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Botox Migraine Treatment is becoming an increasingly effective means of battling powerful migraines. However, as it is still a relatively new treatment – it was only approved for use with migraines by the Food and Drug Administration as recently as 2010 – some insurance companies might balk at the idea. So how does one go about getting insurance to cover it?

WHAT IS BOTOX?

Let’s start with what Botox is. It’s a neurotoxin that’s created using the bacterial compound onabotulinumtoxinA and, in medical circles, is intended to treat muscular disorders. In cosmetic circles, it’s known to eliminate wrinkles by temporarily paralyzing facial muscles.

HOW DOES BOTOX AFFECT MIGRAINES?

When it comes to migraines, Botox is used in small but deeply concentrated quantities to stop brain signals reaching certain muscles. Typically, if left alone, those signals contract the muscles resulting in pain. With Botox, however, those muscles become relaxed and thus lessen the physical effects of the stress and tension associated with a migraine. This ultimately means that a migraine might be totally avoided (with no stress and tension to trigger it) – and it also means that by blocking nerve and muscle activity, Botox blocks the pain signals. Botox therapy for migraines is not effective on every type of migraine; thus a patient’s eligibility for it is dependent on what they’re suffering from. According to the American Migraine Foundation, it works best on those experiencing chronic migraine. A chronic migraine is defined as more than 15 headache days per month as well as a minimum of eight migraine episodes – or if you suffer headaches that last a minimum of four hours.

THE THERAPY

With most migraine therapies, patients are required to administer medication once a headache has begun. Botox, though, is taken as a preventative measure. A person would get a set of 31 injections every 12 weeks with each session lasting around 15 minutes. Patients do not need to be sedated and can drive home after. The botox is administered via injection.  Using a small needle, the doctor will inject into seven areas of both the head and neck including the nose bridge, the forehead, temples, and back of the skull. It is a relatively painless procedure; the patient only experiences tiny pricks. It generally takes at least two sessions to begin to experience the benefit but some patients feel it sooner. The results last from four to six months. While it is an effective relief, it is not permanent - but some chronic sufferers can expect their headache days to be cut in half. Ultimately, botox treatment is just that; a treatment, not a cure. The side effects can include stiff and sore neck muscles and some bruising or swelling around the injection sites. This usually only lasts for 48 hours. Other side effects may include dry eyes and skin rash – symptoms that mimic influenza. There are also nausea and headaches reported but nothing like the sort that is associated with migraines.

COST

The price of Botox migraine treatments can range from $200 to $500 per session. That can add up to serious money for the two to three courses a patient would require.  One option is the Botox Savings Program that allows eligible patients to save on costs – sometimes up to $1200 a year. The other, of course, is insurance.

INSURANCE

So how do you get insurance to cover Botox migraine treatment? In the past insurance companies saw anything Botox-related as cosmetic. There are some horror stories where patients were required by their insurance to try drugs that didn’t work. But times are changing and often, they will require evidence that other treatments have failed and this is more of a last-resort option. Since the FDA now approves the treatment, insurance companies can no longer claim the procedure is merely investigational. And after all, migraines cost employers almost $13 billion every year – so it is definitely a huge health concern. First, contact your insurance company provider to see what they cover. Some insurers work with your doctor and have you take several tests before they go ahead and authorize the treatment. This is known as prior authorization. The doctor will put together a report including your history of chronic migraines and submit this to them. You can assist your doctor with this report by providing additional information such as medications and treatments you’ve tried in the past and a detailed calendar of the frequency/intensity of your migraines.

FOUR BRIEF TIPS

Connect with your doctor’s nurse as your advocate. Retrieve a recent copy of your insurance company’s formulary. Compare policy coverage of the botox migraine treatment. Talk directly to someone at your insurance provider. You can also still use the Botox Savings Program in addition to insurance for a one-two punch at the costs. Either way, you should definitely get insurance before beginning what could be a costly but beneficial program.

A dangerous new fad is simmering in some less reputable circles of the cosmetic medical trade. Fast plastic surgery or “lunchtime” procedures (so named because they purport to be done on your lunch hour) are suddenly all the rage… but at what cost? We’re breaking down the myths behind this too good to be true trend.

Myth #1 - You Heal as Quickly as the Procedure

While it may sound convenient and desirable to get a quick filler for your upper lip, the results (and resulting problems) are another reality completely. In one patient’s case, the material they used was hastily chosen and all wrong for her face. The swelling didn’t go away, even a week later… then she was told to wait six months… then five years passed and she is still dissatisfied with the bump in her lip. Choosing your filler is a delicate and exacting process. By rushing into a procedure, you risk complications, pain, or worse. That’s why a reputable and trusted physician will weigh your options with you well before you plump those lips.

Myth #2 - Fast Equals Cheap

The notion that you can pop in for a quickie facelift and only pay by the hour is foolhardy on so many levels. First, you should never rush when it comes to your health. And second, true health care providers shouldn’t punch a clock and charge by the minute.  Finally, just because it’s fast, that doesn’t mean it’s cheap. A so-called “lunchtime” facial procedure can still cost upwards of two thousand dollars, and since it’s performed so hastily, it will most definitely require follow up visits and special attention in the long run.

