What to Consider Before Having A Rhinoplasty

healthcare-medical-and-plastiA Rhinoplasty, or nose job, is the oldest and most common plastic surgery procedure around, it is also one of the most difficult. So before deciding on whether this procedure is right for you, it is important to know what to expect after the surgery. Here’re a few things to consider before getting a rhinoplasty.

Take Time Off Work

You will need to take at least 7-10 days off before returning to work after your rhinoplasty. You can cut down your healing time if you stop taking fish oil, non-steroid anti-inflammatories, or aspirin, two weeks prior to your procedure.

Be Prepared for the After-Effects

While getting a Rhinoplasty is not as painful as other plastic surgery procedures, there is some pain related to the procedure as well as, swelling, bruising and slight bleeding, especially right after the procedure. Make sure you have cold compresses and ice gels to help manage the swelling, and bruising, around your nose and eyes. The swelling and bruising are at their worst in the first 3 to 5 days and should completely be gone, within ten days. However, the residual swelling, particularly at the tip of the nose, can last up to 12 – 15 months. This residual swelling may cause your nose to seem asymmetrical, until you hit the 12-15 month mark. It is normal within the first few days to experience some slight nasal bleeding and tiredness. It is also important to keep you wounds clean and manage your recovery with your doctor.

Avoid Exercise

You should avoid exercising for 2 to 5 weeks after your procedure. Elevating your heart rate can cause more swelling, bruising and even bleeding.

The Healing Process

Because it takes about 12 to 15 months for the residual swelling to dissipate, you will not truly see your final results until that time. You must be be patient and monitor your progress with your surgeon. Your internal splints will not be removed until the first post-op visit, seven days, after your rhinoplasty.

Manage Your Expectations

There is no such thing as a perfect nose and is not possible to just “add” any nose to your face. Noses are very specific, and there is a limitation to how yours can be shaped. The best way to manage your expectations is to be in constant communication with your surgeon, prior to the procedure, providing them with as many pictures or descriptions of your ideal nose, as possible. This way you can get an idea what you can expect to look like after your procedure.

Hopefully the information provided will help you decide whether this procedure is right for you. If you have further questions or if you would like to discuss the procedure, feel free to contact us at your earliest convenience. Our expert staff will be happy to address any concerns you may have. To schedule a consultation visit doctorbinder.com today.

Why You Should Consider Botox To Treat Your Migraines?

Beauty-woman-giving-botox-injeBotox has quickly become one of the most popular cosmetic procedures on the market. However, some would be surprised to learn the Botox also treats a number of health issues, from hypertension to overactive bladder. Botox has also proven to be a highly effective treatment for those who suffer from chronic migraines- since the FDA approved it as a migraine treatment in 2011. If you suffer from chronic migraines, and have been thinking about using Botox to relieve your symptoms, here is what you need to know.

How does Botox Treat Migraines?

Botox works by preventing the movement of certain muscles as well as preventing the release of certain brain chemicals. Botox relieves headaches because, this muscle restriction, prevents the muscles from becoming tense and sensitive, as they would during a headache. In addition, it is believed that Botox blocks the nerves that send pain messages to the brain.

How well does it work?

Most patients that use Botox, to treat their chronic migraines, experience a significant decrease in how often they experience migraine attacks. In fact, the vast majority of chronic migraine patients a day experience, 7 to 9, fewer headache days per month, making Botox one of the most successful migraine treatments to date. Is important to note that these results take time and usually do not present themselves until up to a two weeks, after your Botox procedure. In addition, these results usually do not happen after the first round of Botox and are more likely to start after the second, or third, treatment.

Who should try it?

Chronic migraine sufferers who experience debilitating migraines 15, or more, days out of the month, lasting four hours or more, should consider utilizing Botox to treat their symptoms. Most doctors will want you to try more traditional migraine treatments before recommending Botox. But if other migraine treatments or medications are not working for you, or you have a health condition the medicine may interfere with, such as stomach ulcers, you should definitely consider Botox as an alternative treatment.

How long does it take?

A round of Botox treatment can take anywhere from 10 to 30 minutes. For maximum and long lasting results, chronic migraine sufferers should receive Botox treatments every three months for a 15 month period.

