Skin Damage: Common Culprits and How to Avoid Them

Unavoidably, the skin becomes weaker as it ages, making it more susceptible to damage from simply living life. However, there are also many other factors that weaken and damage skin that are totally avoidable. Ideally, people should start taking precautions to avoid these factors at a young age, but even older people or people who already have significant skin damage can take these precautions to avoid further damage. Read on for common causes of skin damage, as well as advice on minimizing their impact on your skin.

Sun Exposure

Exposure to the sun is probably the most common cause of skin damage. In fact, most of the changes we think of as simply a part of aging are actually due to sun exposure. Signs of aging caused by the sun include wrinkles, a loss of elasticity in the skin, sallowness, dilation of small blood cells under the skin, freckles, sunspots, and other forms of discoloration. The sun can also cause more significant damage by causing the development of benign, cancerous, or precancerous tumors.

Fortunately, there are also plenty of simple precautions that can be taken to minimize the impact of this common culprit. Try to avoid sun exposure when the sun is at its most damaging, between 10 a.m. and 2 p.m. Hats, sunglasses, contact lenses, and even clothes with sun protection are available. Most importantly, wear sunscreen, or a product that contains it, such as cosmetics or a moisturizer, with at least SPF 30 and zinc oxide daily. Apply at least 20 minutes before sun exposure and reapply every two hours if you’re sweating or swimming. Be careful about layering products with sun protection, as the active ingredients in some products can break down when they come into contact and you only get the protection of the strongest product regardless.


Irritants can be almost anything, but are most commonly strong chemicals, allergens, or something environmental. Most chemicals, like water, have no effect on you or can even be good for you. However, some chemicals, like bleach or ammonia, can irritate the skin causing damage via chemical burns or dermatitis, which is scaliness or irritation that can occur at the site of contact or elsewhere. Irritants can also be substances that a person is allergic to, such as an ingredient in a cosmetic or skin care product, or something that they encounter in their environment, such as smoke, fumes, and other pollutants.

Most people know to avoid things they’re allergic to, but it can be hard to predict how your body will respond to something new. Patch test new products on a less visible part of your body before applying them to your face so you can see how you respond. You can learn what triggers irritation for you by keeping a list of the ingredients of products that cause irritation to help your doctor determine the exact cause. Your doctor may also recommend a clinical allergy test. Whenever you notice skin irritation, thoroughly but gently wash the spot immediately to remove the irritant from the skin.


Smoking causes blood vessels to contract. One effect of this is that nutrients and oxygen aren’t carried to the skin effectively, causing it to wrinkle, lose elasticity, and become less able to heal efficiently. The more you smoke, the more damage occurs. If you don’t smoke, don’t start. If you do smoke, there are plenty of tools to help you quit, including nicotine gum, lozenges, patches, inhalers, and nasal sprays, as well as prescription medication. Your doctor can help you determine the best way for you to quit.

Acne Scars

There’s a myth that only teens experience acne; and while it’s true that puberty is usually the worst time for acne, adults, especially women, are experiencing acne at growing rates. Adult acne alone can be annoying, but when coupled with the long term damage of acne scars, it’s even more frustrating. The most common cause of acne scarring is an inadequate healing environment, such as dry or dirty skin and constant irritation.

The best way to prevent acne scarring is to prevent acne in the first place. Use acne fighting products if you’re prone to breakouts. Keep cosmetics to a minimum and be sure to thoroughly cleanse the face in the evening to remove them and other debris from the day. Use non-comedogenic (oil free) products, but be sure to moisturize. If you do break out, you can avoid acne scarring by doing many of the same things you do to avoid acne, as healthy skin is better able to both fight acne and heal scars.

Continue to use acne fighting products and moisturizer. It can be tempting to slather a breakout in foundation and concealer to hide it, but it’s best to let the break out breathe. If you must cover the blemish, remove the product as soon as you can. Don’t pick at the breakout or the scar, as this will only further irritation, which causes scarring and can actually worsen existing scars. Vitamin E is often touted as a way to prevent scarring, but there’s actually evidence to suggest that it impairs the healing process. Instead, use a cortisone product to prevent and even heal scarring.

Treating Skin Damage

Avoiding skin damage in the first place is the best way to help the health and appearance of your skin, but there’s no need to fret if you already have skin damage. Dr. William J. Binder has many treatment options available for reversing damage to your skin. If you have skin damage that you want taken care of, contact our office today to schedule your consultation.


Is Hardened Skin after a Rhinoplasty Normal?

Most people know to expect soreness and swelling after their rhinoplasty surgery, but one particular after-effect often takes patients by surprise. A few weeks after surgery, many patients are shocked to discover that the skin on their nose, especially around the tip of the nose, feels hard or firm. While not all patients experience this phenomenon, it is a relatively common, but rarely permanent, side effect of rhinoplasty surgery.

What Causes Hardened Skin after Rhinoplasty?

There are two major reasons for the skin on the nose to feel hard after rhinoplasty, but neither has to do with the skin itself. The hardness does not actually reflect a change in the skin, but rather the tissue underneath.