Myth #3 - I’ll Just Do It This One Time…

While Botox has been proven to be safe and effective if administered responsibly, there is a new theory that excessive and repeated sessions could do more harm than good. The rise of “fast” plastic surgery is now dovetailing with the preponderance of addictive behavior among patients who schedule multiple Botox sessions in quick succession. An estimated 40% of these lunchtime procedure enthusiasts are undergoing injections too frequently, according to health experts.

Myth #4 - It’s as Effective as the Real Thing

A procedure as delicate and involved as a breast augmentation requires extensive consultation and consideration. However, some disreputable surgeons are promoting their hasty methods for the lunchtime crowd these days. It is inconceivable to think that you could recover from such an invasive process in less than two hours. Also, the actual technique required for a successful breast surgery doesn’t work in a truncated time frame. When done in a rush, surgeons can only apply the implant to the front of the breast, on top of your existing muscle. This won’t sit correctly, causing unsightly wrinkles and puckering where the implant meets your tissue.  To be done properly, an implant must go beneath the muscle, which requires more time on the operating table. The experience may take longer, but the results are preferable in every way. In addition to the aforementioned aesthetics of a thorough intramuscular technique, the implant is also more protected when it is tucked within your existing tissue.

Myth #5 - Plastic Surgery Has Become Completely Standardized

While it’s true that medical science has progressed rapidly over the past two centuries, that doesn’t mean that it is now a “one size fits all” endeavor. Your body, face, and general physiology are unique. You have individual needs and specialized goals for who you are and how you want to look. If a doctor tells you that cosmetic surgery has become “standardized” or in some way uniform, then you need to visit another doctor. For a consultation as special as you are, schedule an appointment with Dr. Binder. He is ready to listen to your questions, and he’ll take the time to explain his answers… even if that lasts more than just a lunch hour.

  Ever since its FDA approval back in 2002, Botox has been the go-to injection for people looking to unfurl their wrinkles and eradicate their crow’s feet. But its effectiveness goes beyond the brow; Allergan (the pharmaceutical company that holds the patent on Botox) sees hundreds of potential uses for the wonder drug.

ADDITIONAL COSMETIC APPLICATIONS

Botox immobilizes certain muscles that lead to age lines in the brow, but this functionality can also help reverse several other facial abnormalities.

•    Cleft Lips – Over 4,000 babies are born with cleft palates and/or lips annually. By introducing Botox to the affected area, doctors can alleviate the scarring process by allowing the afflicted muscles to heal.
•    Facial Tics – Similarly, a small dose of Botox can reduce the facial spasms that lead to nervous ticks, delivering relief to its recipient.
•    Crossed Eyes – The FDA has also approved Botox to help the approximately 4% of Americans who suffer from a condition called Strabismus or crossed eyes. The injection helps relax the surrounding tissue so the eyes can properly line up without stressing the muscles.
•    Jaw and Lip Musculature – A strong jaw can have its benefits, but it may result in a silhouette that looks bulky and misshapen. By injecting these muscles with Botox, you can relax the face and slim down the profile. Also, injections into a “short lip” can help relax it and cover up what is perceived to be a “gummy smile”.

NO PAIN, YOUR GAIN

If you are experiencing chronic pain, be sure to consult a medical professional right away. You may be surprised at his/her diagnosis: Botox. This serum was discovered to be an effective treatment for migraine headaches all the way back in 1992 by a pioneer named Dr. William Binder. It took the FDA almost two decades to catch up, but they finally approved the use of Botox to alleviate migraines in 2010. The procedure involves approximately 30 injections around the head and neck and its benefits last for up to three months. But headaches aren’t the only pains that can be treated with Botox. Lower back spasms may be reduced with these injections, as can mogigraphia, commonly known as writer’s cramp. The repetitive use of the hand and forearm creates tension in the muscles, but Botox can relax this region and bring relief to the suffering scribe. Botox is also useful to patients suffering from coldness or tremors in their extremities. Patients could use the injections to counteract their painful esophagus spasms during the process of digestion.

PROFUSE SWEATING

One unexpected by-product of Botox injections is the reduction in perspiration. When doctors began noticing this trend, they started treating patients with severe primary axillary hyperhidrosis, aka profuse underarm sweat, with the aforementioned serum.

BLADDER CONTROL

For people suffering from OAB (overactive bladder), Botox presents a source of relief. A series of targeted injections can relax the spasms of the bladder, providing a treatment for incontinence, especially in patients recovering from spinal cord damage.

PARKINSON’S AND A.L.S.

Neurodegenerative disorders such as Parkinson’s disease and Amyotrophic Lateral Sclerosis (A.L.S., also commonly referred to as Lou Gehrig’s disease) sometimes trigger excessive drooling by those afflicted. Botox can help curb the salivation process and help restore the patient’s facial control temporarily.

ANAL FISSURES

When the human sphincter spasms excessively, it can overexert the tissue of the rectum. This often leads to anal fissures: painful tearing of the internal rectal walls. Traditional treatment of anal fissures involves nitroglycerin ointment or surgery, but Botox presents a less invasive (and often more effective) third option. By relaxing the sphincter, the fissures are allowed to heal organically.