What else should I know?

Botox treatments are virtually painless, so there may be a slight swelling, or irritation, at the injection site- particularly, for those for with sensitive skin. Most insurance companies cover Botox procedures as a treatment for chronic migraines but you should definitely contact your insurance company to verify that they do. In rare cases, they may want you to undergo certain tests before they agree to cover the procedure.

Now that you know how effective Botox treatments are for chronic migraines, if your suffering from severe migraines, this might be the perfect procedure to relieve you of this pain. To learn more about Botox treatment or discuss any of your questions or concerns about the procedure feel free to reach out to us today. Or to schedule a consultation visit doctorbinder.com.

How Long Will It Take My Face To Heal After A Chemical Peel?

5552681678_2First, let’s define the term Chemical Peel:

• A chemical peel is a procedure that can improve the skin’s appearance. There are many factors that can affect your skin. A chemical peel uses a chemical solution that is allowed to soak into the skin and will remove the damaged outer layer of your skin. This is one of the easiest, and most cost effective, ways to improve the appearance of your skin. The chemicals applied to the skin will make the skin blister, and eventually peel off, leaving behind a smooth and taut texture.

There are three degrees of chemical peels:

• Light chemical peels usually do not require any type of pain killers.

o A mild chemical peel, with Glycolic Acid of 30% to 40%, will typically have a short healing time and will have a very minimal downtime.
o Initially after the peel, the skin will likely be red, dry and slightly irritated.
o It usually takes about 4 to 7 days for the treated areas to develop new skin.
o Light and superficial peels typically yield good results after about 3 sessions. Patients will see excellent results after about 6 sessions.

• Medium chemical peels may or may not require pain killers. The doctor will likely give you the option.

o This type of chemical peel, usually, achieves excellent results. Expect skin peeling to start 3 days after the peel, and last about 1 week.
o Initially after the peel, the skin will likely be red, swollen, and tight.
o It usually takes about 5 to 7 days for the treated areas to develop new skin.
o Some patients experience redness on the skin for several months.
o A medium depth chemical peel will provide excellent results after only 1 session. However, patients are encouraged to adopt an in-home care program to maintain the results.

• Deep chemical peels typically require local anesthetic and a sedative.

o These deeper peels will result in a much more dramatic result but it does come with an increase in pain and a longer healing time.
o These procedures usually take up to 90 minutes.
o Patients will, likely, experience severe redness and swelling.
o It usually takes 14 days for the treated areas to develop new skin.
o Some patients will develop cysts and white spots, which may be present for 2 to 3 weeks. Expect the redness in the skin to last for several months.

Regardless of which chemical peel you choose, be sure to follow your doctors explicit instructions for cleaning and moisturizing the treated skin. Dr. William J. Binder, M.D., F.A.C.S. will answer all your questions and concerns during the consultation.

Why and How to Massage Your Skin After Liposuction

massage after liposuctionThe reality is a Liposuction surgical procedure usually creates pooling of excess lymphatic fluids. This results in swelling and dissatisfaction with the patient.

Lymphatic Drainage Massage (LDM) is a specialized massage technique that is recommended by plastic surgeons, after liposuction, to accelerate the recuperation period.

The science behind why this massage works is fairly simple. Stroking the areas of the body that process the lymph fluid, and the lymph nodes, causes the fluid to drain.

This massage procedure works well and has been demonstrated to show positive results, only after a couple of massage treatments! However, most patients need 4 to 6 LDM treatments to remove most of the excess fluid. Patients can expect relief from swelling after the 6th treatment.

Some patients will experience lumpiness to the areas affected with liposuction. This is normal for most patients after surgery. The lumpiness is caused by inflammation and trauma from the surgical instrument that is used under the skin to extract the fatty tissue. The tunnels and channels which are created by the surgical instrument will fill with fluid and become swollen with both fluid and left-over fat. This fluid and left-over fat tends to begin to harden between one week and three weeks after surgery. LDM will help move the fluid by gently pushing back into the lymph passages.

Doctors will advise their patients that, without LDM, there is a risk that the swelling and inflammation could turn into fibrosis, which is a permanent hardening of the area. LDM ensures you’ll achieve the best results possible from the surgery.

