Should You Be Able to Tell If Someone Has Had Work Done?

No doubt you’ve participated in conversations—after seeing an old friend—about how young she looks. Or, maybe, she was trying to look young through obvious plastic surgery or cosmetic procedures, such as too much Botox or overfilled lips. 

With either situation, we bet money (and we don’t bet often – we’re a medical practice after all) that you’ve heard friends say in hushed tones – “well, you know she’s had work done.” Maybe she has. Maybe she hasn’t. 

Today, it’s harder to tell if plastic surgery or cosmetic procedures have been done correctly. 

Having “work done” is a personal choice. And, we’re not here to convince you of undergoing plastic surgery procedures or sitting back and letting nature take its course. However, if you decide to have a procedure or two, we want you to be informed about what plastic surgery looks like today.

The Past: Looking Down on Women Opting for a Plastic Surgery Procedure

In the past, women were often looked down upon – or otherwise judged harshly – for getting work done. Perhaps people judged them for wanting to hang on to their youth. Or maybe that they had low self-esteem. Or that they only wanted to attract men. 

Bad cosmetic surgery procedures didn’t help matters. Most plastic surgeons will tell you that procedures should result in subtle transformations in appearance, not immediately recognizable and drastic changes.  

Here are some “not-so-subtle” results:

  1. A pulled look from a bad facelift, where the skin on the face looks pulled back towards the ears or up to the scalp.
  2. A tight forehead, where your face looks frozen from too much Botox, making it impossible for you to create natural expressions.
  3. A pixie ear, where your earlobes are elongated (resembling the ears of a pixie) after a bad facelift.
  4. Unnatural proportions often resulting from bad breast or butt augmentations, making you look like you could literally tip over.
  5. No natural body movement after surgery, such as breasts that are rock hard, showing no natural movement or feel. 

The Present: Normalizing Having Work Done

According to the American Society of Plastic Surgeons’ most recent 2020 annual statistics, “$16.7 billion was spent on cosmetic procedures in the U.S.,” despite the global pandemic. 

Although the overall number of procedures was lower than those completed in 2019, “11% of women surveyed said they are more interested in cosmetic plastic surgery or non-surgical procedures now than before COVID-19 –  and the figure is even higher among women who have already had surgery or a procedure.”

Not only has the COVID pandemic had an impact on interest in plastic surgery, but younger generations have also normalized these procedures, helping to remove any judgment and stigmas. 

For example, “Millennials and Gen Z are seeking plastic surgery options earlier than any other generation, making it more the norm rather than a secret of the rich.” In 2018, adults under 34 underwent more cosmetic surgery procedures than those in the 51 to 64-year-old age group, according to the American Society of Aesthetic Plastic Surgery

Through this trend, “Millennials and Gen Z are effectively erasing any stigma around plastic surgery through social media, selfies, and attitudes towards health and aging, including ‘preventive’ procedures such as Botox injections. By normalizing these procedures as a part of your regular self-care routine, these procedures will likely continue to rise in popularity.”

Despite the rise in popularity, “[f]or many, a reticence remains, and—fearing stigma or backlash or something else–they keep it under wraps,” according to Town & Country. But, lucky for these patients, the stigma will continue to disappear as plastic and cosmetic procedures continue to become more popular – and more frequently discussed – moving acknowledgment of these procedures out of the shadows and into the light. 

The Future: What to Expect in the Plastic Surgery Field

Often today, we talk about before COVID and after COVID. Or the “old normal” and the “new normal.” Plastic and cosmetic procedures aren’t left out of this comparison – in fact, they are a top topic in the medical field. 

As the American Society of Plastic Surgeons reflects, “[m]any are wondering if this increased interest in plastic surgery in general and facial procedures, in particular, is going to last once the pandemic is finally brought under control. While this is difficult to predict, most likely, these plastic surgery trends will continue even after the masks are put away.”

With the work-from-home model dominating employee-employer relationships, and Zoom dysmorphia impacting how we view ourselves, many patients seek a more balanced, aesthetically pleasing image

Additionally, with Millennials aging, with the oldest members of that generation turning 38 this year, they realize that “they are no longer the young kids on the block.” As noted by the American Society of Plastic Surgeons, “[u]nlike previous generations, they are facing 40 while living in an online world. Even if the new normal were to fully disappear, social media will not.”

According to Baylor College of Medicine, plastic surgery techniques and technology continue to improve (dramatically, we might say). Further, plastic surgeons “better understand aging and its physiological and anatomical effects,” allowing plastic surgeons to better address “facial and total body concerns.” 

Because of these continued medical advances, plastic and cosmetic procedures will continue to enhance images through subtle transformations. And the key here is that people will not be able to tell if you’ve had work done – unless you choose to tell them. 

And, with a board-certified plastic surgeon, you can fully understand your options and results, giving you a natural look – whether you’re on Zoom calls or aging gracefully. So, contact us today to learn more about plastic and cosmetic surgery – giving you the subtle transformation you desire. 

A Look Back on the Top Cosmetic Procedures of 2021

According to, the last two years have created an entirely new vocabulary – from social distancing to flattening the curve. We’ve also seen new terms emerge around our appearance as we continue to work from home while on video conferences day-in and day-out.

With people now spending hours on video-conferencing tools like Zoom or Microsoft teams – for both personal and work events or meetings – we all have plenty of time to scrutinize our images, often creating distortions in perception. 