HEART RATE

One possible future application of Botox injections could be seen in the realm of heart surgery outpatient programs. After enduring an open-heart procedure, some patients suffer from atrial fibrillation or an abnormal heartbeat. Botox could help regulate these palpitations when the heart is at its most vulnerable, giving the subject a much-needed boost on the road to recovery.

SEXUAL DYSFUNCTION

Another experimental use of Botox involves the treatment of premature ejaculation. By injecting the penis, the surrounding tissue relaxes and delays the subject’s urge to climax. The same material could also aid in female patients who suffer from pain during intercourse. Botox can reduce the spasms in a woman’s pelvic floor, which can lead to discomfort when overactive and/or pronounced.

EMOTIONAL BENEFITS

There is a burgeoning theory in some medical circles called the facial feedback hypothesis. This is the idea that Botox can make a patient look happier, which in turn can actually make them feel happier. It’s impossible to accurately quantify joy or sadness, but we have been trying for millennia. That’s why such clichés as “mind over matter” and “put on a happy face” have endured for so long. Perhaps there is some validity to the psychological benefits of using Botox to battle depression, but the statistical data is still inconclusive. For more information on the benefits of Botox, consult a true maverick in the field: Dr. William Binder. His friendly and helpful staff can schedule a consultation to discuss your specific needs and guide you forward in your quest for a healthier, happier you.

Even though the number of plastic surgery operations in America and worldwide has increased every year for the last two decades, there is still a popular misconception that many people have of facial cosmetic procedures as something strictly reserved for those over the age of fifty years old. This is obviously a myth, and as plastic surgery becomes more normal than not, a more realistic view and understanding of facial plastic surgery will emerge. In the meantime, here are some statistics to get a better idea of who is getting facial plastic surgery and why. According to statistics published by the American Society for Aesthetic Plastic Surgery, patients in the age range of thirty-five to fifty years old have received the most plastic surgery procedures since 1997, making up a plurality of 43% of the total number of surgical procedures performed. Of course, there are plenty of patients older and younger than that age range who are receiving plastic surgery as well, and altogether they comprise a greater number of procedures, but no comparable age range has more plastic surgery operations than those aged thirty-five to fifty years old. And in just three years from 2014 to 2017, the average age of women getting plastic surgery has dropped three years, from forty-two three years ago, to an average age of thirty-nine today. The average age of men dropped two years over the same time period, from forty-seven to forty-five. In the much younger thirteen to nineteen-year-old age group, there were 229,000 total cosmetic operations performed on thirteen to nineteen-year-olds in 2016. 66,000 of those procedures were surgical in nature and 163,000 were minimally invasive cosmetic procedures. Of those aged twenty to twenty-nine years old, there were 829,000 total cosmetic procedures performed in 2016, with 256,000 of those being surgical in nature and 572,000 were minimally invasive. According to the New York / New Jersey area Associates in Plastic Surgery group, the most common facial plastic surgery procedure for the thirteen to nineteen-year-old age group is a rhinoplasty operation or “nose job.” They say: “Puberty brings changes to the body, and the nose is no different. Significant changes can occur, but by the age of 16, the nose you have will typically be the nose you will grow old with. As you age, other body parts grow and take on new shapes, but the structure of your nose will change the least over time, meaning the defining features will remain the same throughout your life. Teens and young adults often turn to rhinoplasty as they are entering new phases, such as high school graduation. The late teens are the best time to perform this procedure.” A rhinoplasty might be desirable by a patient of any age after puberty since rejuvenation is not the goal of rhinoplasty surgery – the goal is achieving a more aesthetic look by enhancing the harmony of the face’s lines and balancing the proportions of the nose. Rhinoplasty can achieve 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

In addition to aesthetic motivations that may lead a patient to desire a cosmetic nose job, rhinoplasty can also solve medical problems such as difficulty breathing due to the shape and structure of the nose, and a nasal structure that impairs breathing is not an age-related issue. There are other non-age-related medical issues that can be helped with cosmetic facial surgery. Cosmetic facial reconstructive surgery is a welcome remedy for people who suffer a severe disfigurement or scarring from accidents, or even the ravages of infectious diseases, cancer, or other medical conditions. Mole removal is also a cosmetic facial procedure that has nothing to do with rejuvenation, and everything to do with better skin health and a patient’s personal aesthetic preferences for how they look.

The Rise in Teenage Cosmetic Surgery

With the advent of social media, young people are more conscious than ever of how they look. With every tweet, share, and like, teenagers are comparing their features with influencers, celebrities, and classmates. While we must maintain a realistic and healthy outlook for our friends in Generation Z, it is inevitable for them to be curious about their options in the realm of cosmetic procedures. In the year 2017, approximately 230,000 patients from the age of 13 to 19 received such procedures. This accounts for roughly four percent of the total number of people who explored the world of cosmetic reconstruction. On top of these surgical procedures, teens racked up another 160,000 non-invasive touch-ups, chief among them being Botox visits and laser hair removal appointments. With the influx of new patients comes an increased sense of caution. Teens must be well counseled before embarking upon any sort of cosmetic procedure to make sure they are doing so for the right reasons. In addition to the aforementioned guideline of 16 being the recommended minimum age for rhinoplasty, experts have agreed upon the following