Every patient is different, however, most doctors advise their patients to begin their LDM treatment after the 4th or 5th day after surgery to obtain the best, and fastest, results.

A professional LDM massage therapist will know exactly what to do. He/she will massage in right place and with the right amount of pressure. However, this can be a DIY project at home, if you so choose. Here are some high-level instructions on how best to perform a ‘Self-Lymphatic-Massage’.

• Place index and middle fingers in the indent area, just above the collarbone.
• Gently move the fingers up onto the neck area.
• Gently rub in a clockwise fashion in the direction of your chest.
• Make sure to drive the lymph toward the node. This will encourage the lymph fluid to flush throughout the body.
• Press and pull, firmly, the skin under the armpit in the direction of the neck. Repeat this motion several times.
• Using a flat hand, massage the complete thigh area in the direction of the inner knee. Do not apply heavy pressure, as this will risk flattening the nodes.
• Finally, massage the back of the knee in a pushing, and scooping, motion.

It is very important, during your consultation with Dr. William J. Binder, M.D., F.A.C.S., that you ask questions before embarking down the path of Self Lymphatic Massage.

What is Otoplasty and Can It Help My Child?

What is Otoplasty?  Otoplasty is a plastic surgery procedure to reshape the outer ear.  It is performed for cosmetic/appearance reasons or for reconstruction of the ear after an injury.  Otoplasty will not change the ears hearing ability.  Otoplasty is sometimes incorrectly referred to as ear pinning.

Otoplasty surgery is a very common plastic surgery procedure for children between the ages of 4 and 14.  This surgery is usually performed to correct large ears caused by excessive cartilage in the ear.

 Otoplasty can help your child’s self-esteem.  A child’s ear is usually over 90% developed by the age of 4 or 5.  The surgery will dramatically improve the appearance of your child’s ears which will lead to potentially less ridicule, verbal abuse, or bullying from peers during their childhood.

 There are a couple of very good justifications for electing to provide this surgery to your child at a young age:

  • From a self-esteem perspective, the sooner the surgery, the greater the psychological benefits of not having to endure the unwanted attention on the playground.
  • The cartilage is much easier to shape because it is much more pliable at a young age.

Otoplasty surgery usually takes between 1 ½ and 2 ½ hours under normal conditions.

The U.S. National Library of Medicine conducted a study that clearly demonstrates the psychological benefits of Otoplasty for children.  The study was performed over a 4 year period on children between the ages of 5 and 15.

Here are some excerpts of that study:


  • 97% of children reported an increase in happiness
  • 92% of children reported an increase in self-confidence
  • 100% reported that bullying was reduced or completely stopped.


The study concluded that Otoplasty is an effective surgical procedure in diminishing and relieving the psychological anguish in most children that have the Otoplasty surgery.  The study strongly supports Otoplasty for children with large or prominent ears.

When selecting a Otoplasty plastic surgeon for your child, choose carefully:


  • Make sure you have a clear understanding of how many times your surgeon has performed this exact same procedure.
  • Look at before and after pictures of his Otoplasty patients.  An experienced doctor will offer these in advance and will give you enough pictures to make you feel comfortable.
  • Make sure your surgeon provides you with specific steps to follow before and after the surgery.


The healing process is critical to the success of the surgery.  After your child has the surgery, your doctor will ask that you limit and restrict their physical activities for about three weeks.

Otoplasty should not be forced on to your child.  Dr. William J. Binder, M.D., F.A.C.S. will want to meet with you and your child at a consultation to ensure he/she is emotionally ready and willing to have the surgery.

 The short answer is that Otoplasty can absolutely help your child self esteem and quality of life.



When Is It Safe To Blow My Nose After Rhinoplasty?

Dr. William J. Binder, M.D., F.A.C.S. is a highly respected global leader in the field of facial contouring. Surgeons around the world now replicate his techniques and breakthrough advancements in facial plastic surgery. His peers recognize him as the premier surgeon in the field of rhinoplasty.

Rhinoplasty, the number one surgical procedure in the U.S., can be a very difficult procedure. Let the expertise of Dr. Binder guide you through your procedure as well as any questions you may have.

