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Structure Rhinoplasty:  A new approach to primary nasal surgery

For many years, Rhinoplasty was performed with the singular goal and approach of reducing the size of the nose by removing tissue.  This reductive approach, however, did not always hold up well over time. The removal of too much supportive cartilage weakened the nasal cartilages causing deformity and symmetry issues and, in extreme cases, a collapse of the nose.  These appearance issues are intimately related to functional breathing problems, sinuses conditions, and sleeping and eating disorders.

Strengthening rather than Weakening the Nose
Realizing the importance of preserving the structural integrity of the nose and that beauty had more to do with proportion and balance of facial features, Dr. Binder pioneered an approach to rhinoplasty aimed at reshaping rather than simply reducing the nose.  Instead of removing, he repositions and reinforces weaknesses in the nose that contribute to problems in both structure and function. Dr. Binder’s philosophy is to create a nose that fits the face and remains in proportion with other facial features. Now known as “structure rhinoplasty”, this individualized, interdependent approach uses a three-dimensional perspective to create a consistent, naturally-shaped nose that harmonizes perfectly with the rest of the face.

Dr. Binder’s Structure Rhinoplasty techniques produce individual results that:

  • are characteristically subtle and natural
  • focus on strengthening and restructuring the cartilage framework of the nose, and
  • correct abnormalities caused by weaknesses in the nasal framework that affect nasal function.
The result is a completely natural looking nose. The patient never has to worry about ending up with the unappealing appearance of a "surgically-overdone nose." If the patient experiences breathing problems, the air passage can simultaneously be opened by either straightening the deviated septum and/or reducing structures inside the nose called turbinates, that become enlarged by chronic allergy or other nasal disorders.

Closed rhinoplasty technique
To create that desired naturally balanced appearance, Dr. Binder generally performs the entire rhinoplasty procedure from the inside of the nose (the closed technique), so there are no visible signs of scarring. The closed technique is performed without making an incision across the columella (the delicate island of tissue between the nostrils). Because of the ease of access and a shorter learning curve, the open approach is often preferred by many surgeons even though it may leave an exterior scar.  Depending on needs of each case, Dr. Binder sees different advantages to each method, but in most cases he incorporates the best philosophies of both approaches into the closed approach.

Revision Rhinoplasty
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los Angeles magazine
Closed Rhinoplasty
"The original ‘nose job’ was called a reduction rhinoplasty," says Dr. William Binder, a facial plastic re-constructive ls...
Los Angeles Magazine
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