One term that has made headlines of late is “Zoom dysmorphia,” which according to Science Direct occurs when “patients seek cosmetic procedures to improve their [perceived] distorted appearance on video-conferencing calls.” With Zoom becoming a part of our everyday lives, many people are seeking plastic surgery and cosmetic procedures to correct or enhance those perceptions – thus, guiding many procedures in 2021.

Looking Back to 2020 to Predict 2021’s Top Procedures

Before we look at the procedures that dominated 2021, let’s first look back to 2020. After all, looking backwards can often help predict trends for not only 2021 – but beyond into 2022. 

According to the American Society of Plastic Surgeons, the top procedures in 2020 were:

The top five cosmetic surgical procedures:

The top five cosmetic minimally invasive procedures:

Top Cosmetic Surgery and Procedures in 2021

Although we didn’t know it then, 2020 was only the beginning of the pandemic. As we rounded the corner into 2021, we’re not sure anyone expected COVID-19 to hang around for the entire year – essentially directing how we live and work. 

As businesses tried to get back to “normal,” employers adopted work from home policies and turned to video-conferencing as the “norm” for meetings and collaboration. Although Zoom meetings allowed us to resume working into 2021, video-conferencing platforms created other physical issues and demands.

From Zoom fatigue to Zoom dysmorphia, workers worldwide were confronted with entirely new issues – such as pure exhaustion for day-long video meetings to staring at our own images, hours on end. 

As reported by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), 83 percent of respondents in a 2021 survey indicated that the “Zoom effect” influenced behavior changes, such as undergoing plastic surgery. 

Further, a recent study published in AAFPRS’s journal, Facial Plastic Surgery & Aesthetic Medicine, found that “ZOOM dysmorphia” had “a huge impact on the way we view ourselves.” Simply, “through this hyperawareness of our images on live video (with no filters), people are turning to plastic surgery to fix imperfections and balance facial structure, creating a more pleasing look (and boosting self-confidence).”

In April 2021, The Economist introduced yet another term:  Zoom face-envy, when those on video-conferences compare their skewed impression of their own image with others. Because of this, “[t]he American Academy of Facial Plastic and Reconstructive Surgery reckons that the pandemic has led to a 10% increase in cosmetic surgery countrywide.”

With all of this self-examination and comparison, here are four of the most popular procedures that took place in 2021:

  1. Masseter Botox®

To say that people were stressed and exhausted in 2020 and 2021 is very much the understatement of the young decade.  And when stressed, many of us clench or grind our teeth we sleep. 

Because of this, the masseter muscle is “one of the muscles activated during chewing, and it’s located at the angle of the mandible (jaw).” When we clench our jaw or grind our teeth, extra tension is applied to this muscle, causing pain and weakening the masseter muscle. Masseter Botox® blends beauty and wellness by thinning and softening the jaw while reducing pain within one to two weeks. 

  1. Nanofat

If you’re looking for fillers that look more natural and long-lasting, nanofat emerged as “a whole new level of facial fat injections” for 2021. Since traditional fillers can often appear and feel lumpy instead of smooth. 

Nanofat, on the other hand, smooths into a “milkshake-like consistency” more along the lines of Juverderm® or a hyaluronic acid injection.  And a bonus?  It’s permanent. 

  1. The “Eyes” Have It  

And we don’t have to tell you, pandemic stress and fatigue often reflects in our eyes – from dark circles to droopy or swollen lids. From upper eyelid blepharoplasty to undereye filler to Botox brow lifts, many patients sought procedures that would lighten and brighten their eyes, making them look less stressed, younger, and – well, more awake. Think of it as a more permanent undereye concealer.

  1. Liposculpting

As its name suggests, liposculpting is a variation on liposuction, where fat is removed from the body. However, with liposculpting, the physician does more than just removes unwanted fat. Through liposculpting, your body is reshaped, improving your body’s contour. 

Ideal candidates are over 18 years of age and no more than 25 pounds over their ideal body weight. Additionally, the fat has not disappeared naturally through diet and exercise. 

With COVID 15 (pounds that is), there is no doubt that this procedure will continue to be popular as we move into 2022. 

Thinking about exploring some cosmetic procedures as we move into a new year?  To get the most accurate information on cosmetic procedures, be sure to talk to a board-certified plastic surgeon.  Contact us today to learn more. 

The Dangers of TikTok’s Most Popular Procedure

On your TikTok FYP, you may have started seeing #BBL or #BBLjourney pop up.  Trending into the billions, #BBL has caught the attention of many – including critics.  And for good reason.

BBL stands for “Brazilian Butt Lift,” popularized by Kim Kardashian and others. When receiving a BBL, the surgeon takes fat from one part of the body through liposuction, transferring it to your hips, thighs, and butt, giving you that voluptuous fat-bottomed look.

Like many social media users, TikTokers are showing their before and after pictures, not only showing off their bigger booties but claiming the surgical procedure gives them the #BBLeffect. Sarcastically coined by TikToker Antoni Bumba, the “BBL effect is the unbothered confidence of those who have elected to bolster their buttocks,” essentially creating an unattainable savage diva effect.

Yes, you read that correctly.

Although many TikTokers are finding laughs in the #BBLeffect, poking fun at a cosmetic surgery that can change your attitude, the numbers don’t lie about this procedure’s skyrocketing popularity.

Citing the American Society for Aesthetic Plastic Surgery, Business Insider stated that in 2020, 40,000 butt augmentation surgeries were performed, raking in $140 million in revenue, with these surgeries increasing 90.3 percent between 2015 and 2019.

Additionally, with these surgeries dropping in costs, nationally from $5,507 to $3,329 on average, the procedure is more affordable. However, these lower prices haven’t prevented droves of patients from traveling to other countries, such as Mexico, in pursuit of cheaper procedures.