Edema (swelling caused by liquid under the skin) is the most common cause of hardness in the months directly following surgery. Built up scar tissue, however, does not fade so quickly, causing long term, even permanent, feelings of hardness. These two things generally cause a greater feeling of hardness for patients who already had thick skin on their nose.

How Long after Surgery Does Hardened Skin Last?

While the sensation of hard-feeling skin can be off-putting for patients, this hard skin is typically neither visible nor permanent. The nose, especially the tip, will remain hard for several months after surgery, after which the tissue will begin to soften as the remaining swelling fades. It will, however, not reach full softness until about a year after surgery.

It is recommended that patients wait one to two years after their rhinoplasty before seeking treatment for their hardened tissue or a revision rhinoplasty because tissue may soften, results can change during this time period, and surgical techniques are more difficult when the surgeon has to work around hard scar tissue.

Treating Persistent Hardened Skin

If you still experience hardened skin two or more years after your rhinoplasty, there are several treatment options. The two most common are steroid injections and revision rhinoplasty. The medication in steroid injections is very successful in breaking down scar tissue and is not particularly invasive.

Revision rhinoplasty, on the other hand, requires the surgical removal of built up scar tissue. This allows for more extensive changes than steroid injections and allows the surgeon to address any cosmetic issues the patient has after their surgery; but if not conducted in a delicate manner, revision rhinoplasty can lead to even more build up of scar tissue.

For this reason, it is important that the patient choose a skilled doctor with ample experience in detailed rhinoplasty surgery. Patients should always look at their prospective surgeons’ patient reviews and before and after photos to ensure that their surgical experience will leave them with the results they want.

Preventing Hardened Skin

Unfortunately, there is little the patient can do themselves to prevent hardened skin after their rhinoplasty surgery. However, the right plastic surgeon can minimize hardness by minimizing swelling and scar tissue, so it is important that the patient takes the time and effort to carefully select an experienced plastic surgeon. This is also true, perhaps even more so, for patients seeking a revision rhinoplasty, as hard scar tissue complicates the surgical process.

Dr. William J. Binder

Dr. William J. Binder is one such surgeon whose office is conveniently located in Beverly Hills. Not only is Dr. Binder skilled and experienced, he’s a facial and reconstructive plastic surgery specialist, and one of the world’s leading plastic surgeons; he has multiple patents, extensive published works, and board certifications from both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology and Head and Neck Surgery.

Whether you want your hardened skin treated, or are planning an initial rhinoplasty procedure and hope to avoid hardened skin altogether, Dr. Binder is heads above the rest. Contact his office today to schedule your consultation.


Revision Surgery: Why Some Go Under the Knife Again

No one gets plastic surgery expecting to have to modify their results, but nonetheless it sometimes happens. The most common revision surgeries are scar revision and revision rhinoplasty, but virtually any plastic surgery procedure can be revised. There are a number of reasons why patients might feel the need to undergo revision surgery.

Displeasure with Aesthetic Results

Sometimes plastic surgery patients simply do not get the aesthetic results they were hoping for out of plastic surgery. Sometimes this is because the patient did not have realistic expectations about what plastic surgery can achieve or because of an unskilled plastic surgeon, but often this occurs because of miscommunication between the doctor and the patient.

Excessive Scarring

Virtually any plastic surgery will leave some scarring, but usually the scarring is thin, minimal, and not easily visible. In some cases, however, scarring can be obvious, turning what would have been beautiful results into something displeasing and unsatisfactory. This can be due to a variety of different things, including improper surgical technique, or complications such as an infection during healing.

Change in Results

In other cases, the appearance of results simply change. This change can be due to any number of things, including aging, weight gain or loss, or trauma to the site of the surgery. Aging and weight loss can partially or fully reverse the results of surgery or simply change the contours and proportions of the face, making plastic surgery results that previously looked wonderful appear less than beautiful. Trauma can damage or move implants and delicate tissue, causing not only aesthetic concerns, but also potential health problems.

Functional Problems

Functional issues after plastic surgery are rare, but are most common after rhinoplasty. In some cases, rhinoplasty can result in obstruction in one or both of the nasal passages, significantly impairing the patient’s ability to breath and often, by extension, to get adequate sleep.

Choosing the Right Plastic Surgeon for Your Revision Surgery

Choosing the right plastic surgeon for revision plastic surgery is just as important as choosing the right plastic surgeon for your initial cosmetic surgery procedure, and is imperative in ensuring satisfaction with the results of the revision surgery.

The reasons patients seek revision surgery often mean that the surgeon who conducts the procedure needs to be highly skilled and very experienced. Ideally, patients are able to seek out a surgeon who specializes in revision and reconstruction procedures. Specialized plastic surgeons are able to give patients far better results than their more generalized peers because specialists have unique knowledge and experiences about revision procedures.

Dr. William J. Binder

One revision and reconstruction plastic surgery specialist, who also happens to be one of the world’s leading plastic surgeons, happens to be located in Los Angeles. Dr. Binder has a passion for educating patients and helping them meet their aesthetic goals, whether through an initial procedure or as part of a revision surgery.

