By Dr. William J. Binder
The nose is a prominent facial feature that never goes unnoticed. In fact, the nose is the most central feature of the face, which contributes to facial symmetry. When someone’s nose looks only slightly disproportionate compared to their other features it can affect their self image, ultimately damaging self-esteem. The size and shape of a person’s nose has the greatest impact on their appearance. This is why a minor alteration of the nose can dramatically improve facial balance and harmony.
Rhinoplasty is the most commonly requested surgical procedure in America. However, Rhinoplasty is also one of the more complex operations performed in plastic surgery. Many plastic surgeons describe Rhinoplasty as an art form in itself because of the numerous different technical procedures that can be done to the nose. It is not only cosmetic nose surgeries that patients ask for, but also functional abnormalities exist. Patients often request simultanteous correction. These abnormalities causing problems in breathing include a deviated septum or restricted nasal valves with reduced air passages. The nose is comprised of many areas that typically require different procedures. In addition, it is important to remember that no two noses are alike. This is also critical for the surgeon to keep in mind when designing a specific operation for each nose that meets the needs of each individual patient.
Dr. William J. Binder, a Beverly Hills Facial Plastic Surgeon, is recognized as a premier Rhinoplasty and Revision Rhinoplasty surgeon amongst his peers. Dr. Binder is known as the “end-of-the-line” surgeon that corrects severe cases that require reconstructive surgery. He strongly believes in the idea that nasal surgeries should yield natural-looking results. Dr. Binder also explained that the technique behind achieving consistent looking results in Rhinoplasty procedures is for the surgeon to have a strong three-dimensional perception of not only the nose, but the patient’s overall facial structure as well. A nose that is proportional with the rest of the features creates an even and more balanced appearance to the face.
Dr. Binder maintains a strong stance behind o his philosophy because of so many patients who present with undesirable post-operative effects after having a Rhinoplasty procedure. In fact, over 60% of the total number of nasal surgeries that are performed in his practice are Revision Rhinoplasties. It is estimated that up to 15% of all nose surgeries are “botched.” Some botched nose surgeries are obvious immediately after surgery, while others can take years to develop.
“Many of the patients who are referred to me for Revision Rhinoplasty have conspicuously artificial-looking or altered noses that often have serious structural damage or deficiencies, such as collapsed nasal valves and simultaneous breathing problems,” said Dr. Binder.
Through his hard work and dedication to this area of plastic surgery, Dr. Binder has pioneered new “structure rhinoplasty” techniques. These techniques describe what the surgeon should take into consideration while assessing a patient for Rhinoplasty. Aesthetic surgery of the nose involves the following factors: nose size, width, and profile, over and under projection of the nose, nasal tip shape (hooked, bulbous, drooping, or pointed upward), oversized flared nostrils, nasal asymmetry, and limitations or advantages of skin type. Other considerations that require simultaneous evaluation are functional problems such as a deviated nasal septum or a collapse of the nasal valvular cartilage structures. In teens, surgery of the nose is best performed when facial growth is completed. This begins at around age 15 for girls, and the latter part of age 15 and 16 for boys.
These “structure” techniques developed by Dr. Binder provide solid guidelines to follow. During nasal surgery consultations, patients want assurances that their nostrils won’t stick out, the tip of their nose won’t turn up, or that they won’t experience a “pinched” look.Dr. Binder believes that his techniques provides the answers to most of these problems.
“Most of these untoward effects of Rhinoplasty result from older techniques. These techniques removed too much cartilage or bone, based on the theory of reducing size or sculpting the nose. This is what created most of the problems. Those of us who became interested in revising and correcting these problems quickly realized that in order to accomplish this, we had to add cartilage back to the nose because too much had already been removed,” said Dr. Binder.
Since then, the term “Structure Rhinoplasty” has replaced the older term “Reduction Rhinoplasty.” Essentially, surgeons reposition, identify, and reinforce weaknesses in the nose, instead of removing what causes problems in the structure and function of the nose. Although a natural-looking nose is desired by the majority of surgeons and patients, Rhinoplasty should never jeopardize or negatively impact breathing through the nose. Dr. Binder’s approach is proven to produce results that are subtle enough, yet strengthen the nose, and fix the existing nasal abnormalities.
Structure Rhinoplasty can be performed with a local or general anesthetic, and always under the strict supervision of a Board Certified Anesthesiologist. The length of time required to perform primary Rhinoplasty is usually between 1 ½ to 2 hours. For Revision Rhinoplasty, 2 ½ – 4 hours is common. All incisions are made inside the nose. However, in the exceptional cases where the sides of the nostrils are wide, they require reduction in width where parts of the nostril can be removed and this approach generally requires an alar incision which leaves only a fine scar that is hidden along the nostril base and is usually completely inconspicuous upon healing. Following surgery, soft packing is placed inside each nostril and is removed one day after surgery. A small comfortable splint is then worn for 5 to 6 days to protect the nose and ensure rapid healing. The splint is not placed to retain the shape of the nose, but is merely used for protection and to minimize post-op swelling. The patient is up and about the day after surgery, and within a few days, can perform most sedentary tasks. Typically, the majority of patients who undergo Structure Rhinoplasty have only minor discomfort or stuffiness with minimal bruising and swelling during the first few days after surgery. Proper follow-up care is an essential part of this operation. Following the procedure, the patient’s recovery process is usually observed and directed for 6 to 12 months to ensure that healing continues correctly. “While this might seem lengthy, it is necessary for the successful outcome of the procedure,” stated Dr. Binder. “At my Beverly Hills practice it is our ultimate goal to provide our patients the best and most natural rhinoplasty result.”
About Dr. William J. Binder
The dynamic Beverly Hills Plastic Surgery Practice of Dr. William J. Binder thrives at the forefront of medical technology and innovation. These breakthrough discoveries include the concept of Structure Rhinoplasty, the development of the field of facial contouring and custom-designed implants for reconstructive and cosmetic surgery as well as the use of Botox for the treatment of facial lines and migraine headaches. He is double-board certified by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology and Head and Neck Surgery. Dr. Binder is a fellow of the American College of Surgeons, the American Academy of Facial Plastic Surgery and the American Academy of Otolaryngology and Head and Neck Surgery. His medical office and surgical facility are in Beverly Hills. For more information, go to www.doctorbinder.com.
Tags: Cosmetic Surgery, Facial Surgery, Nasal Surgery, Nose, Plastic Surgery, Reconstructive Plastic Surgery, Revision Rhinoplasty, Rhinoplasty