• Breast augmentations or reductions: 18 years and older 
• Liposuction procedures: 18 years and older 
• Otoplasty (ear alteration surgery): 5-7 years old
• Retin A: 16-18 years of age 
• Lasers for acne scar removal: 16-18 years old
• Other laser procedures: 18 years and older 
• Chemical peels: 18 years + 
• Botox and other filler injections: 18 years and older

The Benefits of Cosmetic Procedures for All Ages

While the age restrictions above are vitally important to consider, there are also a myriad of benefits that facial procedures can elicit. According to a recent study of approximately 550 patients, the majority of those who underwent their desired cosmetic alteration reported blockbuster results. Self-esteem skyrocketed in this sample group, as did feelings of joy and general satisfaction in life. As anyone who has endured adolescence can attest, it is a volatile period, characterized by self-doubt and insecurity. While teenagers shouldn’t rush into cosmetic procedures to counteract these forces, it can’t be overstated that looking good often leads to feeling good. Consult a trusted physician and don’t be afraid to discuss any and all psychological stresses and emotional issues you may be feeling. We can all work together to make sure that you grow up to be the best you possible. About Dr. William J. Binder Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery. For almost three decades, his individualized philosophy and approach to facial plastic surgery has led him to pioneer new techniques for facial surgery procedures and earned him international acclaim for his results. If you want your facial plastic surgery performed by one of the world’s leading cosmetic surgeons, contact Dr. Binder’s office today to schedule an initial consultation.

A facelift, or rhytidectomy, is a facial rejuvenation surgery performed by a licensed cosmetic surgeon in order to restore a youthful appearance to your facial features. The facelift procedure as a cosmetic facial rejuvenation surgery turned exactly 100 years old in 2016. The very first face lift operation was performed by a German physician named Erich Lexer in 1916. According to Dr. Rajiv Grover, the president of the British Association of Aesthetic Plastic Surgeons, Lexer performed the first ever facelift by, “Lifting the [sagging] skin from the underlying fat, drawing it back, re-draping it and then removing the excess.” Many other surgeons throughout the world began to perform the procedure after Lexer, but with no major innovations or improvements on the surgical technique until the 1960s and 1970s. The first 70 years of facelifts in cosmetic surgery are now referred to as the Cutaneous Period of rhytidectomy (facelift) surgery. During this time facelifts were performed at the most surface level of the skin by lifting the skin from the face, pulling it taut, and cutting away the excess loose skin. Surgeons became experts at performing plastic surgery during World War II in order to reconstruct the faces of injured war veterans, and these skilled plastic surgeons began turning their talents toward cosmetic facial rejuvenation in the 1950s and 1960s. In the 1970s facial rejuvenation entered the SMAS period, which is short for Superficial Muscular Aponuerotic System— the stronger, deeper layer under the surface of the skin. Improvements in the safety and effectiveness of anesthesia and more precise surgical techniques allowed plastic surgeons to achieve more dramatic, natural looking, and longer lasting results by augmenting this muscle layer under the skin. The first major innovation in facial rejuvenation surgery since its inception, the SMAS technique became the standard for facelifts throughout the 1970s. It allowed cosmetic surgeons to take a more extensive, radical approach to facial rejuvenation, enhancing more of the face and even the neck as well. By the 1980s facial rejuvenation had entered the Deep Plane Period as plastic surgeons could skillfully and safely cut deeper into the face, down to the subperiosteal layer over the bone. Dr. Paul Tessier, the surgeon who had coined the term Superficial Musculoaponeurotic System, pioneered this deep plane facial rejuvenation technique. In 1979 Tessier demonstrated that cutting to the subperiosteum above and to the sides of the orbital rim of bone around the eyes created a better looking result for the eyebrows than facelifts performed at the SMAS layer. This innovative approach could create a far more attractive and youthful appearance for cosmetic surgery patients. From 1991 to the present, the history of facial rejuvenation has entered into what cosmetic surgeons call the Volumetric Period of rhytidectomy surgery. This period was characterized, in the early 1990s by a reconceptualization of the aims and means of facial rejuvenation surgery. Plastic surgeons, starting in the 1990s, began to take more care reduce the appearance of scars from facial plastic surgery, and also began to focus on restoring the subcutaneous volume of fatty tissue under the skin that is naturally lost as we begin to age. Another major innovation in the volumetric approach to facial rejuvenation was the introduction of facial implants to contour the face. The rapid advancement during this time of computer processing power and 3-D imaging techniques, along with computer aided drafting for perfectly fabricating custom facial implants, allowed this innovation to reach a very high standard of perfection in creating an ideal, natural looking result for patients seeking facial rejuvenation. Dr. William J. Binder was an early innovator in the field of custom facial implants for cosmetic rejuvenation. When the technique first appeared, Dr. Binder saw the potential for aesthetic results for patients through the use of facial implants, but with a keen eye for facial anatomy, he noticed the results did not look completely natural; they were “non-anatomic” as he would say. Dr. Binder did not believe facial implants could achieve the high standards of perfection he aims to achieve for his patients without applying the precision and power of high-resolution 3-D imaging, powerful digital rendering and imaging, and digital computer-aided drafting to fabricate ideal custom facial implants for patients seeking facial reconstruction or rejuvenation. By innovating a system capable of fabricating custom-designed facial implants to a high degree of precision, Dr. Binder was able to pioneer a technique that allows the reconstruction of most facial contour defects with a higher degree of accuracy and better results than were ever before possible. His efforts have helped to bring modern plastic surgery into the 21st Century.   About Dr. William J. Binder Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery. For almost three decades, his individualized philosophy and approach to facial plastic surgery has led him to pioneer new techniques for face lift procedures and earned him international acclaim for his results. If you want your face lift performed by one of the world’s leading facial plastic surgeons, contact Dr. Binder’s office today to schedule an initial consultation.

