot that develops in childhood and later in life and can be found anywhere. Typically, normal moles are smaller than a pencil eraser and are round and symmetrical with smooth borders and an even color.
• Dysplastic nevus—is a type of mole that looks different from a common mole. It can have a mixture of several colors, from pink to dark brown, and is usually flat with a smooth, slightly scaly, or pebbly surface, with an irregular edge that may fade into the surrounding skin.
• Actinic keratosis—is a common precancerous growth often found on your scalp, face, hands, or forearms. They are a rough, flesh-toned pink or red patch that may be itchy or scaly. Actinic keratosis should be removed because five to 10 percent of them can become cancerous.
• Basal cell carcinoma—is caused by sun damage and typically found on the face. It normally appears as a pinkish or reddish patch that may bleed or scab. This type of cancer is easy to treat if caught early.
• Squamous cell carcinoma—this type of cancer often appears on the body, legs, or hands and is curable if caught early. It appears as a thick growth that can peel and bleed and may have an irregularly shaped border.
• Melanoma—this serious form of cancer can spread quickly, but is curable if caught early. Alert your doctor if you see a dark, irregularly shaped growth with an uneven reddish-brown, brown, or black coloring.

Since this last form of a mole is the most potentially hazardous, let’s take a closer look at its symptoms, features, and variations…

What is Melanoma?

Melanoma is a type of skin cancer that begins in melanocytes. It is potentially dangerous because it can invade nearby tissues and spread to other parts of the body, such as the lung, liver, bone, or brain. Since most melanocytes are in the skin, melanoma can occur on any skin surface. It can develop from a common mole or dysplastic nevus, and it can develop in an area of apparently normal skin. In addition, melanoma can also develop in the eye, the digestive tract, and other areas of the body. Often the first signs of melanoma are a change in the shape, color, size, or feel of an existing mole. Melanoma may also appear as a new colored area on the skin. The early features of melanoma are:

• Asymmetry—This is defined as a mole that is off-kilter. In other words, if the shape of one half does not match the other half, then it is asymmetrical.
• The border is irregular—If the edges of your mole are ragged, notched, or blurred in outline, then it qualifies as irregular. The pigment may spread into its surrounding skin in these cases.
• A color that is uneven—Shades of black, brown, and tan may be present in some cancerous moles. Areas of white, gray, red, pink, or blue may also be seen.
• Diameter—Be aware if there is a change in size, usually an increase. Melanomas can be tiny, but most are larger than ¼ inch wide.
• Evolving—If the mole has changed over the past few weeks or months, then be sure to contact your doctor as soon as possible.

Melanomas can vary greatly in how they look. While many will show all of the above features, some may only show one or two of the above features.

Screening and Prevention

The only way to diagnose melanoma is to remove tissue and check it for cancer cells. Your doctor will remove all or part of the skin that looks abnormal. Usually, this procedure only takes a few minutes and can be done in a doctor’s office, clinic, or hospital. The sample will be sent to a lab and a pathologist will look at the tissue under a microscope to check for melanoma. If you want to help prevent melanoma, then you need to be sun smart. Here are some tips on how you can be sun smart:

• Spend time in the shade between 11 am and 3 pm
• Wear a T-shirt, hat, and sunglasses
• Use sunscreen with at least SPF 15 (the higher the better), with good UVA protection (the more stars the better)
• Avoid sunbeds as they are not a safe alternative to tanning outdoors (the intensity of the UV rays can be 10-15 times higher than that of the midday sun)

You may be more at risk of developing skin cancer if you have:

• Fair skin
• Lots of moles and freckles
• Red or fair hair
• Had skin cancer before
• A family history of skin cancer

Early Detection Yields Healthy Results 

The stages outlined above give doctors and patients a roadmap of how to maneuver the detection and treatment of potentially cancerous moles. Case in point: one comprehensive study recorded the survival rates of approximately 60,000 patients recovering from melanoma diagnoses. This is what they found:

• People who identified their affliction during Stage One-A recorded a 97% rate of survival after the five-year mark. That same group boasted a 10-year survival rate of approximately 95%.
• The numbers dip slightly when we move on to Stage One-B. 92% of that subgroup survived the five-year benchmark while 86% went on to the 10-year milestone.
• Stage Two saw lower statistics. The five-year survival numbers for 2-A patients were about 81% and the 10-year rate was around 67%. Stage Two-B marked a 70% rate for the five-year study and 57% at the 10-year mark. 
• Patients in Stage Three saw even lower survival rates on average, although the numbers ticked up for those in Stage 3-A. That may be due to the fact that the initial tumor is smaller than in advanced Stage Two cases and therefore more treatable.
• If the melanoma advances to Stage Four, the five-year survival range drops to between 15 and 20 percent. The 10-year rate dips even lower to 10-15%.