Blowing your nose after rhinoplasty is only one of many questions that patients have after surgery. Other frequently asked questions are:

  1. Will there be any visible signs of a scar?
  2. How painful is the procedure?
  3. How long after surgery should I expect the pain to persist?
  4. What type of pain reliever should I take?
  5. Will I have bruising after surgery?
  6. How long should I expect swelling?
  7. How should I clean the nose after the bandages are removed?
  8. When can I wear start wearing glasses?
  9. How long before I can expect a full 100% recovery?

All these questions and concerns should be discussed with the doctor during the consultation.

Now to address the question at hand: When is it safe to blow your nose after rhinoplasty?

  • When you can blow your nose and how hard you can blow depends on the type of rhinoplasty procedure you have undergone.
  • The timeframe can be as little as two weeks after surgery and as long as 12 weeks after surgery.
  • You should wait for your doctor’s explicit approval before you blow your nose. Until you get that approval, you should apply a saline spray inside the nose and then gently dab.
  • Doctors emphasize that when you do blow your nose, it must be done gently to avoid a nosebleed.

The key take-away is that your doctor is your best source of information for all your questions regarding rhinoplasty and your specific questions regarding blowing your nose after surgery.

Everyone’s nose is different is some way. During your consultation with Dr. Binder he will discuss with you your desired goals and results. He will also use the consultation to educate you on the procedure and the uniqueness of your specific goal. The most important aspect of the consultation is to address any and all your questions and concerns. Ultimately, his overarching philosophy is to create a natural looking appearance for you.

Revision Rhinoplasty

What if I already had a nose job but don’t like the results? Can I get another one?


A rapid exploration on the web will highlight this is not an unprecedented event. Rhinoplasty is thought to be a standout amongst the most challenging corrective surgical techniques.

Pick your specialist carefully. Ensure that he/she has the experience and effective reputation for your particular surgery.

If you have had unpleasant nose work, you will probably be furious, negative, and incredulous of every single plastic surgeon. Your chief emphasis should be to plainly impart to your second plastic surgeon what precisely it is that you are troubled about. You need be to a great degree clear and exact with reference to what you need repaired and/or rectified and what your objectives are from the second surgery.

Bad nose jobs will characteristically fall into one of numerous major categories identified as corrective prospects. There are particular demonstrated remedial methods that will repair each of these with surgery. Your specialist will have the capacity to instruct you with reference to what should be possible to rectify the issue and how he/she will revise it. There are times when the nose must be remade for both appearance and proper breathing.

Before you consider remedial modification Rhinoplasty surgery, ensure that you’ve given your body adequate time to recuperate. The perceptible results one month after your first surgery will look significantly changed 6 months after surgery. As a rule, restorative Rhinoplasty surgery ought not be performed under 12 months after the starting surgery.

What would it be advisable for you to do in the event that you’ve had terrible nose work?


  1. Give your nose time to mend. In case you’re still troubled following the 1 year update, .

rhinoplasty may remedy the issue.


  1. Choose another specialist with the demonstrated reputation in correction rhinoplasty.


  1.      Consult with your specialist (no less than 2 or 3 times) and inform yourself on all parts of

the corrective surgery.


The unfortunate truth is that in a few occurrences, the scar tissue from the first surgery is severe to the point that it makes it for all intents and purposes difficult to accomplish certain outcomes. You and your specialist need to concur on reasonable desires amid your discussion. Dr. William J. Binder, M.D., F.A.C.S. will take the time during your consultation to inquire what your needs and wants are. A co-plan will be implemented so that you will receive the most effective care and results possible.


Your First Nose Job Didn’t Go as Planned. So What Next?


You spend hours debating about it. You spend even more hours researching the perfect surgeon. You finally undergo a rhinoplasty procedure, only to be disappointed with the results. Your nose is the focal point of your face, and you can’t hide poor results. Maybe your results need to be tweaked to give you the perfect nose, or maybe your original nose issues were never properly corrected. It can be easy to feel discouraged and upset after such an ordeal. Because you may not know what your next step should be, we are here to help you make the best decision and  plan your revision rhinoplasty.

What Should You Do Now?