For something as important and personal as the appearance of one’s face – arguably the most memorable and distinct feature that each one of us has – there are many people who would like to improve some aspect of their facial appearance, knowing they would like the way their face looks better if they could improve or enhance one or more of its features. Many others are happy with their facial structure and features but would like to rejuvenate their facial appearance to look more like they did when they were a little younger. For some, the desire stems from an insecurity about their looks that a facial cosmetic procedure can correct, giving them a valuable boost of confidence and self-esteem. For others, the motivation is simply a desire to look their best. Whatever the reasons for seeking plastic surgery, one relevant factor in a patient’s decision to undergo a facial plastic surgery procedure is the cost involved, and in the beginning stages of researching the pros and cons of plastic surgery, potential patients want to get an idea of the price of a facial plastic surgery procedure. You may have found that it’s difficult to get an accurate assessment of the cost without an in-person examination of your face and medical history by a cosmetic surgeon, and an in-depth consultation about your specific goals and desired outcomes for undergoing facial plastic surgery. Because your face is as unique as your fingerprint, and because the facial enhancements ought to vary by patient, cosmetic surgery to alter facial features is an individualized plan and operation for every patient based on their face and their aesthetic desires. No two facelifts are the same, each rhinoplasty will be different for each patient, and each eyelid or earlobe procedure is unique. Facial surgery to correct a medical problem (such as rhinoplasty to improve breathing) may be covered by some insurance policies. There are also multiple procedures to achieve the same result and multiple surgical methods for performing the same procedure:

• Each with their own pros and cons,
• Each more or less invasive and prone to complications for a given patient,
• Each with different requirements for anesthesia,
• Each with their own typical recovery times,
• And each with varying limits on the extent of the results that can be achieved.

All of these different factors and the surgical plan you and your doctor choose will determine how much a facial plastic surgery operation will cost for each different patient. In helping patients to come to a decision about their plastic surgery, a modern, professional cosmetic surgeon will help the patient assess how each separate aesthetic feature of their face contributes to their overall facial appearance. The surgeon will also help determine what enhancements to the brows and eyelids, nose, cheeks or mid-face, lower face and chin, neck and/or the composition of the facial skin, fat, and muscle will achieve the most aesthetic overall result in line with the patient’s goals. Subsequently, the cosmetic surgeon and patient will develop an individualized surgical plan that addresses the patient’s concerns and desires. Therefore the price of the operation will depend on what each person needs and the amount of time it will take the surgeon to perform the operation. For something that will affect your life as much as facial plastic surgery, it is important to take your time researching plastic surgeons, reviewing their credentials and experience, reading over their websites, viewing before and after photos, and calling to ask any questions you have after researching online.

The High Cost of Impatience

As the old saying goes, haste makes waste - and it can also be costly. When patients require a second or even third visit to the surgeon, each of these revisions could cost as much as the initial operation. That’s why it’s important to be diligent with your research before undergoing any procedure. Communicate your concerns and questions to your doctor. If he or she doesn’t respond to your satisfaction, then it’s time to ask for a second opinion. Medical professionals must be just that: professional. They should never rush you into a procedure for which you are not ready. The ramifications can be dangerous and pricey. Take, for example, breast augmentation surgery. Last year, the cost of this operation averaged $3,718. Now consider the fact that somewhere between 20 and 40 percent of all breast augmentation patients sought additional surgeries within eight to ten years of their first procedure. This leads to soaring healthcare costs, not to mention the discomfort and inconvenience of repeated recuperation times. In addition to the price of the actual operations, you must also factor in lost salary from work as you take time to heal, not to mention the consultations and residual medical costs involved with each follow-up visit. Caution is advised for any cosmetic procedure, not just the one detailed above. Rhinoplasty, for example, is a delicate operation that requires an equally delicate touch. Of course, you want a skilled doctor in the O.R., but you also want that exacting attention to detail long before the date of your procedure. Planning ahead is essential, and your physician should map out your unique facial structure before formulating any plans when it comes to reconstruction. Your cartilage is as individualized as your bone structure. Some people have thick, sturdy reserves of cartilage that is more difficult to reshape. Others have thinner nasal shapes that are extremely vulnerable to change and must be treated as such. Also, once the cartilage has been reconstructed, your skin must be assessed for its elasticity. Will it conform to your new face? How conducive will it be to breathing and general functionality? Are your cosmetic goals attainable given the parameters of your cartilage and skin, as detailed above? If not, how can you and your doctor work together to re-imagine your plans and move forward safely and effectively? It’s important to answer these questions before the day of your procedure to avoid the need for a repeat visit. After all, the average rhinoplasty costs somewhere in the vicinity of $5,125 according to recent studies. That’s a price tag you only want to encounter once, so let’s work together to get it done right the first time. When it comes to facial surgery, the most important consideration is safety and the quality of the results you will achieve. USA Today personal finance correspondent Regina Lewis has sound advice to offer regarding the costs of cosmetic surgery. “Don’t cut quality corners,” she said. “Regardless of the procedure you’re interested in, always look for a top board-certified surgeon. Certification standards can vary.” Lewis outlined the following questions to consider when choosing a surgeon:

• What is the doctor board-certified in?
• Is the doctor licensed? Are there any state disciplinary actions?
• How often has the doctor performed the surgery you are considering?
• Is the facility where the surgery taking place accredited?