Dr. Binder is well-known and respected among members of his field. He is board certified by not only the American Board of Facial Plastic and Reconstructive Surgery, but also the American Board of Otolaryngology and Head and Neck Surgery, demonstrating his impressive knowledge of the medical aspects of cosmetic surgery – not just the aesthetic aspects.

If you are unhappy with the results of your plastic surgery, regardless of the reason, there is no reason to live with these displeasing results, and there is no reason to settle for anyone but the best possible surgeon. Dr. Binder’s office is accepting consultations, so contact us today so that you can schedule your appointment and get the look you have been hoping for.


13 Things You Can Do to Beautify Your Skin

Human skin is a study in contradictions. It’s our barrier to the world and yet it reacts to every stimulus with which it comes into contact. How do we protect the outer layer of our body while promoting its natural glow and vulnerability?

1) Hydrate Inside and Out

As refreshing as a cool blast of water feels on your face, just imagine how the rest of your cells feel when you drink it. Our bodies are predominantly comprised of liquids, so it’s important to maintain a healthy balance of H2O in your system. Staying hydrated serves several functions when it comes to the health of your skin: it replenishes damaged cells, regulates your body temperature and heart rate, and flushes impurities from your body. So enjoy a nice, tall glass of agua with your next shower!

2) Cleansing: Keep It Cool

Speaking of showers, don’t get overheated. Excessively hot water can dry out your skin, so be mindful of the temperature and always be gentle. There is no need for heavy pressure while cleansing. You don’t require anything but your hands for this step, although you may choose to use a washcloth.

3) Massage Products into Your Skin Gradually

While your doctor will encourage you to use moisturizer after cleansing, it’s also important to consider exactly HOW you apply these products. Massage the cream into your flesh in an upward motion, gently working it into the epidermal layer. This is important for all body types, as this is the step that feeds your skin.

4) When Life Hands You Lemons, Eat Them!

Citrus snacks nourish your liver and kidney, which in turn helps replenish your skin’s vitality. Along the way, Vitamin C also prevents wrinkles. Win-win!

5) Exercise for That Extra Glow

Aerobic activities have myriad benefits for the enduring health of your skin:

  • Exercise releases endorphins, which reduces cortisol, an acne-forming agent.
  • It also increases blood flow, which brings more oxygen to your cells.
  • Vigorous movement amplifies your body’s natural production of collagen, the protein central to maintaining your skin’s elasticity and firmness.
  • Sweating opens your pores, flushing out toxins in the process (but be sure to shower after you work up that sweat).

6) Got Chocolate?

Now that you’ve burned those calories, you’ve earned a chance to gain them back! Dark chocolate contains antioxidants, which reduce blemish-inducing toxins. A snack can also make you happy, and happiness promotes endorphins (see the exercise example above)!

7) Have Some Wine with Your Chocolate

Another decadent treat that promotes healthy skin: a glass of red wine. When consumed in moderation, the antioxidants in vino serve up a bevy of health benefits. As always, drink responsibly and consult a professional if you think you are developing a dependence on alcohol.

8) Mask Maintenance

Use masks every one or two weeks to detoxify, renew, and tighten your pores. Before you apply a facial mask, it is important to cleanse and tone. Be sure to leave the mask on your skin for five to 20 minutes, depending on the type you’re using. Gently and thoroughly remove the mask with warm water, and then tone and moisturize your face and neck.

9) Tea Time

Much like water (see above), tea is a mystical skincare product that can be applied externally as well as taken internally. By drinking chamomile tea, you ingest quercetin, a flavonoid (plant pigment) that bolsters your skin’s natural defense against the harmful UV rays of the sun. Other teas boost your immune system (thus guarding against diseases that could sap your skin’s healthy pallor) and aid in digestion (drawing toxins away from your epidermis).

Once you’re done brewing all of those delicious concoctions, save the bags and re-use them for additional skin love. The caffeine in tea shrinks the blood vessels under your epidermis and reduces the bags under your eyes, for example. You can also reach for a cool tea compress to alleviate sunburn pain. Speaking of which…

10) Don’t Skimp on the Sunscreen

This should go without saying, but the sun accelerates the aging process with every minute of exposure to its searing heat. Avoid the worst of these ravages by applying sunblock EVERY time you go outside.

11) Go Nuts!

Almonds are packed with Vitamin E and “good” fats like omega 3’s, all of which promote skin health. Not to mention, they’re loaded with protein that can help you stay active, thus feeding into your overall health even more.

12) Exfoliate with a Gentle Brush

The right brush can stimulate blood flow to the epidermis and exfoliate your skin as it goes. Use circular, upward, gentle motions with very gentle products. Remember that you are simply exfoliating dead skin, which takes very little pressure. Abrasive loofahs or shell powder-based exfoliants are not necessary. Remember to exfoliate your skin no more than every three to five days.

13) Reduce Makeup Use

Now that you’ve got your skin looking fresh and fierce, why cover it up? Excessive makeup clogs your pores and hinders the various successes you’ve achieved with the previous 12 steps.