So, why the concern with TikTok boosting BBL posts?  Read on to learn about the potential dangers of this social media frenzy.

What Are the Dangers Associated with BBL?

With all surgical procedures, dangers can exist.  From going to an untrained surgeon to practices resulting in death, a BBL is not something to take lightly.

But couple that with the fact that TikTok is glorifying (and trivializing) plastic surgery to its primary audience—teens and children—it’s unsettling to say the least that young women are seeking to undergo surgery that alters their physical appearance when they’re not even done growing.

Potential Health Risks

When cosmetic surgeries become overly popular, you may find a host of unqualified, unlicensed practitioners willing to perform the procedure with unregulated standards of care in non-approved facilities, clearly putting profits above health and well-being.

Some physicians (not surgeons) can take an online or weekend class, learning how to perform a BBL. However, not going to a board-certified plastic surgeon can cause a higher risk of harm to willing patients, such as death, heart or pulmonary fat embolism (PFE), or irreparable physical damage.

A national medical malpractice law firm highlighted a traumatizing illustration of the dangers of a BBL when a 40-year-old woman died from a butt augmentation. According to the firm, the patient died during the surgery when “a vein deep in the patient’s buttocks was injured causing the fat being injected for the buttock lift to enter the bloodstream.  The medical examiner also found fat clots spread throughout the patient’s organs, heart, and lungs.” In this case, the surgeon was not board-certified in a specialty and did not carry any medical malpractice insurance.

In other cases, physicians may use fillers or silicone instead of fat.  Although both have been approved by the Food and Drug Administration (FDA), they are federally approved for breast or aging procedures, not butt augmentation. Using these products can give you undesirable results or may create significant complications, including death.

Other risks of BBL procedures include infection, bruising, stretch marks, blood clots, deep vein thrombosis, excessive blood loss, and complications from anesthesia or liposuction.

The Industry’s Response

In response to surgical abuses and the highest death rate of any cosmetic surgery, the American Association of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, International Society of Plastic Regenerative Surgeons, International Society of Aesthetic Plastic Surgery, and the International Federation for Adipose Therapeutics and Science formed the “Task Force for Safety in Gluteal Fat Grafting [the BBL Task Force] with the goal of conducting studies to develop specific safety guidelines.”

Representing board-certified plastic surgeons, this task force issued an advisory to surgeons in 2018, “urging discussion of these risks with patients and providing additional recommendations for the safe performance of the procedure.”

If you’re interested in getting this procedure but want it done safely and correctly, read on.

What Should You Consider Before Getting a BBL?

As recommended by the BBL Task Force, before signing up for a BBL procedure, consult with a board-certified plastic surgeon with experience in doing butt augmentations. Be sure to ask questions during this consultation, knowing how the surgery may impact your body. Ask about the surgeon’s fat injection techniques, understanding all the in’s and out’s of the surgery. Finally, ask about what risks or complications may occur and what you should do if they appear.

Your physician should also advise you on what to do pre-surgery and post-surgery, with safety as a priority. Additionally, your surgeon should discuss any medications you’re taking and how to handle these doses before and after the surgery.

A Real Eye-Opener: The Low Down on Blepharoplasty

Aging gracefully.  Sometimes Father Time makes the “gracefully” part challenging.  For many signs of aging, such as graying hair, a visit to your local stylist can fix that with hair dye.  However, what about your eyes?

You may have laugh lines that add character to your face. Those dark circles?  You finally found good makeup for those. 

But then there are saggy eyelids.  Developing in our late thirties and early forties, this droopiness may make you look more tired and older than you care to admit. 

A popular cosmetic surgery procedure, blepharoplasty (or “bleph” for short) is “an outpatient procedure that involves trimming excess tissue (that includes skin, muscle and fat) from around the eyelids. It can be performed by an ophthalmologist, oculoplastic surgeon, plastic surgeon, oral or maxillofacial surgeon, or ear, nose and throat surgeon.”

Some patients opt for blepharoplasty for cosmetic reasons, as we discussed above. Other patients, however, choose this procedure to correct vision issues as sagging eyelids can impair your vision. Surgery can be performed on both the upper and lower lids. 

Read on to see if you’re a good candidate for eyelid surgery.

Are You a Good Candidate for Blepharoplasty?

To fully know if you are a good candidate for eyelid surgery, consult with a board-certified physician with significant experience in blepharoplasty procedures. However, here are some things to consider when determining if this surgery is right for you:

  • You’re physically healthy.
  • You have no health conditions that can interfere with healing.
  • You’re a non-smoker.
  • You don’t have any eye conditions, such as dry eyes, that can interfere with the surgery itself or the healing process.

Your physician can weigh these conditions during your consultation, advising you if you’re a good candidate for surgery. Of course, in deciding whether to move forward, you should discuss the possible risks involved while expressing any expectations and concerns. Information is abundant but not always reliable, so it is always best to openly discuss the process and your concerns with your surgeon.

What to Expect Before the Surgery?

Before surgery, be prepared to have both a vision and physical exam done. You’ll also be instructed to arrange for transportation on the day of the surgery, as you will be unable to drive. You may also be asked to discuss your medical history and to avoid specific medicines, such as aspirin, before the procedure, as they can often cause bruising and excessive bleeding. Additionally, if you’re a smoker, you’ll be advised to stop smoking so as not to interfere with your healing process.

What to Expect During the Surgery?

During the surgery, you may be put under general anesthesia.  If you have ever had any adverse reactions to anesthesia in the past, be sure to tell your doctor in your pre-surgery consultation. 