Lewis concluded, “Just because you’re getting a nip and tuck, you never want to cut corners on quality.” Be wary of plastic surgeons who advertise discounts on their fees. “Bargain” and “surgery” are two words that do not look good together. Discounting the value of any specialized, professional service, especially surgery shows very poor judgment in marketing and calls into question the quality of the face-altering surgery you may receive. When consulting with your prospective plastic surgeon about the cost of your operation, pay attention to whether your surgeon is carefully listening to you, make sure they truly understand the aesthetic results you hope to achieve and gauge your sense of how available and attentive they will be to you after the operation has been completed. Don’t hesitate to look elsewhere if you have any concern that an operation with them might cost you more than their fee.

About Dr. William J. Binder

Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery. For almost three decades, his individualized philosophy and approach to facial plastic surgery has led him to pioneer new techniques for facial surgery procedures and earned him international acclaim for his results. If you want your facial plastic surgery performed by one of the world’s leading cosmetic surgeons, contact Dr. Binder’s office today to schedule an initial consultation.

A Rhinoplasty operation, also called a "nose job" in common parlance, is a surgical procedure that reshapes or resizes the nose for health or cosmetic reasons.   The aim of the cosmetic surgeon who performs the operation is always to create the most attractive and natural result that complements the rest of a patient’s facial features.   Sometimes rhinoplasty is undertaken to help improve a patient’s breathing by minimizing nasal airway obstruction. In all cases, achieving the best possible functional and aesthetic result is the hallmark of a successful rhinoplasty.   Rhinoplasty surgery 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   Both the open and closed rhinoplasty techniques are performed by making incisions (either across the columella or hidden inside the nose) to allow the surgeon to gently raise the skin that covers the nasal bones and cartilage, allowing access to alter the structure of the nose.   The skin is then carefully draped back over the newly enhanced nasal framework to give the nose its new and improved appearance.   Here are the 7 signs of a successful rhinoplasty:  

1. Symmetry

  For centuries facial symmetry “has been linked to the perception of facial beauty, resistance to disease, and quality genetics.”   The goal of achieving greater facial symmetry is a very common one for patients seeking facial cosmetic surgery, particularly so for those seeking rhinoplasty.   Achieving greater bilateral symmetry of the face, or maintaining the symmetry of an already symmetrical nose while correcting another aspect of its shape or size is essential in rhinoplasty.  

2. Breathing

  When it comes to the nose, form and function are intimately intertwined.   A1999 article from WebMD’s archives mentions how a few of the 130,000 patients to undergo rhinoplasty annually, at the time, would experience difficulty with nasal breathing after their procedure.   The reason for this was that a cosmetic surgeon at the time would occasionally remove too much cartilage during a rhinoplasty, causing the sides of the nose to collapse during inhalation.   Modern rhinoplasties avoid this complication through more delicate sculpting and an emphasis on creating a stronger overall nasal structure.   A successful rhinoplasty will improve or maintain a patient’s ability to breathe easily and comfortably.  

3. No Scars

  A successful rhinoplasty should improve, not worsen, the appearance of the nose. In facial cosmetic surgery the results are intended to be aesthetic, so any visible scarring is considered an unsuccessful result.   An inexperienced or indelicate plastic surgeon is more likely to improve the nose’s shape without the concern of conspicuous, visible scarring.   The first and most important step for preventing unwanted complications and poor results like visible nasal scarring is choosing a plastic surgeon who is board certified, highly recommended, and very experienced in the rhinoplasty procedure specifically.  

4. No Need for Revision

  Many times after a rhinoplasty the nose looks great, but after some operations many patients report having a collapsed nose, pinched nose, or a “skeletonized” – artificial-looking nose.   Unfortunately this problem is not rare. In fact it is estimated that between 5 – 15% of patients who undergo “nose jobs” will need revision rhinoplasty surgery. Some patients require only minor adjustments, while others need more significant revisions.   A successful rhinoplasty is one that’s done right the first time by an expert cosmetic facial surgeon with years or decades of experience, performing rhinoplasties that consistently achieve the very best results.  

5. Natural Look

  The newly enhanced nose must look natural after a successful rhinoplasty. Unnatural results are obvious and unaesthetic.   The profile cannot be scooped too much. The nose should not be too upturned. The tip cannot appear pinched. The nostrils must not look too large. The front of the nose should not look pencil-like, something that occurs when the tip has been narrowed as much as the bridge.   An unnaturally enhanced nose calls attention to itself. A well-done nose looks great and inconspicuously complements the rest of the face.  

