Archive for February, 2011
Monday, February 28th, 2011
Q: I am going to undergo Zerona body contouring treatments. I wanted to check with you first to make sure it is safe to do Zerona treatments with my inguinal hernia that protudes over my belly button area. I know the hernia is made up of fat, and I want to know if I should cover it with something to keep the Zerona from affecting it. Thanks so much for the help.
A: Zerona is a body contouring device that uses cold laser technology. This a low frequency low power laser light that should not be thought in the conventional laser sense. It is not a focused high energy beam which would normally burn anything in its path including skin and eventually fat. Rather it works by a different light principle known as a photochemical effect which will not injure or burn any tissues. This photochemical effect makes fat cells temporarily leaky by opening up channels or pores on the cell walls. This is not harmful to the fat cell per se, it just makes it lose some of its lipid volume. Thus, it is perfectly safe even if it would coincidentally be directed onto an abdominal area in which a hernia would be present. It would also be unlikely that the penetration of the Zerona energy would pass more than 5 cms below the skin, which is too superficial for many hernia locations.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, zerona body contouring
Posted in Your Questions | No Comments »
Monday, February 28th, 2011
Q: I have been left with a dog ear on my face after a nose reconstruction due to skin cancer. The nasal ala was reconstructed but the end result looked like a further growth. (like a pin cushion of skin stuck on to the side of my nose) It underwent a revision about two months later. I am still not totally satisfied as I now have a further deep scar on the side of my nose and an awful obvious dog ear that looks very unsightly. I went for a follow-up and they suggested giving it a year before considering any further surgery. I am desperate to have something done but if we did operate on the dog ear, I fear it might end up worse!! How can this be and why should I live with my face like it is? What can be done now?
A: Reconstruction of the nose after cancer is one of the biggest challenges in plastic surgery. This is particularly true of the nasal ala which is a small but delicate area. Having had two surgeries and now some degree of scar contraction or dogear, it is very important to let the tissues heal and settle down. The healing must progress to the point that it is not only complete but the scar tissues have relaxed. Operating on tissues that are not soft and supple will only lead to further scar contracture problems. It is certainly frustrating to have to wait a whole year with less than an optimal result sitting on your face, but the best result from an effort at scar revision depends on good quality of tissues to manipulate.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, plastic surgery of the nose, scar revision of nose
Posted in Your Questions | No Comments »
Monday, February 28th, 2011
Q: I read an article on jaw implants in which you wrote “In some cases, no available off-the-shelf chin or jaw angle implant can create the desired effect due to a patient’s unique anatomy or aesthetic needs. In this situation, a customized ‘wrap-around’ jawline implant can be made from a 3-D CT scan of the patient. These can be made as a single implant or in multiple units that can be inserted in pieces and assembled when next to the bone. This approach is particularly useful when the jawline needs to be vertically lengthened. (implant sitting on the bottom edge of the bone)” Can you go into detail about the process of the custom mandibular implant with the 3-D CT scan? And from that how that fits into someone who travels for the surgery?
A: While standard chin and jaw implants will work most of the time, there are some patients whose jaw problem is beyond conventional implant designs. There are also patients who have been successfully implanted but do not like the aesthetic outcome that has resulted. These ‘implant-deficient’ patients have either vertical jawline deficiency, extreme chin deformities or the desire to have a more exaggerated jaw angle prominence. In these cases, only a custom jaw implant will suffice.
The process of making a custom jaw implant begins with the patient getting a 3-D CT scan at a local hospital or x-ray facility. That 3-D mandibular data is then sent to a custom model manufacturer. (I use Medical Modeling, Golden, CO) That model is then sent to me where I will hand carve out of wax or acrylic the desired implant(s) shape. Once approved by the patient, it is then sent to an implant manufacturer who will manufacture and sterilize the final implant(s). It will then be shipped to me for surgical implantation. This entire process takes about 4 to 6 weeks to complete. For someone traveling from afar, they only have to make one visit for the actual surgery. All preparations can be done from afar.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: custom jaw implants, dr barry eppley, indianapolis, plastic surgery of the jaw
Posted in Your Questions | No Comments »
Monday, February 28th, 2011
Pregnancy and childbirth can wreck havoc on a woman’s body. Few women would cast doubt on a phenomenon that they have probably seen or experienced. Throw in the strain of a few months of breast feeding and a bunch of sleepless nights and a woman’s body is sure to suffer (not to mention how she may feel). To reverse some of these changes, plastic surgery has come up with a variety of cosmetic procedures to help restore a woman’s body. Dubbed the “Mommy Makeover”, it has become popular as both a marketing concept and a treatment strategy for the post-pregnancy female body.
A Mommy Makeover is a collection of female body reshaping procedures that focus on the breasts and abdomen- the two body areas that are most affected by pregnancy. These can include breast procedures such as a breast lift to perk up sagging breasts after breast feeding, breast implants to bring back a woman’s cup size or even more, and a breast reduction to reduce breasts that may have become enlarged during pregnancy. Abdominal and waistline options include various forms of tummy tucks to tighten stretched stomach muscles and remove loose and sagging skin, and liposuction to eliminate unwanted pockets of fat from the stomach, hips and thighs.
None of these plastic surgery procedures are new, but combining them all at once in a single surgery is. Combining breast and abdominal reshaping can create the most dramatic changes ever seen in a woman between the shoulders and the hips. Some women can never return to exactly the way they looked before children even with the best of plastic surgery, but others can end up looking more shapely than before pregnancy.