Don’t be a statistic. Take control of your wellbeing, consult a trusted medical professional, and be on the lookout for suspicious growths.

Getting Your Moles Checked

If you are worried about any mole that you have, please don’t panic. Our skin is varied and complex; it evolves and changes in response to how we age and grow, and it also reacts to environmental conditions such as sun exposure. It may be nothing to worry about, but awareness is always encouraged. Regardless of your particular physiological situation, knowledge is the best medicine. If you have any questions or concerns, you should schedule an appointment with Dr. Binder. The most effective way to ensure that you don’t have skin cancer is to have your suspicious moles checked out and, if necessary, removed by a qualified doctor. As noted in the statistics above, moles that are diagnosed early can be treated for skin cancer. While the “Big C” is a scary notion to us all, we must work together to minimize its risks, maximize our awareness, and move forward to a healthier tomorrow.

Life goes on. It’s a common saying that’s often overused in times of strife or when accepting something outside of our control. However trite it may sound, it’s true when concerning the aging process, we can’t control it. However, that doesn’t mean it’s completely out of our hands. Or rather, in the hands of someone like Dr. Binder. Years and years of research and procedures have led to tremendous strides in technology along with higher quality results in the facial rejuvenation and cosmetic surgery industry. The multi-level approach to facial surgery is one that provides a personalized procedure to those with specific desires for particular areas of the face.

Facelift Surgery

As we all know, aging is a completely natural and inevitable process. The loss of both superficial and deeper adipose fat tissue is what causes the undesirable sagging of skin, development of deep wrinkles, and thinning of the lips. These results of the aging process can be accelerated by factors such as over-exposure to the sun or drug/alcohol use. Considering aging is so universal, it’s no wonder some people might be inclined to restore some of the elasticity and youthfulness to their face. This is the primary goal of a facelift procedure. Drooping jowls or eyebrows, bags under the eyes, wrinkles, or a sagging neck are all common areas patients have successfully improved with facelift surgery. Where old facelift procedures would “pull” the skin tight around the face in an effort to forcibly smooth out wrinkles, this grew ineffective and often resulted in an artificially sleek looking face. This is because of the now-outdated focus on only surface level skin. With newer technology and practices, contemporary facelifts focus on deeper tissues in the face and aim to achieve a longer-lasting and more natural result.

The Multi-Level Approach

The multi-level approach to a face-lifting surgery is a relatively recent approach to the cosmetic surgery industry. No single patient is the same and no single patient should be treated as such. That’s why Dr. Binder and his team adopted this highly-personalized method of surgery. Where one patient may desire a full-scale face and neck lift, another may only require a neck liposuction, double chin correction, or eyelid fat removal. This customizable technique of administering treatment is an ideal way to effectively deliver individualized results for everybody. The different facelift procedures are:

• Vertical Midface Lift - Lifts the deep fat tissues, primarily of the jowls, and aims to prevent the unnatural “mask-like” look.
• Under the Chin Neck Lift - The Bidirectional Neck Lift takes muscle from underneath the chin and repositions it upward, creating a better contoured muscular sling. Results are long-lasting.
• Submental Neck Lift - Reinforces the platysmal muscle that is responsible for bands over the front of the neck.
• Neck Lipo - This procedure is aimed at younger patients with an excess of fat around the neck and a substantial amount of skin elasticity.
• Subperiosteal Midface Lift - Designed for younger patients who desire elevated cheeks. Produces nearly-invisible scars just above the hairline.