Revision rhinoplasty can give you a second chance to improve your nasal contours and help you achieve the results you desire. Revision rhinoplasty, sometimes called secondary rhinoplasty, is a surgery that reinforces weakened nasal structures and corrects further aesthetics. There can be many reasons for a second nose surgery, but most often, the procedure is performed to help address an issue that was either not impacted by the first treatment or an issue that has since developed as a result of the surgery.

Taking the time to do some simple research can help you determine for yourself if you would benefit from another nose job.  Rhinoplasty Society can provide you with insight on the procedure process. Getting  information from physicians can also be helpful in making your decision.

Revision Rhinoplasty is a Complex Procedure

Rhinoplasty is a very detailed facial plastic surgery to begin with. But, understanding the ins and outs of the procedure can help put your mind at ease. The nose is delicate and easily damaged, so this procedure must be performed with tender care and fine attention to detail.

What’s the Best Approach for Revisions?

The closed approach works well for minor revisions and does not involve any incisions being made on the outside of the nose. This method relies mostly on the skill of the surgeon to play to his or her strengths regarding nasal adjustments. For major conceptual nose job repairs, an open approach is often used. An incision is made in the columella, or the area between the nostrils at the tip of the nose, in order to address the complexities of the inner anatomy of the nose.

Certain revision rhinoplasty cases may require the use of cartilage grafts. A rhinoplasty often involves repositioning or trimming nasal cartilage. If more cartilage is required to support the nose or repair the columella separating the nostrils, a cartilage graft from the septum, ear or ribs may be recommended. This gently removes a small amount of cartilage to restore anatomical components.

Finding a Surgeon to Fix Your Nose Job

After understanding the complexity of the surgery, you will understand the need for an experienced and certified plastic surgeon to perform it. You certainly don’t want to be disappointed with your results yet again, so taking the time to find a professional who pays very close attention to detail is of the utmost importance.

How to Make the Most of Your Consultation

Once you have decided on a surgeon, you’ll want to have an in-depth consultation. You’ll want a surgeon who is detail-oriented in his or her treatment plan. Also make sure that he or she completes a thorough examination of the inside and outside of your nose. Here are some additional tips for making the most of your consultation:

  • Provide your surgeon with before and after pictures of your previous rhinoplasty to help clarify your concerns.
  • Ask your physician about his or her rate of rhinoplasty revision.
  • Discuss your expectations with your surgeon and get their honest opinion on the likely outcome of your surgery.
  • Keep a running list of questions as you think of them and bring the list to your consultation to ensure that your needs are addressed.

Allow a Master Facial Plastic Surgeon to Correct Your Nose Issues

Don’t settle for a bad nose job. An experienced facial reconstructive surgeon can repair your nasal issues thoroughly and help you achieve the look you’ve been striving for. Make sure the surgeon is an expert in the complex art of revision rhinoplasty. Dr. William J. Binder is considered one of the top revision rhinoplasty experts. His technical skill and wonderful communication can help turn your nose job nightmare into a thing of beauty.

Schedule a consultation today. With our advanced techniques and dedicated staff we can help you achieve the nose you deserve.


Recovery Tips After Facial Reconstruction

Facial reconstruction equals big changes in your life. Post-surgery can be a big adjustment. Not only does your face look different, but you also feel different. Taking steps and preparing in advance to have a smooth recovery can help ease the adjustment period. Preparation can also help your face heal better so that you achieve the best possible results when you’re done healing. The length of time needed to recover from facial reconstruction differs from person to person depending on the condition of each individual’s overall health, the specific facial reconstruction procedure they elect to undergo, and the specifics of their procedure:



Generally by 3 months after a rhinoplasty procedure, most of the swelling has subsided, the new shape and size of the nose is apparent, and patients can go back to their normal routines, including exercise. They should, however, avoid high-impact, high-risk activities for at least 6 months after surgery.



For most patients undergoing a facelift procedure, most of the swelling and bruising subsides after about three weeks, and it may be hard for anyone else to tell that they have even had a facelift, other than their more youthful appearance. Patients can return to their normal routine after about two weeks.


Eyelid Surgery

While no two patients are alike, some patients experience a full recovery from eyelid surgery in as few as four or five days, although in other cases a complete recovery may take as long as three to four weeks.

