Brow Lifts and Your Options


What You Need to Know about Brow Lifts

Are you tired of having deep lines and wrinkles on your forehead that just seem to get worse as you age? Do you miss the way your skin used to be smooth and youthful looking?

Then a brow lift might be the right cosmetic procedure for you. But before you book an appointment with your doctor, here are some things to keep in mind about brow lifts.

What is a Brow Lift?

A brow lift, also known as a forehead lift or browplasty, tightens the soft tissues of the forehead to restore a more youthful look to your forehead skin, upper eyelids, and eyebrows. As you get older, it’s common for the brow to assume a flat or horizontal position. A brow lift can help reverse the effect of gravity by rejuvenating the upper third of your face.

Having a brow lift can help:

  • Reduce wrinkles that develop across the forehead
  • Improve frown lines (vertical creases between the eyes)
  • Raise sagging brows that are hooding the upper eyes
  • Place the eyebrows in an alert and youthful position

Getting Your Brow Lift

There are three types of brow lift surgery: open brow lift, endoscopic brow lift, and limited incision technique. The type of brow lift that you get will be based on your facial features and aesthetic preferences.

Open brow lift—a long incision will be made across the forehead at the hairline or in one of the forehead creases, so that the skin can be lifted away from the underlying tissues. Your doctor will then loosen the muscles and remove the fat. Excess skin will be trimmed away before the remaining skin is pulled down and stitched to the brow in its new position. This type of brow lift is also known as classic, coronal, or trichophytic.

Endoscopic brow lift—an endoscope (a long, thin tube with a light on the end attached to a video camera) will be inserted through several tiny incisions in the scalp. This will allow your doctor to see and work on the various internal structures of the forehead. This technique requires minimal incisions, but it may not work equally for all patients.

Limited incision technique—this procedure is a combination of both the open brow lift and the endoscopic brow lift. It is a non-endoscopic procedure with limited incisions. This type of brow lift uses a small portion of the open brow lift technique to elevate the outside part of the eyebrows. The resulting scars are hidden in the temporal hairline. This procedure doesn’t address the center of the brow, but can reduce wrinkles at the corner of the eyes (crow’s feet).

Dr. Binder regularly relies on this form of minimal incision temporal lift given its unique advantages, which you can read more about here.

Recovery and Aftercare

In the majority of cases, the postoperative course after a forehead lift is relatively short, with minimal bruising or swelling. All sutures and clips are typically removed within 10 days. By styling the hair to hide the incision lines, most patients are able to resume a normal non-exceptional routine within two to three days after surgery.

Pick the Best Doctor

One of the most important things that you can do before receiving brow lift surgery is to pick the right doctor for the job. To learn more about your options and find out if you’re a good candidate for this type of surgery, book a consultation with Dr. Binder. With years of experience in his field, he has the knowledge and know-how to help you achieve the results you desire.

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.

Revision Rhinoplasty


The Benefits of Revision Rhinoplasty

Revision, or secondary, rhinoplasty is by no means an uncommon procedure. Rhinoplasty as a whole was the second most common plastic surgery procedure in 2015, after breast augmentation, with 217,979 rhinoplasty surgeries conducted that year, and 10 to 15 percent of rhinoplasty patients undergoing a secondary rhinoplasty procedure.

Just like people undergo primary rhinoplasty (their first rhinoplasty procedure) in order to obtain a variety of benefits, there’s also a variety of benefits that patients may hope to gain from revision rhinoplasty procedures. Here are five of the most common benefits of revision rhinoplasty.

1. Improving Results after Primary Rhinoplasty

Sometimes, patients are unhappy with the aesthetic results of their rhinoplasty or become unhappy with their results later on. Sometimes this is because the surgeon who conducted their first procedure did so improperly, placing the implants incorrectly; improperly revising the nostrils, leaving them too large, too small, or asymmetrical; or otherwise not giving the patient the look they wanted.

On the other hand, sometimes even initially gorgeous results can change or look unbecoming as the face changes with age. This is of course no one’s fault, but still needs revision to ensure that the patient remains happy with their face.

2. Dramatic Changes

Sometimes patients have such severe trauma or a desire for such dramatically different results that one procedure won’t allow them to get the look they want. In these cases, additional rhinoplasty procedures may be needed later, after the patient has healed from their first procedure, to complete the patient’s goals for the look of their nose.