Some doctors, however, may give you a mild sedative or local anesthetic, where you’ll be awake during the procedure. Discuss these options with your doctor, determining which is best for you.

Next, the doctor creates an incision, opening up the eyes by removing excess skin and fat from the area, improving your appearance. This may also help in fixing any overhanging skin that could be affecting your vision. Incisions are made in the natural folds of the eyelid, making scarring virtually unnoticeable once the healing process is complete.

Here are some standard techniques used during a blepharoplasty procedure:

Transconjunctival Blepharoplasty

This procedure is ideal for younger patients, who have fatty pockets under their eyes but no excess skin.

Transconjunctival Blepharoplasty with the Pinch Technique

This procedure is ideal for patients who have only a small amount of excess skin under their lower lid, utilizing a pinch technique.

Peels and Laser Resurfacing of the Lower Eyelid

In situations where a patient has excessive fine wrinkling or discoloration in the lower lid, a chemical peel or laser resurfacing can be performed along with surgery.

External Incisions & Canthoplasty

More severe eyelid conditions may require a reconstructive approach. These conditions include drooping lower lids, sagging skin and muscle of the lower lids, and tear trough deformity. Board-certified plastic surgeons may use various methods to shape and perfect the eye area, brightening the patient’s face.

Eyelid incisions are typically closed with skin glue or sutures. If sutures are used, then they are usually removed within a week.

What to Expect After the Surgery?

Like many cosmetic procedures, your results will appear gradually as the bruising and swelling diminish. Sutures will either dissolve or be removed within a week after the surgery. Patients can expect to experience some short-term discomfort such as light sensitivity, watery eyes, or dry eyes. You may also experience some discomfort or itching at the incision points.

Although severe complications are rare, patients should avoid straining or heavy lifting, rubbing the eyes, or wearing contacts, immediately following surgery. They should also make sure to wear darkly tinted sunglasses to protect their eyes from sunlight. You should also sleep with your head raised higher than your chest for a few days. Be gentle when cleaning the eyelids, and avoid makeup for ten days.

As you recover, you may use cold compresses or lubricating ointments, helping with any discomfort you may experience. Your doctor will give you further instructions for care, such as which oral medications are permissible. Further, your doctor will set a follow-up appointment, checking your healing process.

Schedule a Consultation

Ready to look bright and refreshed? Schedule a  consultation with Dr. Binder today to discuss what blepharoplasty can do for you. With over 30 years of experience in the industry, Dr. Binder has the skills and expertise to give you the results you deserve.

How Botox Can Help Reverse Sun-Damaged Skin

Ah, summer. Sand, waves, and a good beach read. Many of us dream of having this kind of downtime, helping us to recharge and regroup.

However, those summer rays can do some damage if you’re not careful. Remember your freckles as a kid? Or that vacation where your shoulders and face burned?  Or, if you’re of a “certain age,” maybe you laid out with baby oil. On foil. Yikes.

All of these examples can cause or are signs of sun-damaged skin, which can appear as early as our teens or 20s.

According to the Skin Cancer Foundation, if you’ve received five or more sunburns over your lifetime, you have doubled your risk for melanoma. Further, 90 percent of “skin aging is caused by the sun.” Sun damage is also cumulative. Each year of too much sun exposure can increase damage to your skin. 

But all’s not lost. The damage to sun-soaked skin can be reversed if you know your options. 

Read on to learn about how Botox can help reverse your sun-damaged skin.

Signs of Sun-Damaged Skin

Signs of sun-damaged skin are numerous, depending on the pigmentation of your skin and your exposure. However, common signs include:

  • wrinkles, 
  • dark or sunspots, 
  • uneven skin tone, 
  • blotchiness or redness, or
  • dry, coarse, or leathery skin texture. 

When the sun damages our skin, it essentially breaks down the skin’s structure, weakening it.  Further, the resulting damage often does not appear until years after the exposure.  

How to Protect Yourself

The best way to protect yourself from sun exposure is to—well—stay out of the sun.  Although this is an impossibility for most of us, the theory itself can be extended to everyday life.

For example, you can wear a hat to shield the sensitive skin on your face from the sun. You can sit in the shade or under a beach umbrella, preventing the sun’s rays from wrinkling or blotching your skin. 

Further, unlike the lack of advice in the 70s and 80s, now, it’s common to hear about the benefits of sunscreen, for your face, body, and lips. According to Cleveland Clinic, most people should use sunscreen with lead at 30 sun protection factors (SPF). If you’ve had skin cancer yourself or your family has a history of skin cancer, you should wear a higher SPF.

You can also use facial moisturizers and creams containing retinoids, vitamin C, and antioxidants. These elements can reduce the appearance of sunspots as well as the size of your pores, giving you a more youthful look. 

Don’t forget to shed those dull, dead skin cells with exfoliants, helping with uneven skin tones, dry skin, and clogged pores. 

With proper guidance, you can also pursue chemical peels, laser therapy, or lightening agents, evening out your skin tone while removing sunspots and blemishes caused by sun exposure. Again, be sure you work with someone skilled in these procedures, giving your look a boost. 

How Does Botox Help to Reverse Sun Damaged Skin?

Botox Is one of the “most versatile medical tools” available today. In addition to treating migraines, bladder disorders, and TMJ, Botox is most used “to eliminate the appearance of fine lines and wrinkles on the face and neck,” including those caused by sun exposure.