Whatever kind of facial cosmetic surgery you elect to undergo, here are a few helpful tips to ensure that your recovery is as easy, successful, and painless as possible:


Enlist An Assistant

Facial reconstruction affects the whole face, and sometimes the bandages can make it hard to see. During the first couple of days, you may need someone to provide you with transportation, changing bandages, preparing your meals, and other everyday tasks. Enlist a close friend or relative to help with those things for the first few days after surgery.


Invest in a Food Processor

One of the biggest concerns following facial reconstruction surgery is diet. It’s still okay to eat all of your favorite foods, but they have to be chopped into small pieces that do not require chewing. This way, you can easily eat all of your favorite foods until your no-chew diet restrictions are lifted.


Take Your Pain Medication!

Facial reconstruction surgery can affect the nerves throughout your face. This can cause severe discomfort in addition to the pain already experienced from the incisions and other corrective measures. Staying ahead of the pain curve will keep you calm and comfortable. It will also reduce the amount of stress on your body, ensuring that you heal quickly and properly.


Dust Off the Recliner

Sleeping with your head elevated is important after facial reconstruction. It will reduce the amount of swelling and stabilize circulation. It is also recommended to sleep in a reclined or a seated position. You can also prop two or three pillows under your head and shoulders while lying in bed to keep your body elevated.


Buy Some Frozen Veggies

Ice is another important factor in reducing swelling after surgery. Medical ice packs can be helpful, but frozen veggies, especially corn or peas, make for pliable ice packs.


Use Squirt-Top Water Bottles

Staying hydrated is required after any type of surgical treatment. Facial reconstruction patients must also be sure to keep their mouth clean after surgery. A water bottle with a squirt top is helpful because it makes it easy to stay hydrated while also aiding in rinsing out your mouth with very little head movement.

Bonus Tip: Use a child’s toothbrush to help brush in between meals, as it is smaller and easier to fit into the mouth without opening too widely.


Stock Up On Food & Supplies

Having a fully stocked house can make recovery time less stressful. Be sure that you have all of the bandages, antibiotic ointments, and over-the-counter pain medications as recommended by your doctor. Also make sure that you have foods that can be cut into bite-sized pieces or are soft enough to eat after treatment. Don’t forget to also make sure you have the essentials, such as laundry detergent and toilet paper.


Talk To Your Doctor

The most important recovery tip is this: attend all of your follow-up appointments and don’t hesitate to call your doctor with questions or concerns. Dr. Binder would rather you bring up a concern than have it go unaddressed and that lead to bigger problems later. Rest easy and know that your facial reconstruction by Dr. Binder will help you achieve the best possible aesthetic results.

The Rise of Skin Cancer Reconstruction Surgery

 Skin Cancer Reconstruction Surgery

Skin cancer is more common than you might think. In fact,  around 50% of people will have experienced some form of skin cancer when they reach age 65. The most common type of skin cancer, and also the most common type of cancer in general, is Basal Cell Carcinoma. This disease can cause disfiguration of the tissue in question if left untreated for long periods of time.

Because of the prevalence of skin cancer and its tendency to lead to disfigurement if left untreated, we are seeing a rise in  skin cancer reconstruction.

The Importance of this Procedure

These cancers should be removed immediately. However, even when the cancer is spotted and removed in time, the removal of these cancers can cause disfigurement without reconstruction surgery.

There are two techniques of skin cancer reconstruction:

  • Skin Flaps:   Often a skin flap procedure will be chosen as the best way to limit scarring and restore full function to the affected area. This procedure involves the removal of a flap of skin from the area adjacent to the cancer removal site.
  • Skin Grafts:   This technique involves taking skin from a predetermined donor site on the patient’s body and transferring it to the affected area. This technique leaves some scarring.

Discuss your Options

The rise in skin cancer has led to a rise in skin cancer reconstruction. If you’ve been diagnosed with skin cancer, it is important to not only have the cancer removed, but restore the affected area with skin cancer reconstruction.

As a leading surgeon in facial plastic surgery, Dr. Binder is an expert in both removal and reconstruction techniques. Schedule your consultation, and Dr. Binder will discuss what options are available to you.

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