3. Improved Breathing

Many patients seek their initial rhinoplasty procedure because of breathing issues, usually caused by nasal obstruction. Often patients seek a revision rhinoplasty for the same reason. In rare cases, an unsatisfactory surgeon can cause breathing problems through an improperly conducted rhinoplasty, but more often breathing issues are either not completely resolved by the primary rhinoplasty or are a result of aging or illness that occurred after the first procedure.

4. Improved Sleep

Just like rhinoplasty can improve breathing, it can also improve sleep, and for many of the same reasons. Poor or obstructed breathing during sleep causes problems like snoring and sleep apnea, which can disrupt sleep. Often times, patients don’t even realize that issues with their sleep are the result of breathing difficulties, but their partners may notice the inconsistent, noisy, or strange sounding breathing. Once again, these problems can be caused by an improperly done rhinoplasty, illness or aging, or were not resolved by the first procedure.

5. Repairing Damaged Results

Finally, revision rhinoplasty may be needed if the results of the first rhinoplasty are damaged because of a broken nose or other facial trauma. This trauma is often the result of a blow to the face, but may also be caused by heat or chemical burns. Just like with a primary rhinoplasty used to repair trauma, a secondary rhinoplasty intended to do the same thing is usually covered by insurance.

Ensuring Your Revision Rhinoplasty is Done Right

Choosing the right doctor for your revision rhinoplasty procedure is of the utmost importance. If you’re choosing a revision rhinoplasty because of unsatisfactory results from your first surgery, you have already experienced just how true this is. Dr. William J. Binder is an experienced and double board certified facial plastic surgeon who has been passionately serving and satisfying plastic surgery patients in the Los Angeles area for decades while also conducting research and giving informational lectures to plastic surgeons around the world.

Dr. Binder specializes in reconstructive surgeries. If you want your revision rhinoplasty performed by one of the world’s leading facial plastic surgeons, don’t wait to act. Contact our office today to schedule your consultation.

Cheek and Chin Implants


Cheek and Chin Implants: Defining the Face

Though dramatic cheekbones have always been considered attractive, people have been seeking more and more dramatic facial structure in general over the past few years. While chin augmentation has decreased in popularity by 35 percent since 2000, according to the American Society of Plastic Surgeons, chin augmentation surgeries used to be preferred to soften the appearance of the chin; a look that is no longer en vogue. Cheek augmentation, on the other hand, has increased in popularity by 20 percent since 2000 according to the same source. 12,668 cheek augmentations and 17,451 chin augmentations were performed in 2015.

About Facial Implant Surgery

Cheek augmentation surgery, also referred to as malar augmentation surgery, is used to modify the shape and size of the contours of the cheeks. Chin augmentation surgery, also called mentoplasty, is used to change the shape and structure of the chin. Though chin augmentation surgery was less popular in 2015 than it was in 2000, in recent years the procedure has experienced a resurgence in popularity. From 2010 to 2012, chin augmentation surgery increased in popularity by 71 percent.

Cheek augmentation surgery and chin augmentation surgery can be performed separately or together to achieve a more significant change in the face. These surgeries both use implants custom designed for the individual patient. Common facial implant surgeries in addition to cheek and chin augmentation include jaw and tear trough implants.

Good Candidates for Facial Implant Surgery

Candidates who wish to change the contours of specific facial features are the best candidates for cheek and chin implants. Candidates who are more interested in changing the overall appearance of their face, or in reversing the signs of aging, may be more suited to other types of plastic surgery procedures, such as face, eye, or brow lifts. Patients should be in good health and free of any preexisting nasal or dental complications. Fat, bone, and skin grafting, as well as bone repositioning, may be alternatives for patients who aren’t good candidates for cheek and chin implants.

The Facial Implant Procedure

In preparation for chin or cheek implant surgery, the patient is administered both a general anesthetic and a local anesthetic. Then, the plastic surgeon makes small incisions and pockets in the facial tissue. Custom made and designed facial implants are inserted through these incisions into the pockets in the facial tissue. Finally, the incisions are stitched closed and cleaned. The incisions may also be bandaged or taped to protect them as they heal. If so, the plastic surgeon will be able to tell the patient when these bandages need to be removed and if and how often they need to be changed.