The drug Botox is typically administered through an injection, weakening and paralyzing the underlying muscle. Because of this paralysis, Botox can reduce the appearance of wrinkles by smoothing the skin. With the sun potentially causing deeper lines and wrinkles, Botox injections may be an ideal treatment.

 It’s important to know that Botox doesn’t eliminate wrinkles.  However, with proper use of Botox and as advised by your dermatologist or plastic surgeon, you can reduce the appearance of sun damage for three to six months before you need another injection. Over time, you may find that you only need two injections yearly to maintain your desired appearance. 

Even if your teens or 20s are well in the past, it’s never too late to protect your skin from sun exposure. However, just like with any procedure, cutting corners is not advised. Instead, a qualified and experienced physician can analyze previous damage to your skin, informing you of the best approach forward. So, to get that youthful, smooth skin, contact us today!

eyelid surgery

Why You Could Be Causing Premature Aging

Ah, aging. You either embrace it or hate it. Unfortunately, there doesn’t seem to be much in-between.

But one thing is for sure. Plastic surgeons are frequently asked about the best way to reverse the aging process. Is it through fillers? Botox? Facial contouring?

One way to reverse or slow the aging process is to look at how you live your life. Through your daily activities, you may be causing your own premature aging.

Let’s look at some ways you could be causing premature aging and what you can do to combat it.

The Culprits of Premature Aging

Exposure to the Sun

According to the Skin Cancer Foundation, sun exposure is “the number one cause of aging.” If you’re of a certain age, this may make your skin crawl (in addition to aging). For those of us who laid out in the sun with nothing but baby oil back in the 1970s and 1980s, we may be seeing those carefree summer activities now reflected on our faces with premature wrinkling and sagging.

Ultraviolet (UV) radiation, part of the sun’s rays, “speeds the natural aging process [and ] is the primary cause of early wrinkling,” according to Mayo Clinic. UV rays exposure “breaks down your skin’s connective tissue—collagen and elastin fibers, which lie in the deeper layer of skin.” When your connective tissue breaks down and weakens, your skin loses its flexibility and strength, causing it to wrinkle and sag.

If you learned anything from those days of laying out with baby oil, it’s to wear sunscreen—anytime you’re in the sun for an extended period of time. So don’t forget protection for your skin when you’re outside gardening, at a ball game, taking a long walk, or, of course, at the beach or pool. It will do wonders for your skin.


Smoking, another culprit, can prematurely age your skin as well.  According to the American Osteopathic College of Dermatology, smoking is directly linked to “premature aging of the skin, increased amount[s] of infections, and delayed wound healing.” And if that weren’t enough, smokers are more apt to get inflammatory skin diseases than their non-smoking counterparts.

And the Mayo Clinic says that smoking can accelerate the aging process, giving you “crow’s-feet, pronounced lines between the eyebrows, uneven skin complexion, a grayish tone on lighter skin, deep creases and puffiness below the eyes, wrinkles around the mouth, and thinner lips.”

The best course of action is to stop smoking, often easier said than done. However, if you can back down on smoking, including vaping (and eventually quit), your skin will thank you.

Lack of Sleep

Quality sleep plays an integral role in our health. It helps our bodies recover and heal, letting us wake up well-rested, ready to take on what the day brings. However, for many of us, quality sleep is as elusive as a rainbow-colored unicorn.

According to the Sleep Foundation, over one in three people sleep less than seven hours a night. In addition, close to half of all Americans “say they feel sleepy during the day between three and seven days per week.” Between 30 percent and 48 percent of older adults have insomnia.

If you’re not sleeping enough hours or not sleeping soundly, then your body’s largest organ—your skin—will show it. Without good sleep, your skin can’t renew. Taking time to figure out what helps you sleep better can help slow signs of aging. Is it your mattress? A snoring spouse?  Toddlers jumping in bed with you? Think about how you can reduce distractions, allowing you to drift off – and stay asleep – in dreamland for at least seven hours nightly.


Like smoking, stress directly impacts our physical and mental health. And our skin is not exempt. As reported by the Business Insider, “[h]igh amounts of cortisol – the stress hormone – can break down the skin’s collagen and elastin, and form wrinkles.”

Citing to two different scientific studies published in the National Institute of Health’s journal, Business Insider further reports that “chronic stress can have negative effects on skin aging and cause wrinkles to form . . . because stress causes inflammation and impairs the body’s ability to repair itself.” Further, Business Insider cites that “[r]esearch has found that skin aging is often accompanied with a two to four times increase in plasma levels of inflammation.”

Learning how to combat stress seems to be a never-ending task. However, prioritizing yourself and your mental and physical health, can do wonders for your skin – as well as the rest of your body.

Although this list of culprits is a good start, it’s not comprehensive. We didn’t get a chance to talk about pollution and toxins, poor diet choices, and making repeated facial expressions (yep, that one). All contribute to premature aging as well. If you’d like to learn more ways about combatting premature aging, call Dr. Binder, an esteemed, board-certified plastic surgeon in Beverly Hills.

Eyelid Surgery Los Angeles

Facial Implants: An Inside Look into the Ultimate Contouring Job

From “selfie-awareness” to the “Zoom effect,” people have spent more time looking at their facial features more than at any other time in history. According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), 83 percent of respondents in a recent survey indicated that the “Zoom effect” was a major indicator in seeking change, such as undergoing plastic surgery.

A recent study published in AAFPRS’s journal, Facial Plastic Surgery & Aesthetic Medicine, found that “ZOOM dysmorphia” had “a huge impact on the way we view ourselves.” Simply, through this hyperawareness of our images on live video (with no filters), people are turning to plastic surgery to fix imperfections and balance facial structure, creating a more pleasing look (and boosting self-confidence).