When considering such a permanent change with a procedure such as a facelift, it is critical that your treatment and care are personalized specifically for your needs and your needs alone. Along with the state of the art advancements in the plastic surgery space, a multi-level approach ensures you achieve not only facial rejuvenation, but the facial rejuvenation that is right for you. Find out more about Dr. Binder’s cutting-edge procedures and quality care by contacting us today.

Rhinoplasty, sometimes called a “nose job” or “nose reshaping” by patients, is a surgical procedure that reshapes or resizes the nose for health or cosmetic reasons. Due to its status as a well researched, regulated, and safe procedure, it is the third most common plastic surgery procedure in the United States.  According to data collected by the American Society of Plastic Surgeons (ASPS) there were 217,979 rhinoplasty surgeries performed in 2015, accounting for about 13 percent of the year’s plastic surgery procedures.  Both revision rhinoplasty surgery and the initial rhinoplasty procedure can be used to resolve health problems, such as correcting impaired breathing caused by the structure of the nose. Rhinoplasty is also used to resolve aesthetic problems by enhancing the harmony of the face’s lines and balancing the proportions of the nose. Rhinoplasty can create dramatic improvements to:

• Nose size and proportion in relation to facial harmony
• Nose width at the bridge, or a profile with visible bumps on the bridge
• The size, shape, and position of the nostrils
• A nasal tip that is bulbous, drooping, upturned, or hooked
• Nasal asymmetry (an imbalance between the left and right hemispheres of the nose)

There are two major rhinoplasty techniques, open rhinoplasty and closed rhinoplasty. Let’s take a closer look at each procedure now… 

About Open Rhinoplasty 

Open rhinoplasty is performed after an incision is made in the columella (the delicate tissue that separates the nostrils). This allows the surgeon greater access to the tissue throughout the nose. Because it allows increased visibility of the nasal tissue during the operation, an open rhinoplasty is easier for the surgeon to perform. Another advantage to having an open rhinoplasty is that it can also allow for more dramatic revision of the shape and proportion of the nose.  The open technique does sometimes lead to more noticeable scarring than the closed rhinoplasty technique.  Recovery after rhinoplasty using the open technique can also be more unpredictable and prone to complications than closed rhinoplasty recovery. On the other hand, open rhinoplasty can actually be less traumatic to the nose because the technique gives the surgeon more room to work and requires less modification to other internal nasal structures.

About Closed Rhinoplasty

Closed rhinoplasty involves performing the surgery entirely inside the nose without interfering with the columella. An internal procedure prevents visible scars from showing, so it is more favorable to patients seeking a more subtle transformation with less intrusive techniques. The closed rhinoplasty technique does require a facial surgeon with more experience and precision than its counterpart, the open rhinoplasty. Although the closed rhinoplasty technique does result in minimal scarring, which is inside the nose and therefore not visible, it is also limited in the scope of the revisions it can make to the nose. Closed rhinoplasty recovery time can be easier and more predictable than recovery following rhinoplasty performed with the open technique, but it can also be more traumatic if a surgeon is indelicate or tries to make revisions that are too significant.

A Brief History of Rhinoplasty

Cosmetic surgery procedures of today are so medically advanced that they bear little to no resemblance to the techniques that gave birth to the field of rhinoplasty. Believe it or not, the first nose job was performed over 2,500 years ago on the subcontinent of India. It was achieved by removing a portion of flesh from the patient’s face and using this biomaterial to form a new nose. About 20 centuries later, Europeans tried their hand at reimagining the human nose. Rampant warfare had left soldiers disfigured by the thousands, so medical experts of the time decided to engineer a prototypical grafting technique. It required the patient to keep his or her face pressed up against the upper region of the arm, allowing the skin around the new facial feature to re-grow. This process took a staggering three weeks of time, demanding an unimaginable level of stasis and contortion on the part of the recipient. After this initial phase of grafting, another two weeks was necessary to heal and reshape the flap of skin that was the patient’s de facto new nose. These early examples would be considered the ultimate in “open rhinoplasty” since they greatly altered the skin around the nose (and elsewhere on the body) to create drastically new facial protrusions for these rudimentary test cases. Luckily, technology and health sciences have made quantum leaps in the years since those dark old days. Instead of looking outward for tissue to replace the nose, skilled surgeons can utilize the flesh within it to craft a whole new look via closed rhinoplasty methods. Hence, you now have the benefit of extensive research, experience, and options as you approach the myriad possibilities for your impending rhinoplasty procedure.