If you have any questions or concerns about how to properly care for your facial skin, be sure to schedule a consultation with Dr. Binder. He can advise you on any cosmetic procedures you may want to enhance the healthy glow you’ve just attained, and keep you looking your best for years to come.

The 6 Products You Need in Your Skincare Routine:

    1. Cleanser
      A good cleanser sets the stage for your whole routine. Ultimately, your cleanser should be gentle, water-soluble, and able to remove makeup. Avoid using anything with soap in it (soap’s pH level is too basic and will dry out your skin). When it comes to finding the best cleanser, let your unique skin be your guide and choose a product designed to target your primary skin concern (acne, dryness, oiliness, or sensitivity).
    2. Toner
      Toner often gets dismissed as overkill, but as part of a comprehensive skincare routine, a toner is actually pretty crucial. Not only does it remove any oil or makeup residue, it also preps your cleansed skin to receive whatever treatments you put on next. Choose a gentle, non-alcohol based formula with skin-repairing ingredients, as well as calming and anti-inflammatory properties.
    3. Exfoliator
      The best ways to go about exfoliating your face is to either use a cleanser with chemical exfoliants in it or a dedicated physical exfoliator. Either way, you should only use this product about two times a week. Chemical exfoliators are best for sensitive skin, and physical ones (with gritty bits) are good for occasional use if your skin is on the dry and flaky side.
    4. Serums
      Packed full of active ingredients, serums are for brightening, repairing, evening, smoothing texture, hydrating, and anti-aging. Some have multiple purposes and some are singular in the way that they work. You can layer serums or pick just one to focus on your biggest skin concern.
    5. Targeted treatments
      These are generally used for treating blemishes, dark spots, and physical symptoms of skin conditions like eczema. They usually have powerful ingredients that should be used sparingly and (usually) at night to avoid damage from sun sensitivity.
    6. Moisturizer
      Moisturizers are made for all kinds of complexions, either oil-free or loaded with skincare goodies like antioxidants and vitamins. You can use facial oil as a moisturizer too, no matter what your skin type.

In the event that none of the above alleviate the entirety of skin health-related issues or concerns you have, cosmetic options such as chemical peels or microdermabrasion may be the answer you’re looking for. In the event that you believe a professional cosmetic solution is the way to move forward, make sure you discuss this at length with the plastic surgeon you’re considering before making any impulsive decisions.

Consult with Dr. Binder

If you have any questions or concerns about how to properly look after your facial skin or the cosmetic options that are available to you, then be sure to book a consultation with Dr. Binder.


Questions to Ask Before Getting Plastic Surgery

Before having any type of surgery, it is important that you make sure to broach any questions or concerns that you might have about the entire surgery process with your doctor. Here’s a list of some of the questions that you should ask your doctor during your consultation appointment.

Questions to Ask Your Doctor

  1. Are you board-certified?
  2. Do you have other professional affiliations?
  3. How long have you been performing this type of procedure?
  4. How many of these procedures have you performed?
  5. What surgery do you perform the most in your practice?

Questions About the Procedure

  1. Which surgery will best address my needs?
  2. How is the surgery performed?
  3. How safe is the procedure?
  4. How long does the procedure usually last?
  5. Are there other options available?
  6. Can I have multiple procedures done at the same time?
  7. Will I need revision surgery?
  8. Am I a good candidate for this procedure?
  9. Will I have visible scars?
  10. What complications may occur and how frequently?
  11. What kind of anesthesia will be used on me during surgery?
  12. Will I be able to speak with the anesthesiologist before surgery?
  13. Who performs the skin care/postoperative follow-up/suture removal?

Questions About Preparing for Plastic Surgery

  1. What do I need to do in the week leading up to surgery in order to prepare?
  2. What preparation is required the day before and the morning of the surgery?
  3. Should my regular medicine be taken the morning of the surgery?
  4. Where will the surgery be performed?
  5. What time should I arrive at the surgery location?
  6. Should someone drive me to and from my surgery?
  7. Will I need to stay overnight?
  8. What sort of clothes should I bring to wear home?
  9. Will I need to see a doctor prior to surgery for examination or testing because of pre-existing medical conditions?
  10. How long before surgery should I stop smoking?

Questions About Post-Surgical Problem Solving

  1. If a problem should arise after I go home, who answers calls after hours and on weekends?
  2. If I need to be seen after hours, where will this occur?
  3. If I need help in my home, is a private duty nurse available?
  4. What if I am unhappy with the results or with the degrees of changes achieved?
  5. If touch-ups are necessary, when would they be performed?

Recovery Questions

  1. How long is the recovery period?
  2. Do any of my medical conditions mean that recovery will last longer than average?
  3. What kind of medical care is required during recovery?
  4. What sort of help will I need at home during my recovery?
  5. What will my physical limitations be during recovery?
  6. Are any special medications or diet required during the recovery period?
  7. What should I watch for during healing that may indicate a problem?
  8. How much pain/swelling/bruising is to be expected?
  9. How will my pain be managed after I go home?
  10. How many follow-ups are necessary and when will they take place?
  11. Will I need to wear a compression garment or other special clothing?
  12. When can I start exercising again?
  13. When will I be able to take a bath or go swimming?
  14. When will I be able to drive again?
  15. When will I be able to return to work and normal activities?