6. Facial Harmony

  The eyes may be the windows to the soul, but nothing interferes with facial harmony like a disproportionate nose.   Flaws in such a prominent facial feature draw unwanted attention and can really hurt self confidence. Fortunately, just a slight alteration can balance the face and restore confidence.   A successful rhinoplasty surgeon comprehends the necessity of understanding both the nose and the patient’s overall facial structure in achieving natural-looking results and reducing the chance of needing revision rhinoplasty at a later date.  

7. Patient Satisfaction

  What should an attractive nose look like? There really is not a single answer to this question.   Jeffrey R. Marcus, MD, a pediatric plastic surgeon at Duke University Health Center says it well:   “In the past, many plastic surgeons adhered to personal or popularized aesthetic ideals and allowed them to guide rhinoplasty procedures somewhat universally on their patients. Sometimes, this led to common appearance features among post-surgical patients. This is a trend that has fortunately been left to rest.”   A qualified, expert cosmetic surgeon will work with their rhinoplasty patient to create an individualized goal, plan, and result to achieve the unique goals of each individual patient.     About Dr. William J. Binder   Dr. William J. Binder is a facial plastic surgery specialist with over three decades of experience with facial plastic surgery.   For almost three decades, his individualized approach to rhinoplasty has led him to pioneer the new “structure” techniques of rhinoplasty, yielding more consistent results and rendering the pre-existing look of an unnatural nose-job obsolete.   If you want your rhinoplasty performed by one of the world’s leading facial plastic surgeons, contact Dr. Binder’s office today to schedule an initial consultation.

3-D imaging via medical diagnostic tools such as MRIs and CT scanning is completely revolutionizing modern medicine. As these medical devices become increasingly more precise at an accelerating rate, they are providing doctors with more finely-detailed, high resolution 3-D imaging of their patients with each passing year. At the same time as the rapid increase in the sensitivity and resolution of these modern imaging devices, the processing power of digital computation has continued its exponential growth in price-performance year over year, allowing physicians to render and analyze the data from 3-D imaging all the more effectively.   Innovations in 3-D Imaging Resolution By contrast to the incremental improvements of medical techniques over the centuries, and even to radiography during the decades of the 20th century, in recent years the improvements to medical imaging are coming fast and making a difference by orders of magnitude. A little over a year ago researchers at MIT announced they had developed an algorithm that exploits light polarization to boost the depth resolution of conventional 3-D imaging technology by 1,000 times. Researchers say the technique is so promising that it could bring this technology to your pocket: “The technique could lead to high-quality 3-D cameras built into cellphones, and perhaps to the ability to snap a photo of an object and then use a 3-D printer to produce a replica.”   3-D Image Processing Speed A high resolution imaging device has little useful application without the processing speed to match it. Processing power is essential to creating the images and manipulating the data in quality diagnostic scans made by imaging devices. And it’s not only the rapid pace of improvement in the brute force of computer processing power that’s been essential to 3-D imaging innovation in recent years. It’s the implementation of software solutions that can use that power to effectively reconstruct volumetric data. There’s also the configuration of hardware processing power in a way that’s effective and efficient for the kind of computation involved in 3-D imaging, such as the incorporation of GPUs (graphical processing units) like those used by gaming software to create better images faster than CPUs can.   Machine Learning and Modern 3-D Imaging One innovator in the field, Mountain View, Calif.-based EchoPixel is helping surgeons take the guesswork out of surgical planning by allowing them to create a 3-D image from patient-imaging data and manipulate it in a virtual environment— to remove tumors, dissect tissues, or measure blood vessels. The technology is allowing physicians to get a more accurate view of their patients’ anatomy. Furthermore, with the application of machine learning, the software records the clinician’s interactions with the 3-D imaging data, so other doctors can learn from the same steps and methodology. The software is compatible for use on different hardware devices, including wearable tech such as Google Glass, so it can be used in an operating room.   How 3-D Imaging is Saving Lives An ounce of prevention: Along with life-saving advancements to surgery prep for critical surgeries that doctors perform on vital tissues and organs, 3-D imaging is saving lives in the critical field of medical diagnostics. The use of modern computer 3-D images made from a composite of multiple 2-D radiographic images using tracers and contact dyes has allowed doctors to view a comprehensive image of a patient’s body and observe minor anomalies that would have otherwise gone undetected, providing vital early warning signs of potential health problems.   And Making Lives Better With today’s level of sophistication in computer 3-D imaging technology, its use in medical practice has also found an ever-expanding role to play in helping doctors improve the quality and results of facial plastic and reconstructive surgery. For patients seeking facial implants to improve the proportions or enhance the contours of their face, the computer era has made it possible for facial implants to be perfectly tailored to a patient’s face. Custom implants made using 3-D imaging and computer-aided drafting look smoother, rounder, and anatomical, and allow facial reconstructive surgeons to correctly perceive the interaction of all facial features to create a balanced, well-proportioned face. Dr. Binder was an early innovator in this field, noticing at first that facial implants of the time were not quite right, or as he would say: “non-anatomic.”   Pioneering Facial Contouring and 3-D Imaging Before bringing the possibilities of high-resolution 3-D scanning, efficient digital rendering and imaging, and computer-aided drafting to fruition in facial reconstruction techniques, Dr. Binder did not see facial implants achieving the desired results he was striving to attain. By innovating a system capable of fabricating custom-designed facial implants to a high degree of precision, Dr. Binder was able to pioneer a technique that allows the reconstruction of most facial contour defects with a higher degree of accuracy and better results than were ever before possible.