Is Open or Closed Rhinoplasty Best for Me?

Each rhinoplasty candidate is unique, so it is impossible to generalize and make a categorical statement about which rhinoplasty technique is better for all or even most patients. Health is never a “one size fits all” endeavor, so you should consult with a trusted physician before taking any definitive action. Generally speaking, closed rhinoplasty is typically preferred because of the easier recovery process and the minimal, hidden scars, but there are numerous situations in which an open technique may be better for the patient. Because it allows for more significant nasal revisions, open rhinoplasty may be preferable for candidates who are seeking a dramatic change, or who need dramatic reconstruction. A skilled plastic surgeon will still be able to minimize scar tissue and the appearance of scars following an open rhinoplasty.  A patient who is only seeking a slight revision, or revisions that are concentrated on the bridge of the nose, and little to revisions desired for the tip of the nose, may be recommended to undergo the more subtle changes of a closed rhinoplasty operation.

Recovery and Results: A Case Study

As mentioned above, open rhinoplasty techniques allow for greater flexibility when it comes to more dramatic alterations of the patient’s chief facial feature. This includes the passage to the tip of the nose from within since the surgeon has full access via the osseocartilaginous vault. But if you’re hesitant to consider this procedure due to its invasive nature, please consider this recent case study: 98 patients underwent open rhinoplasty procedures in a given time period. Of those 98 subjects, only two required revision rhinoplasties, indicating that the open method allowed the surgeon to successfully operate without the hindrance of a closed approach. And in terms of scarring, the incision mark along the columella was virtually invisible on all of the patients involved in the study within weeks of the date of their respective procedures.

Is Rhinoplasty Right For You?

Regardless of which method of rhinoplasty (open vs. closed) you desire, you should be confident in your candidacy for the procedure before moving forward. As always, having a frank conversation with your doctor is the ideal first step in making this determination, but here’s a quick checklist to jump-start that talk… You are a potentially good candidate for rhinoplasty:

• If you are of a mature enough age so that your facial growth is complete
• If you are in good overall health – while cosmetic surgery is safe on the whole, it does require a certain level of stamina to assure a speedy recovery
• If you are a non-smoker (tobacco use is detrimental to your health in a plethora of ways, damaging your skin, lungs, and thus increasing your recovery time)
• And if you have a positive, realistic outlook and goals for what you expect in the improvement of your appearance

Choosing the Right Plastic Surgeon for Your Rhinoplasty

Now that you have considered whether or not rhinoplasty is right for you, let’s ask an even more important question: who is the right doctor for your specific needs? Your facial surgeon must exude a trustworthiness so that you can ask him or her anything that’s on your mind before you set foot in the exam room. This individual can help you determine which technique is best for your rhinoplasty procedure during your initial consultation. It’s important to clearly communicate your expectations for the results of your rhinoplasty surgery and share your complete health history, including dental history, with your plastic surgeon, so that they can choose the best technique for your health and goals. It is therefore essential that you choose the right plastic surgeon for your rhinoplasty procedure in particular so that you can be confident in your results. A plastic surgeon who is skilled and experienced, especially in rhinoplasty, is the difference between glamorous plastic surgery results and a tragic plastic surgery horror story. If possible, patients should seek out a plastic surgeon who specializes in facial plastic surgeries like rhinoplasty.

Dr. William J. Binder

Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery. He is double board certified and has 10 U.S. and global patents on medical and surgical devices and pharmaceuticals and is extensively published across various medical journals. If you want your rhinoplasty, whether open or closed, performed by one of the world’s leading facial plastic surgeons, contact Dr. Binder’s office today to schedule your consultation.

Many things cause our skin to age. Some things we can’t do anything about, like the natural aging process, but others we can influence. Our environment and lifestyle choices can cause our skin to age prematurely. By taking some preventive actions, we can slow the effects that this type of aging has on our skin. Here’s a look at the main culprits behind premature facial aging and how you can take preventive measures against them.

What Causes Skin to Age Prematurely?