Questions About Cost and Payment

  1. Do you charge a consultation fee?
  2. Does the cost depend on where my surgery is performed?
  3. Will it save me money to have multiple surgeries done at once?
  4. Will insurance cover the cost?
  5. What options are available for payment?

Schedule a Visit

If you have any other questions or concerns about any type of cosmetic procedure, then book a consultation with Dr. Binder so that he can help you find the answers you’re looking for.

Mole Removal


Mole Removal: The Options Available to You

Facial moles were popularized by Marilyn Monroe in the 1950s, and again by celebrities like Madonna in the 1980s and Cindy Crawford in the 1990s. Even as recently as 2016, Hollywood darling Jennifer Lawrence has received praise for her moles and criticized magazines for editing her moles out in published photos.

However, some of us don’t feel like glamorous celebrities with our moles, and some moles can even pose threats to our health. In fact, even while they get praise for their moles, Cindy Crawford and Madonna, as well as other celebrities like Sarah Jessica Parker, chose to have their moles removed.

Why Have Moles Removed?

Moles are usually benign, but they can definitely be unsightly, with most moles being removed for cosmetic reasons. Another common reason for mole removal is moles that become constantly irritated from rubbing jewelry, glasses, or clothing.

The most serious reason for removal, however, is concerns about skin cancer. Moles can develop melanoma, while keratoses (rough, mole-like growths that develop from sun exposure) can develop into squamous cell carcinomas. If there is any question about whether or not a mole is cancerous, a biopsy can be performed to find out whether the mole is cancerous or benign. Signs that a mole is cancerous include:

  • Asymmetry between the sides of the mole
  • Ragged, irregular, or blurred edges
  • Inconsistent or uneven coloring, or shades of tan, brown, black, blue, white, or red in the mole
  • Diameter larger than a pencil eraser
  • Changing size, shape, or color

Mole Removal Procedures

There are several ways that moles can be removed, including laser treatment, cryosurgery, surgical removal, and hydrocortisone cream.

Laser removal and cryosurgery are less invasive and less likely to produce visible scarring than traditional surgery methods. Laser surgery uses lasers to remove the mole. Cryosurgery involves the injection of liquid nitrogen into or underneath the mole, freezing it and causing it to break up. Both laser removal and cryosurgery only treat moles on the surface level and are best for small, superficial moles. For cancer that is deeper than the superficial levels of the skin, more traditional surgery methods are required.

The most common way of removing moles is through excision surgery. Moles are usually removed through a simple “shave excision” or “surgical shave,” which removes the mole at the level of the skin before cauterizing the wound for quick healing. This procedure may leave a small, barely visible amount of scarring, but usually leaves no scarring at all. However, like laser removal and cryosurgery, shave excisions only remove moles from the surface level and is best for small, superficial moles.

For cancer that is deeper in the skin or is likely to spread, “excision surgery” is performed. This surgical technique removes the mole, as well as the surrounding and underlying healthy tissue to ensure a more complete removal. Whether removed through shave excision or excision surgery, the removed mole or keratosis is then sent to a pathologist for testing for cancer.

Choosing the Right Plastic Surgeon for Your Mole Removal Procedure

A surgeon not trained in cosmetic and plastic surgery can leave scarring. For this reason, many surgical dermatologists and oncologists refuse to do mole removals on the face, and refer patients to plastic surgeons instead. For optimal results, a plastic surgeon that specializes in facial and reconstructive surgeries is the best option for the patient.

Dr. William J. Binder has extensive experience performing facial reconstructive surgery, as evidenced by his many published academic articles and 10 medical patents. His skill in facial reconstructive surgery is further illustrated by his certification by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology and Head and Neck Surgery.

If you want your facial mole removal done correctly, contact the office of Dr. Binder today to schedule your consultation.

Botox and the Reduction of Migraines


How Botox can Help Alleviate Chronic Migraines

Do you have terrible migraines that don’t seem to respond to over-the-counter prescriptions? Do you feel like you’ve tried everything, but the pain just won’t go away?

Then it may be time for you to consider getting Botox injections. But before you schedule an appointment with your doctor, here are some things that you need to know about how Botox injections can help get rid of your chronic migraines.

What Causes Migraines?

While it isn’t fully understood what causes migraines, genetics and environmental factors seem to play a role, as migraines often begin in childhood, adolescence, or early adulthood. Some doctors believe that migraines are caused by the changes in the brainstem and its interactions with the trigeminal nerve (a major pain pathway). Imbalances in brain chemicals (like serotonin) may also be involved.