Whether on a Zoom call or not, a receding chin, undefined cheeks, a narrow jawline, or damaged facial tissue can make many of us less confident socially interacting with others. We can now achieve a more balanced, aesthetically pleasing image through facial implants.

What are Facial Implants for Contouring?

With facial implants, you can change the contouring and structure of the face by inserting implants into the cheeks, chin, or jaw, enhancing the definition and look of your facial features. Facial contouring, specifically, is “the art and science of merging plastic surgical techniques with these newer implant designs to improve the relative balance of facial features.”

Today’s implants are also very different than those used in the past. “Contemporary facial implants are contoured to imitate the natural bone structure and youthful form of the overlying soft tissues. They may extend over smaller or larger areas with different thicknesses to create varying projections, thus enhancing either a portion or the entire cheek or jawline,” according to Dr. William Binder.

Additionally, these modern implants—typically made of solid silicone elastomer or rubber–can not only fix facial imperfections and feature imbalance, but they can also reverse signs of aging. As facial tissue begins to sag as we climb the years, facial implants can increase volume and definition, making us look younger. These types of inserts have been found to stand the test of time while maintaining “both shape and flexibility and this feel[ing] perfectly natural over the facial structure.”

Types of Facial Implants

For the Chin

If your chin recedes or isn’t defined to your liking, you can get a chin implant. Not your mother’s implants, these “wrap around the entire chin and mandible, provid[ing] a more natural look from both the front and side views than the older button-like chin implants used years ago.”

Chin implants help contour the face by building up the chin, creating a better profile and improving facial symmetry. These implants can also help with sagging skin around the chin, common as we age, by eliminating the double chin or sagging skin, causing us to look older.

A relatively minor procedure, you can receive chin implants in 30-40 minutes as an outpatient procedure.

For the Cheeks

Perhaps you have drooping skin around your cheeks. In that case, cheek implants may be for you. This procedure can dramatically alter your appearance, giving you those classic high cheekbones that most desire. According to Dr. Binder, “[o]lder cheek implants which often created an artificial appearance have been eliminated as a result of the new, more anatomically-designed cheek implants. These take into account the entire area we perceived as ‘cheekbones’ and compensate for both the bone and soft tissue components that comprise the aesthetically desirable ‘high cheekbone effect.’”

You can receive cheek implants in about an hour as an outpatient procedure.


For the Jawline

Another area that benefits from contouring is the jawline. Facial implants can add structure, definition, and volume to the jawline, and are commonly elected among both women and men. Like chin and cheek implants, jaw implants can also balance out all facial features, giving the patient facial symmetry.

More complex than chin or cheek implants, this surgery will take one to two hours as an outpatient procedure.

Using Technology in Face Contouring

Let’s give these new implants a further look. Today, “three-dimensional computer technology is now used for the production of a new generation of more accurate, anatomic facial implants that permit more effective, long-lasting and pleasing results in facial augmentation.”

Here’s how it works

This process begins with a CAT scan taken of the anatomical area surrounding the defect. A computerized three-dimensional image is created from the scan and is available for examination through a video screen. It is then transformed into an exact life-size model of the skeletal structure. The anatomical model is then used to facilitate production of an extremely accurate implant that will exactly correct the contour deformity. The back surface of the implant is extremely precise, fitting the contour of the bony defect and interlocking with the underlying bone to provide long-term stability, preventing movement or slippage.

. . .

With the actual procedure minimized, operative time is reduced and the procedure can usually be performed on an outpatient basis with less complications and a considerable reduction in cost.

However, remember that facial implants and contouring are medical procedures, and cutting corners is not advised. Instead, a qualified and experienced physician can analyze the symmetry of your face, informing you of the best approach forward. So, to get that Zoom-ready image, contact us today!

evolution of botox

The Evolution of Botox: How Millennials and Gen Z have Normalized Getting Injections

If you Google “selfies” along with “Millennials” and “Gen Z,” you get a slew of results discussing new selfie poses and angles. In that case, selfies behaviors that should stop now, and how certain hashtags are traumatizing a generation (so, don’t use those). 

But you won’t find an article on how selfies are on their way out. A recent Google study found that about 93 million selfies were taken each day in 2014 on Android phones alone, as cited by Science Daily. Another study indicates that every third photo for 18-24 year-olds representing Generation Z.

In 2013, the Oxford English Dictionary added the word “selfie” to its tome, giving it the distinction of “word of the year.” And there’s even a National Selfie Day–June 21st, in case you want to mark it in your calendar.

With social media and, in particular, selfies continuing to reach their heights of popularity, we continue to live in a world where appearance matters. Using filters and digital photo correction (all from your smartphone), you can brush over those dark circles or laugh lines while making yourself look brighter, smoother, and younger in seconds. 

Because of this, Millennials and Gen Z are seeking plastic surgery options earlier than any other generation, making it more the norm rather than a secret of the rich. Younger generations approach such treatments like botox to be preventive, often dubbing the procedure as “baby Botox.”

According to the American Society of Aesthetic Plastic Surgery, in 2018, people under 34 underwent more cosmetic surgery procedures than those in the 51 to 64-year-old age group. And, according to the American Academy of Facial Plastic and Reconstructive Surgery, in 2018, 55 percent of patients showed their plastic surgeon a selfie when discussing their medical goals.

Read on to learn more about Botox and why younger generations flock to it.

What is Botox?