Some of the main causes of premature aging to our skin include: Sun—sun exposure causes the appearance of age spots, wrinkles, sagging skin, and reduces skin elasticity. Roughly 70% of the skin aging process depends on the amount of sunlight our skin is exposed to throughout our life. Prevention—you can always protect your skin by seeking shade, covering up with clothing, and using sunscreen that is broad-spectrum, SPF 30 (or higher), and water-resistant. You should apply sunscreen every day to all skin that is not covered by clothing. Smoking—smoking causes premature fine lines that typically appear on places where the skin is very thin, such as the sides of the eyes (smile lines) and above the upper lip. These typical smoking lines may appear 10-15 years before they appear on non-smokers. The reason for the premature wrinkles among smokers lies in the reduction of Vitamin C levels in their blood, which is 60% lower on average compared to the blood of non-smokers. Prevention—Stop smoking. Diet—a diet rich in simple sugars and sweets causes the connective tissue of the skin to become rigid and lose its elasticity. Prevention—east a healthy, well-balance diet. Eating plenty of fruits and vegetables may help prevent damage that leads to premature skin aging. Soluble dietary antioxidants such as lycopene, lutein, beta-carotene, and other antioxidants found in fruits and vegetables reach the deeper skin layers (the dermis) and partially neutralize the oxidative damage associated with prolonged exposure to the sun. Also, fruits and vegetables rich in vitamin C are essential to the proper production of collagen. Complete protein is important to the production of protein structures that are vital to the appearance of fresh skin, such as hyaluronic acid, collagen, and elastin fibres. Stress—prolonged emotional stress causes increased secretion of stress hormones such as cortisol and adrenaline. These stress hormones accelerate various aging processes that include suppression of normal synthesis of connective tissue, characteristic obesity of the face, along with osteoporotic processes that damage bone density and cause changes in bone structure. Prevention—grab a weekly massage and practice calm forms of exercise like yoga. Meditation can also help improve your overall stress level, which can make you feel more focused and younger. If your stress is the result of a more serious mental disorder such as depression or chronic anxiety, you should visit your doctor to discuss mental health options such as therapy and/or medications. Attitude—intensive use of facial muscles brings exaggerated expression lines on the face that cause us to look older than we are. Beyond wrinkles, repeated use of expression muscles causes their dominance under the skin and damages the relaxed and smooth appearance which is typical to a young looking face. Prevention—a happier face is devoid of wrinkled eyebrows and scowl marks because the muscles have spent more time in a relaxed state. Lack of sleep—prolonged lack of sleep is clearly evident on the face and accelerates aging, as well as causes many other pathological processes. Prevention—continuous night sleep is actually one of the few times in the day in which the pituitary gland in the brain secretes growth hormone in adults. This hormone has a great importance in keeping various body tissues and their renewal, including the skin tissue. Alcohol—alcohol causes damage to the skin texture and color, and has considerable influence on the eye sockets. Drinking excessive amounts of alcohol causes bulged eyes and affects the skin due to the accumulation of toxic breakdown products in the deeper skin layers. This can cause the appearance of capillaries and redness of the cheeks on the nasal bridge. Prevention—drink less alcohol. Rubbing your eyes—the skin around the eyes is extremely delicate and fragile, and can wrinkle very easily. Prevention—don’t scrub the area with towels harshly, and stick to dabbing it dry after washing the face. This will help prevent pigment problems and premature aging. Sleeping on your side—the fetal position of sleeping and snoozing on your stomach often means your face is pressed into a pillow for eight hours a night, which can cause the breakdown of skin tissue and cause wrinkles. Prevention—get into the habit of falling asleep on your back and flip over if you wake up on your stomach or side. This decreases swelling or bloating of the face that stretches skin over time. Sipping out of a straw—sipping out of a straw causes fine lines around your mouth, which is a clear indication of premature aging. Prevention—avoid drinking through a straw and pour out your beverages in glasses or cups to maintain a youthful, wrinkle-free mouth.

Contact Dr. Binder

If you find that you have signs of premature facial aging, but you think that it’s too late for you to take preventive measures, then you should contact Dr. Binder to discuss the options that are available to you for getting back youthful looking skin.