Many migraine sufferers have their problems compounded when they don’t fully understand the difference between a migraine and a simple headache. Many people believe that a migraine is “just” a really bad headache, which is an oversimplification that leaves out many of the symptoms that make migraines a nearly unbearable malady for the millions of people who suffer from them. The good news for migraine sufferers is that in the 1990s, Dr. Binder helped pioneer the effective use of BOTOX treatment for migraines, helping many who suffer from chronic migraines to find the relief they desperately need. Below is a quick rundown of the important differences between headaches and migraines. Included in the list are some of the most effective treatments for each, including BOTOX treatment for migraines.   What Exactly is a Headache? Headaches are fairly common, and can affect anyone at any age. They can be a mild to intense pain that typically affects both sides of the head. Headaches are typically most intense around the temples, forehead, and the back of the neck where the spine connects to the skull. Headaches happen for a number of reasons, including sinus pressure, high stress, muscle tension, dehydration, poor nutrition, and many other causes.   What Exactly is a Migraine? A migraine on the other hand is a severe headache that occurs with a number of other acute symptoms that can include:

• Intense Nausea
• Severe pain behind one eye or ear
• Severe pain in the temples
• Seeing spots or flashing lights
• Sensitivity to light and/or sound
• Temporary vision loss
• Vomiting

Migraines range from moderate to severe on the pain scale and can make performing everyday tasks difficult or impossible. Many people end up seeking emergency room care for severe migraines, especially if they’ve never experienced one before. Migraines are also more difficult to treat, and typically last longer than a tension or sinus headache. The extra symptoms such as nausea and vomiting can make it difficult to keep medicine down as well.   Differences Between a Migraine and a Headache A migraine is not just a really bad headache. It is an incapacitating neurological disease with neurological symptoms. In terms of the sufferer’s experience the primary difference between a migraine and a regular headache is the severity of the pain. A full-fledged migraine will involve pain that is much more severe than a typical headache. Migraines can also present with severe nausea and/or a migraine “aura,” a neurological symptom which includes other sensory issues such as sensitivity to lights or sound, “pins and needles” sensation in the extremities, seeing flashing lights, and even depression and mood swings.   Treating a Headache Headaches can typically be treated very effectively with home remedies or over-the-counter medication, and only rarely require professional medical help. Some effective medications include:

• Acetaminophen
• Aspirin
• Ibuprofen
• Caffeine

There are a number of other treatments that have been shown to help as well, including neck stretching, relaxation techniques, meditation, and warm compresses/showers. These are all fairly effective for treating stress or tension headaches. If you have a sudden severe or unusually persistent headache, contact your doctor immediately as this may be the sign of a serious condition such as migraines, stroke, or some other neurological issue.   Treating a Migraine Migraine treatment is typically much more involved than the treatment for a headache. Typical headache treatments will be minimally effective at best, and will do almost nothing to prevent a migraine. Unfortunately, there’s not much that can be done to relieve a migraine headache at home, so chronic migraine sufferers learn to identify their migraine triggers and do whatever they can to avoid them. Common triggers include:

• Alcohol
• Caffeine
• Aged Cheeses or other Aged Foods
• Stress

Beyond the preventative measure of avoiding triggers, there are several medication options for treating migraines, but you’ll need to visit a doctor for them. These include:

• Antinausea medicines, such as promethazine (Phenergan), chlorpromazine (Thorazine), or prochlorperazine (Compazine).
• Triptans, such as almotriptan (Axert), rizatriptan (Maxalt), or sumatriptan (Alsuma, Imitrex, and Zecuity).

  BOTOX Treatment for Migraines Finally, there have been several studies that have shown that BOTOX injections are extremely effective at preventing migraine headaches in chronic sufferers. The exact mechanism of action is not yet fully understood. BOTOX has many cellular level inhibitory effects. It is believed that BOTOX actually inhibits pain pathways through multiple actions at the neurotransmitter level and pain fiber level. BOTOX for migraines: Injection sites - To treat chronic migraines with BOTOX, your physician will make a series of small injections of BOTOX in specific areas across the frontal, temporal and glabellar regions of the forehead. In some instances, it is also injected into the back of the neck. The treatment takes about fifteen minutes. BOTOX for migraines: Side effects - BOTOX has a considerably high safety profile for cosmetic and medical treatments. BOTOX has been used by patients with various conditions for over 20 years in over 60 countries. BOTOX has been approved by the FDA for the treatment of chronic migraines. The most common side effects are localized pain, tenderness or bruising at the site of injection. These side effects are normally local and transient in nature.   If you are interested in BOTOX injections for migraine treatment, contact Doctor William J. Binder today! Call us at: (310) 858-6749 or use our Contact Page. Doctor Binder is the physician that pioneered BOTOX treatment for migraines, and is considered the foremost authority on the application of BOTOX for this purpose.