Scientifically speaking, Botox is the isolated form of the bacterium Clostridium botulinum (also known as the botulinum toxin known for causing lockjaw). Once injected under the skin, into the muscle, the bacteria paralyzes your underlying facial muscles, preventing wrinkles and sagging of the skin, helping to curb premature aging.

Not to worry, though. According to Mayo Clinic, Botox injections are relatively safe when injected by an experienced doctor. 

How Does Botox Work?

When deciding if Botox is for you, you should understand how it works – what it does and what it doesn’t do. First, Botox does not eliminate wrinkles or make them disappear permanently. Instead, it removes (or softens) wrinkles for some time by paralyzing the underlying muscle. 

Typically, Botox injections last between three and six months. Once they wear off, then your fine lines and wrinkles will reappear; however, although they’ll reappear, the fine lines and wrinkles will be less apparent as each injection of Botox shrinks the underlying muscle.

Are There Any Side Effects to Botox?

Although Botox injections are relatively safe when performed by an experienced physician, you may experience side effects. For example, you may have pain, bruising, or swelling at the injection site, according to Mayo Clinic. Additionally, you may experience flu-like symptoms, muscle weakness, or a headache after receiving a Botox injection.

Your doctor can tell you how to prepare for your Botox injection, helping you reduce the chances for side effects. For example, if you ice the area before receiving your injection, you may reduce your pain. It’s best to talk to your doctor before receiving a Botox injection so you can be prepared, knowing what to expect both during the procedure and after.

How Does Botox Differ from Fillers?

According to the American Society of Plastic Surgeons, botox and dermal fillers are two of the most popular minimally invasive procedures performed in the U.S. However, they are not the same.

As discussed above, Botox contains a purified bacteria that paralyzes the muscles under the skin, minimizing fine lines and wrinkles. Also used to combat premature aging, fillers are also injected under the skin. On the other hand, dermal fillers add fullness to desired areas, such as around the lips. Fillers can also treat common areas for wrinkles, such as smile lines, and may reduce the appearance of scars.

Although there is some overlap in the desired outcome for Botox and fillers, the key difference lies in how each product works, from freezing to plumping.

Millennials and Gen Z are effectively erasing any stigma around plastic surgery through social media, selfies, and attitudes towards health and aging, including “preventive” procedures such as Botox injections. By normalizing these procedures as a part of your regular self-care routine, these procedures will likely continue to rise in popularity.

However, remember that they are medical procedures, and cutting corners is not advised. Instead, a qualified and experienced professional like Dr. Binder can analyze your fine lines and wrinkles, informing you of the best approach forward. So, to combat premature aging, contact us today and be ready for your filter-less selfie!

prepare for rhinoplasty

How Should I Prepare for My Rhinoplasty?

A rhinoplasty, often referred to as a nose job, is by far one of the most popular cosmetic surgical procedures in the U.S. and has been for the last three years, according to the Plastic Surgery Statistics Report 2020. It’s also one of the most difficult procedures, with revision (or corrective surgery) rates as high as 15 percent.

This USD 6.2 billion market shows no sign of slowing down, with a compound annual growth rate of 6.5 percent between 2021 and 2028. All impressive figures. But what is rhinoplasty and how should you prepare for one?

According to the American Society of Plastic Surgeons, rhinoplasty “enhances facial harmony and the proportions of your nose.” And the nose, no doubt, is a complex organ, right in the middle of your face. So, any flaw can easily disrupt not only your sense of smell and breathing but the proportions and symmetry of your face.

There are many reasons to get a nose job, separate from looks alone. For example, patients may decide to undergo rhinoplasty for a deviated septum, structural damage, or breathing problems. However, even when fixing non-cosmetic issues with the nose, the surgeon must focus on both the nose’s complex functions and natural shape, “crucially important for patients’ physical and psychological well-being.”

Read on to learn more about rhinoplasty and the recommended preparations you should take before surgery.

Before Your Rhinoplasty

Before your rhinoplasty surgery, the surgeon office will want to meet with you, and potentially run some lab tests and x-rays, depending on your current health and the reason why you want to undergo a rhinoplasty. You’ll also need to provide a list of your medications. 

Your surgeon will also walk you through the steps of your surgery and recovery. Be sure to arrange for someone to drive you home after your surgery, as most patients leave the hospital or accredited surgery center the same day.      

The Surgery Itself

Now let’s look at the procedure itself.

As with any surgery, you’ll receive general anesthesia or intravenous sedation, whichever is the best choice for you. Next, the incision.

American Society of Plastic Surgeons, explains that rhinoplasty “is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.” 

Through these incisions, the surgeon can reshape your nose’s structure by removing bone or cartilage or by adding cartilage grafts.

After your incisions are closed, the surgeon will set your nose with splints, gauze and/or bandages, giving your nose additional support while you heal in the first few days. 

Let’s look more specifically as to what to expect post-surgery.

After Your Rhinoplasty

Once your nose is set, and you’re home, you may experience soreness and swelling. Because of the swelling, it may be difficult to see you’re improved nose. However, after a few days, as the swelling goes down, you’ll begin to see how your nose will look permanently. If swelling seems to come and go over the course of the first year, no worries—this is normal. 

Be sure to be an active participant in your recovery. Understand how to care for your incisions during healing. Take any medicines as prescribed. Follow up with your surgeon. Know how long you should rest and when you can resume normal activities. More than likely, running a marathon or scuba diving will be out of the question until you’re fully recovered.

 If anything looks out of sorts, call your doctor’s office. 

What If You Need a Revision

What if you’ve already had a rhinoplasty, and it didn’t seem to fix your structural problems, or it doesn’t look like it should. Perhaps it looks “skeletonized,” or artificial. Perhaps it collapsed, giving you additional breathing problems. 