Recovering from Facial Implant Surgery

Facial implant surgery does leave scars at the incisions, but with proper care, these scars will be barely visible and can be easily concealed with cosmetics. For many chin implant surgeries, the incisions and their resulting scars can be made inside the mouth, so they cannot be seen after surgery. The patient may need to make a return appointment with their plastic surgeon to have their stitches removed and for other follow up care.

Patients will also be prescribed medications to take after surgery as they heal. This will include painkillers and antibiotics to help the patient’s recovery. These medications may be applied topically or administered orally.

Your Facial Implant Surgery

An experienced plastic surgeon with a passion for helping patients in the Los Angeles and Beverly Hills area is available for consultation should you be considering facial implant surgery.

Dr. William J. Binder is double board certified and exclusively performs facial plastic surgery, allowing him to focus and hone his skills compared to more generalized plastic surgeons. Dr. Binder is one of the world’s leading plastic surgeons, and has both practical and research experience in facial plastic surgery. Contact Dr. Binder’s office today to schedule your consultation.

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.

Eyelid Surgery


Eyelid Surgery: A Closer Look at Blepharoplasty

If the eyes are the windows to the soul, then eyelids are the window dressings. Unfortunately, through both genetics and aging, eyelids can have an unpleasing appearance, hiding and distractive from even the most beautiful eyes. This is why eyelid surgery, also called blepharoplasty, is one of the most common cosmetic surgery procedures in the United States right now, with 203,934 patients undergoing this cosmetic procedure in 2015, according to the American Society of Plastic Surgeons.

Popularity around the World

This procedure is also popular outside of the United States and is the most popular plastic surgery worldwide, according to the International Society of Aesthetic Plastic Surgery, which reports that 1,427,451 blepharoplasty surgeries were performed around the world in 2014. Eyelid surgery actually originated in South Korea, and remains the most popular cosmetic procedure in the country even now as a way to achieve larger, rounder, and more wakeful eyes than naturally possible for those with monolids, though few Korean patients want a truly Caucasian looking eye shape.

Types of Eyelid Surgery

Eyelid surgery can be performed on just the lower lid, just the upper lid, or on both lids.

Lower eyelid blepharoplasty is generally performed to treat puffy and sagging under eyes which lead to darkness under the eyes. While blepharoplasty can’t treat discoloration of the skin itself, lower eyelid blepharoplasty can remove the excess skin and fatty deposits under the eyes that cause puffiness and bags that cast shadows, creating the appearance of discoloration.

Upper eyelid blepharoplasty removes the excess skin, fatty deposits, and muscle folds that can occur over the eye, typically at the inner corner. Excess skin, fat, and muscle can be simply unpleasant to look at as it gives the eyes a sleepy, droopy appearance, but excess skin, fat, and muscle can also be so severe that vision is impeded. Removing the excess tissues above the eyes removes the impediment and gives the eyes a more youthful, awake, and alert appearance.

Double eyelid blepharoplasty involves performing lower eyelid blepharoplasty and upper eyelid blepharoplasty during the same procedure. Double eyelid blepharoplasty can be performed to give the eyes a more comprehensive change in appearance by removing the excess tissues from both above and below the eyes, removing droops and sags from the upper eyelid, as well as bags and puffiness from the lower lid.

Good Candidates for Eyelid Surgery

Like for all plastic surgeries, good candidates for blepharoplasty are healthy with no major illnesses or other health condition that could impair or complicate healing. Plastic surgery candidates should generally not be smokers, or at least able to abstain from smoking for several weeks before and after their surgery to allow their body to heal.

Candidates for blepharoplasty specifically should have no major eye conditions and reasonable expectations for what eyelid surgery can achieve.

Not all sagging or bagging around the eyes can be resolved with eyelid surgery. Your surgeon will be able to talk with you during your consultation about your specific anatomy and issues and whether blepharoplasty is right for you. Other surgeries like lifts may be a better solution for your specific situation.

Scheduling Your Blepharoplasty Procedure

Dr. Binder exclusively performs facial cosmetic procedures, meaning he is greatly experienced in eyelid surgery. If you want the best plastic surgeon available to perform your surgery, whether blepharoplasty or another facial cosmetic procedure, Dr. Binder is the only choice for you. Contact his office today to schedule your consultation.

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