A number of different things can trigger migraines, such as:

  • Hormonal changes in women
  • Certain foods (aged cheeses, salty foods, and processed foods)
  • Food additives (aspartame and MSG)
  • Drinks (alcohol and caffeinated beverages)
  • Stress
  • Sensory stimuli
  • Changes in sleep patterns
  • Physical factors
  • Changes in environment
  • Medications

Migraine Symptoms

Migraines can progress through four stages: prodrome, aura, attack, and post-drome.

Prodrome starts one to two days before a migraine and can present the following symptoms:

  • Constipation
  • Mood changes
  • Food cravings
  • Neck stiffness
  • Increased thirst and urination
  • Frequent yawning

Aura can occur before or during a migraine. However, most people don’t experience migraines with aura (symptoms of the nervous system). Some examples of migraine aura include:

  • Visual phenomena (seeing various shapes, bright spots, or flashes of light)
  • Vision loss
  • Pins and needles in an arm or leg
  • Weakness or numbness in the face or one side of the body
  • Difficulty speaking
  • Hearing noises or music
  • Uncontrollable jerking or other movements

Attack is the duration of the actual migraine, which can last from four to 72 hours, if untreated. During an attack, you may experience the following symptoms:

  • Pain on one or both sides of your head
  • Throbbing or pulsing pain
  • Sensitivity to light, sounds, smells, and touch
  • Nausea and vomiting
  • Blurred vision
  • Light-headedness and, possibly, fainting

Post-drome is the final phase that occurs after the migraine attack. For roughly 24 hours after a migraine, you might feel:

  • Confused
  • Moody
  • Dizzy
  • Weak
  • Sensitive to light and sound

How Botox Treats Migraines

Botox injections block the release of neuro-transmitters (chemicals that carry nerve impulses) that are linked to causing pain. In order to prevent headaches, Botox blocks the nerve signals from reaching the central nervous system, and from becoming highly sensitive. Botox treatments are for chronic migraines, which are defined as headaches that occur at least 15 days per month (eight or more of which must be migraines).

Botox is given through injection sites along seven specific head and neck muscle areas. The number of injection sites range between 31 – 39, with half the injection sites on the left side of the head and the other half on the right side. If there is a predominant pain location, further injections may be given. The recommended schedule for receiving Botox injections is every 12 weeks.

Possible Side Effects

In most cases, people experience little to no side effects from Botox injections. Some of the most common side effects can include:

  • Neck pain
  • Stiffness at the injection site
  • Headache
  • Temporary muscle weakness (neck and upper shoulders)

Rare side effects can occur when the Botox toxin spreads beyond the injection site. Some of these side effects include:

  • Muscle weakness
  • Vision changes
  • Drooping eyelids
  • Loss of strength
  • Allergic reaction

Consult with Dr. Binder

Before you decide that Botox injections could be the answer for treating your migraines, you should consult with an experienced migraine professional, such as Dr. Binder, today. As one of the world’s most experienced physicians in Botox use, and the discoverer of its effects on relieving migraines, Dr. Binder is the perfect consultant to help you make the right choice about whether or not Botox injections are the right fit for you.

Scar Revision and Removal


An Overview of Scar Revisions and Removals

Scars are an almost unavoidable part of life, but they can also be unattractive. Facial scarring especially can make one feel unattractive and lead to low self-esteem. Fortunately, there are a number of procedures, both surgical and nonsurgical, that can be used to lessen the appearance of scars.

Scar Removal Surgery

For severe scarring, surgery is usually necessary to achieve the best results. There are a number of surgical options available. Your plastic surgeon will be able to determine which procedure is best for you based on the type and severity of your scarring.

Elliptical or serial excision is the most straightforward procedure for removing severe but localized scarring. The surgeon removes the scar tissue and closes the surgical site using carefully administered sutures. This leaves a scar, but it is straight, faint, and smooth, making it virtually unnoticeable.

Z-plasty also involves the removal of the scar tissue, but instead of a simple closure, the plastic surgeon performing the procedure creates additional incisions that create a Z shape, producing triangular flaps of skin that can be arranged so that scarring falls in the natural lines of the face which camouflage the scar’s appearance.

Instead of removing existing scar tissue, W-plasty surgery, also called broken geometric line surgery, instead uses incisions to break up the existing scar tissue so that, like in z-plasty, the scar tissue falls in the natural lines of the face. This procedure is best for revising mild scarring.

Tissue expanders are primarily used for very severe or large, wide scars. Tissue expanders are placed under the skin to allow the healthy tissue surrounding the scar to expand, making the scar smaller and less dramatic looking.

Dermabrasion is a surgical process that uses an abrasive tool to remove scar tissue. Dermabrasion can be used on its own, but is often performed in conjunction with other scar revision and removal techniques to create more thorough results.

Non-Surgical Scar Revision and Removal

In addition to surgical procedures, there are a number of nonsurgical options for scar revision and removal. Nonsurgical scar revision procedures are not able to provide the same results as surgical options, but may be sufficient for minor scarring.

Depressed scars, such as acne scars, may benefit from injections of facial fillers. However, the results of injected dermal fillers are not permanent. To maintain their results, patients will need to make appointments for re-treatment every three months to a year, depending on the filler used, individual results, and patient preferences.