Technically, revision rhinoplasties embrace “the concept of ‘reinforcing noses’ that have been structurally weakened by previous surgeries or require further aesthetic correction. In most cases, a good portion of revision rhinoplasty demands a clear understanding of the functional or breathing problems that are often simultaneously associated with these revision cases.” You may need a revision rhinoplasty when this occurs, meaning you may need additional minor or major procedures

And, if you think a regular rhinoplasty is complicated, imagine fixing one. 

To fix a bad nose job, you need to go to a surgeon with expertise in this area, making sure you have a good outcome. Dr. Binder can analyze your nose for your first rhinoplasty, or analyze your botched surgery, taking you through the steps for your revisions—getting you back on path. Contact us today and be ready for your close-up!

acne scar treatment

The Four Types of Acne Scars and How to Treat Them

Skin reflects life experience. Every surface evolves with each smile, frown, and gesture. But when impurities settle into the skin, they can obscure the appearance you wish to project.

Acne is caused by blocked pores and excess sebum (oils). When breakouts are pronounced, they can leave scars that may require medical attention. Before you decide how to address your unique pattern of scarring, let’s assess the four major types of tissue that result from acne.

Hypertrophic vs. Atrophic

There are two main categories of acne scars: atrophic and hypertrophic. The depletion of collagen leads to tissue loss, which is the source of atrophic scars. Atrophic marks often appear as divots or craters in the surface of the skin.

On the other end of the spectrum, too much tissue in a given area is the hallmark of a hypertrophic scar. Raised marks and discoloration can disrupt your natural attractiveness, making hypertrophic scarring quite problematic.

Keloids are an even more severe type of scar than the regular hypertrophic variety. Hypertrophic scars rise above the skin’s surface, but keloids go one step further: they extend beyond the border of the original abrasion. Keloid scars can cause discomfort as they stretch the skin and expand the site of a wound.

Treating Hypertrophic and Keloid Scars

The key to keloid and hypertrophic scar treatment is minimization. Collagen has already accumulated to patch the skin, but it has left a bulky, unsightly blotch in its place. Your doctor can reduce this phenomenon by applying silicone gel sheets to the affected area. A gel will flatten and soften the skin, making it blend more aesthetically with its surroundings. 

In certain situations, your cosmetic care team may recommend laser treatments to ablate the raised portion of a scar and even the proverbial playing field. The exact approach to fixing a keloid or hypertrophic scar depends on the nature of the tissue, the skin tone of the patient, and the desired goal of the procedure. 

Types of Atrophic Scars

As our bodies age, we produce less and less collagen. Collagen is the most prevalent protein in the human body, and it is instrumental in the maintenance and regeneration of the skin.

When the surface of the skin is broken, collagen rushes to the area. This could result in the hypertrophic scar patterns described above, or the collagen surge may be insufficient to patch the wound properly. In the latter case, atrophic scars occur.

But not all atrophic scars are created equal. They manifest in three different ways: ice pick, rolling and boxcar. The main characteristic of ice pick scars is the wedge shape that slices its way through the epidermis and into the dermis. 

On the other hand, a rolling scar gets its name from the irregular, undefined nature of its appearance. The contours of rolling scars are nebulous, stretching beyond the parameters of the original breakout. As collagen filters to the area to heal the patchwork quilt of acne, it forms blotchy, uneven protrusions, like rolling hills.

The third type of atrophic scar pattern is the boxcar variety. When acne leaves pitted, deep punches in the skin, are known as boxcar scars. The sides of a boxcar scar are parallel, delving deep into the dermis. Unlike ice pick scars, they require more attention to adequately fill in the gaps left behind by acne breakouts.

How to Treat Atrophic Scarring

The treatment you require for a loss of tissue due to acne will depend on the type of atrophic scars you are experiencing. 

If a boxcar mark is especially severe, you may need to fill in the area. This can be achieved in various ways, but the correct procedure will depend upon your physiology and complexion. Your doctor may suggest fat grafting to patch a boxcar scar. This process begins with a gentle removal of excess fat from elsewhere on your body. Once the lipids are purified, they are ready for transfer to the area depleted by acne. Boxcar divots can be patched and raised until they are level with the surrounding skin.

Ice pick scars are easier to address since they require more minor corrections than boxcar scarring issues. Your physician can administer a simple course of Botox to ease the tension along the edges of an ice pick scar. This allows your skin to naturally relax and adhere to a more even, flattened appearance. If you need a bit more volume underneath the surface, your doctor can also inject a facial filler at the root of an atrophic scar. Fillers round out the area like you are adding air to a balloon. The surface enjoys a renewed vigor for months at a time, depending on which injectable (or combination of injectables) you use.

Rolling scars are often more difficult to correct than the ice pick or boxcar phenomena described above. Due to the irregular formation of rolling scars, a surgeon may wish to disrupt the abnormality according to its shape.

For example, if the edges of a scar are stretching in opposite or diagonal directions, a Z-plasty procedure can guide the skin into a more pleasing declination. Z-plasty acne treatment begins with a skillful, small series of incisions in the shape of a Z (hence the name). The ridges of this incision are gently sutured together, allowing the skin to heal appropriately and beautifully.

Pamper Your Skin

Just as each case of acne is different, so too are their potential treatments. To determine the right approach for your skin, you should visit a knowledgeable leader in the field of aesthetic enhancement.

Dr. Binder can analyze your acne scarring issues and advise you on the best path back to your ideal look. Contact us today and be ready to be ravishing!

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