Injection of steroid medication can help flatten and soften scars for some patients, but cannot narrow them. Steroid injection is particularly successful on hypertrophic and keloid scars.

Pressure therapy is a more long term solution than other procedures discussed. This treatment option requires wearing an appliance that places pressure on the scar. This appliance must be worn day and night for four to six months, leading many patients to prefer other options. If you have a fear of surgery and needles or have health a condition that prevents other treatments from being viable, pressure therapy may be your best option.

Finally, there are products, such as silicone gel, that can be applied topically at home. These products work best on new scar tissue and cannot replicate the results of in-clinic treatments, but may be helpful in preventing the development of scar tissue when applied to recent injuries.

Choosing the Right Plastic Surgeon

Just like with any other medical procedure, when choosing a plastic surgeon to conduct your scar revision procedure you want the best. Dr. Binder is certified by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology and Head and Neck Surgery and exclusively performs facial procedures, allowing him to refine his techniques. If you or a loved one is interested in scar revision surgery, choose the best doctor possible. Contact Dr. William J. Binder’s office today to schedule your consultation.

Removing Facial Skin Cancers


Removing Facial Skin Cancers: What You Should Know

While any cancer diagnosis is difficult, skin cancer can typically be treated completely with surgery alone as long as it is caught early and not allowed to spread. However, cancer removal surgery, like any surgery, can be scary; and facial skin cancer removal surgery has the added fear of the effect it will have on the face. Fortunately, knowledge and a skilled surgeon can alleviate some of that fear.

About Skin Cancer

The skin is made up of three different types of cells: squamous cells, basal cells, and melanocytes. Squamous cells are the thin cells that make up the top layer of the epidermis. Basal cells are round cells that lie underneath the squamous cells, in the middle layer of the epidermis. Finally, melanocytes make up the lower layer of the epidermis. These cells contain melanin, which gives the skin color. When exposed to the sun, melanocytes produce extra melanin, causing the skin to darken, which we see as a tan.

Each of these types of cells have corresponding types of skin cancer. The first two types are basal cell carcinoma and squamous cell carcinoma, which are non-melanoma skin cancers, while melanocytes correspond with melanoma. The non-melanoma skin cancers are more common and also considerably less likely to spread to other parts of the body than melanoma, making them much less deadly and far easier to treat. The non-melanoma skin cancers are also more likely than melanoma to appear on the face.

Any type of skin cancer can be treated with removal surgery, but certain cases may require additional or alternative types of treatment because of spreading of the cancer or other complications. Your doctor can work with you to determine the best treatment for your individual case.

The Facial Skin Cancer Removal Process

The actual surgical process involved in facial skin cancer removal can vary a lot from patient to patient because cancer growth and health history vary from patient to patient. However, most skin cancer removal surgeries follow the same basic outline of steps.

First, the patient is given an anesthetic to alleviate discomfort during the procedure. This may be local, intravenous, or general anesthesia, depending on the surgical needs.

Next comes the actual removal. A small lesion can be removed through a simple excision, but skin cancer can often be much larger than just what appears on the skin and without clear borders. In these cases, a technique called Mohs surgery, or Mohs micrographic surgery (MMS), may be used. This technique removes the skin in layers, with testing for cancer cells conducted between each layer.

After removal comes reconstruction. This may not be necessary in all cases. Reconstruction typically uses either a skin graft or a local flap, in addition to the relocation of healthy adjacent tissue to minimize the effects of the surgery on the skin’s appearance. Suture lines are placed along natural lines and crevices on the face as much as possible. In particularly severe cases, additional reconstruction may be needed in the form of additional surgeries.

Choosing the Right Facial Skin Cancer Removal Surgeon

An unskilled surgeon can leave scarring or disfigurement. For this reason, patients often choose a plastic surgeon experienced with skin cancer removal because of their ability to minimize scarring and preserve the appearance over a regular surgical dermatologist or surgical oncologist. In fact, many surgical dermatologists and surgical oncologists prefer not to operate on the face and will recommend that patients see a plastic surgeon because of the potential for scarring.

Fortunately, one of the world’s leading plastic surgeons is in the Los Angeles and Beverly Hills area and available for consultation. Dr. William J. Binder specializes in various facial reconstructive surgeries, including the removal of skin cancers. If you have been diagnosed with skin cancer, be it a carcinoma or melanoma, be sure to book a consultation with Dr. Binder today.

Facial Plastic Surgery Statistics


Facial Plastic Surgery Statistics from 2015

The rise and fall of popularity for different types of facial plastic surgery, as well as other cosmetic procedures, is heavily documented and analyzed at the end of each year to determine that year’s most popular trends in cosmetic procedures.

Here’s a brief look at last year’s statistical analysis on facial plastic surgery procedures, separated by patient ages.

Ages 13-19

This age group is the most susceptible to celebrity influence and the effects of the selfie movement. Both celebrity influence and the selfie movement can cause young people to be more aware of their own appearance.

The most popular facial cosmetic surgical procedures and their percentage change compared to 2014 are:

  • Chin augmentation (mentoplasty)—down 4%
  • Dermabrasion—up 5%
  • Ear surgery (otoplasty)—up 3%
  • Eyelid surgery (blepharoplasty)—down 1%
  • Lip augmentation (other than injectable materials)—up 6%
  • Nose reshaping (rhinoplasty)—no change

Facial cosmetic minimally-invasive procedures compared to 2014 are:

  • Botulinum Toxin Type A (Botox, Dysport)—up 2%
  • Chemical peel—up 4%
  • Laser skin resurfacing—up 4%
  • Microdermabrasion—down 10%
  • Soft tissue fillers—up 4%

Ages 20-29

While this age group isn’t as susceptible to celebrity influence and the selfie movement, there is still a lot of pressure to keep up a younger looking appearance.

The most common facial cosmetic surgical procedures compared to 2014 for this age group are:

  • Cheek implant (malar augmentation)—up 5%
  • Chin augmentation (mentoplasty)—down 4%
  • Dermabrasion—up 3%
  • Ear surgery (otoplasty)—up 2%
  • Eyelid surgery (blepharoplasty)—down 2%
  • Facelift (rhytidectomy)—down 2%
  • Forehead lift—down 3%
  • Hair transplantation—no change
  • Lip augmentation (other than injectable materials)—up 6%
  • Nose reshaping (rhinoplasty)—up 1%

Common facial cosmetic minimally-invasive procedures compared to 2014 include:

  • Botulinum toxin type A (Botox, Dysport)—no change
  • Chemical peel—up 6%
  • Laser skin resurfacing—up 4%
  • Microdermabrasion—down 9%
  • Soft tissue fillers—up 5%

Ages 30-39

This time of life, between the exuberance of youth and the age wrinkles, tends to put more focus on outward appearance, as people in this age category often worry about getting older.

The most popular facial cosmetic surgical procedures and their change in percentage compared to 2014 are:

  • Cheek implant (malar augmentation)—up 5%
  • Chin augmentation (mentoplasty)—down 4%
  • Dermabrasion—up 5%
  • Ear surgery (otoplasty)—up 2%
  • Eyelid surgery (blepharoplasty)—down 1%
  • Facelift (rhytidectomy)—down 1%
  • Forehead lift—down 4%
  • Hair transplantation—down 1%
  • Lip augmentation (other than injectable materials)—up 7%
  • Nose reshaping (rhinoplasty)—down 1%

Popular facial cosmetic minimally-invasive procedures compared to 2014 include:

  • Botulinum toxin type A (Botox, Dysport)—up 1%
  • Chemical peel—up 6%
  • Laser skin resurfacing—up 5%
  • Microdermabrasion—down 10%
  • Soft tissue fillers—up 5%

Ages 40-54

For people in this age group, cosmetic surgery can be used as a way to keep yourself in the game. Whether it’s at work or in the dating pool, a younger look can keep you from looking outdated.

Some common facial cosmetic surgical procedures compared to 2014 are:

  • Cheek implant (malar augmentation)—up 3%
  • Chin augmentation (mentoplasty)—down 4%
  • Dermabrasion—up 4%
  • Ear surgery (otoplasty)—up 2%
  • Eyelid surgery (blepharoplasty)—no change
  • Facelift (rhytidectomy)—down 2%
  • Forehead lift—down 3%
  • Hair transplantation—no change
  • Lip augmentation (other than injectable materials)—up 7%
  • Nose reshaping (rhinoplasty)—no change

Some of the most popular facial cosmetic minimally-invasive procedures and their percentages compared to 2014 include:

  • Botulinum toxin type A (Botox, Dysport)—up 2%
  • Chemical peel—up 4%
  • Laser skin resurfacing—up 6%
  • Microdermabrasion—down 8%
  • Soft tissue fillers—up 7%

Ages 55+

This age category is all about the touch up. Just because you’ve lived a full life, doesn’t mean that you have to show it.

The most popular facial cosmetic surgical procedures among this age group, and their change in percentage compared to 2014, are:

  • Cheek implant (malar augmentation)—up 5%
  • Chin augmentation (mentoplasty)—down 4%
  • Dermabrasion—up 4%
  • Ear surgery (otoplasty)—up 1%
  • Eyelid surgery (blepharoplasty)—down 2%
  • Facelift (rhytidectomy)—down 2%
  • Forehead lift—down 5%
  • Hair transplantation—down 2%
  • Lip augmentation (other than injectable materials)—up 4%
  • Nose reshaping (rhinoplasty)—up 1%

Common facial cosmetic minimally-invasive procedures compared to 2014 include:

  • Botulinum toxin type A (Botox, Dysport)—no change
  • Chemical peel—up 6%
  • Laser skin resurfacing—up 4%
  • Microdermabrasion—down 10%
  • Soft tissue fillers—up 6%

Consult with Your Doctor

Before receiving any type of cosmetic procedure, it is important that you book a consultation with your doctor to discuss which procedures are best suited for you. Book a consultation with Dr. Binder today.

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