While many women get stellar results with a Mommy Makeover, it is not right for everyone. The best candidates are those women who are finished having children and are done with breast feeding. One should have made a good effort with diet and exercise to get the best body possible before surgery, and have sufficient time off and support to allow for an adequate recovery. While some women are anxious to begin the process of a Mommy Makeover shortly after giving birth to their last child, it is often better to wait for at least 6 months to a year.
Most Mommy Makeovers are done on an outpatient basis under general anesthesia. No really significant breast and abdominal changes can be done within the limits of local and sedation anesthesia. Real body changes requires real surgery…and recovery.
While some women bounce back from pregnancy like nothing ever happened, other women struggle with feeling their bodies have been ravaged after pregnancy. Mommy Makeovers can reverse years of damage to a woman’s body in just a few hours.
Dr. Barry Eppley
www.eppleyplasticsurgery.com
Indianapolis, Indiana
Tags: dr barry eppley, mommy makeover indianapolis
Posted in Newspaper Articles | No Comments »
Sunday, February 27th, 2011
Q: I have my ears gauged to about 1 inch and I have a really bad tear in my left ear. My right ear isn’t too bad but is blown out in the back. Can these ears be fixed? But I don’t want my ears closed all the way! Just the scar tissue removed and my left ear thickened a little bit so it doesn’t tear off.
A: The repair of the gauged earlobe, while looking intimidating, is actually easier than one would think. The reason is the normal earlobe is small but the gauged earlobe, despite its big hole, has actually created extra earlobe tissue. Through a basic plastic surgery concept of tissue expansion, the earlobe edges may have gotten thinner but the actual amount of earlobe tissue has increased. It is always easier to reconstruct a body part where there is too much tissue than when there is a deficiency.
In reconstruction of the gauged earlobe, it can be done two different ways. The most common method is to remove the excess tissue and put it back together as a complete earlobe. After 3 months of healing, the ear can then be pierced. An alternative method is to do the reconstruction leaving a smaller but complete hole in the middle. The hole can be made very small for a piercing or left larger to wear a smaller gauge. Either 3 months of healing again are needed before anything is inserted.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, plastic surgerye of the earlobe, reconstruction of the gauged earlobe
Posted in Your Questions | No Comments »
Sunday, February 27th, 2011
Q: For most of my life I have considered myself ugly. I avoid having pictures taken and I most certainly don’t look at them if they have to be taken. I have a total lack of confidence and this has definitely poses problems in my personal relationships. I don’t know what it is about my face but it just doesn’t look right. I am only 29 but I look much older. My eye area looks droopy and old and may face looks thin and distorted. I have attached some pictures for you to see and review. What would you recommend to help me look better ?
A: When someone doesn’t like their face, particularly at a young age, this indicates that the problems are with how it is put together (structural components) not that it is has early aging. This means the underlying structures that make up the shape and highlights of the face which are largely bone and cartilage. In reviewing your pictures, I can see that your face has unbalanced structures which include low hanging brows, a broad and prominent nose, hollow cheeks, and a wide and long chin. The combination of these features creates an overall facial look that you do not like. Procedures such as an endoscopic browlift, rhinoplasty, cheek implants and chin reduction collectively would make a major change in how your face looks. It would lend a softer and more youthful due to a better balance of your facial features. Computer imaging with these changes would demonstrate their potential benefit in changing the shape of your face.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: browlift, cheek implants, chin reduction, dr barry eppley, facial shape change, indianapolis, plastic surgery of the chin, rhinoplasty
Posted in Your Questions | No Comments »
Sunday, February 27th, 2011
Q: I had a wart removed from my lip about a month ago. It has left scar tissue that really bothers me. It feels lumpy. People tell me they can barely tell but I know it’s there and was wondering what might be the best option for me?
A: To provide a really accurate answer, it would be helpful to know exactly how this lip lesion was removed and where exactly on the upper or lower lip it was removed. I am assuming that it was cut out and involved part of the wet and dry vermilion. (pink part of the lips) Excisions that involve the lip will frequently leave a bump or hard knot behind for a period of time. This is a normal reaction to injury and is a combined inflammatory and scar tissue reaction. This is usually very noticeable due to the sensitivity of the lips and the natural tendency for one to constantly run one’s tongue over it. In most cases, this reactive lump will eventually subside as it heals. It will usually take about 3 to 6 months for it to soften up and feel more natural. In those few cases where this lip knot does not eventually go away, a scar revision would be needed.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip scar revision, plastic surgery of the lip
Posted in Your Questions | No Comments »
Sunday, February 27th, 2011
Q: Hi, I have hated my nose for a long time and I have finally decided to get a nose job. I am African-American and I don’t like the lower third of my nose. My nose is too wide and big when I smile. My nostrils flare really wide. I just want to get rid of some of the wideness but don’t want to change the whole nose. Is that possible?
A: One of the many distinguishing features of the African-American nose can be its unique tip and nostril shape. The tip is often more flat and less well-defined and the nasal base is wide, often with nostrils that have a larger size that also flare. Many African-American rhinoplasties involves reduction of the wide and flaring nostrils. This can be done by removing skin from the inside of the nostrils for some minor reduction or by repositioning the entire nostril base for a more major change. Nostril and nasal base reduction can be done by itself but it is important to see how this may change the overall look to the nose. This is where computer imaging is absolutely essential. Most likely changing the size of the nostrils will affect how the tip of the nose looks and will make it look even more flat and shorter. Some tip changes through columellar strut grafting may be needed with nostril reduction to keep the lower third of the nose in balance. Dr. Barry Eppley Indianapolis, Indiana
Tags: african-american rhinoplasty, dr barry eppley, indianapolis, nostril reduction, plastic surgery of the nose
Posted in Your Questions | No Comments »
Saturday, February 26th, 2011
Q: I was born with a club foot. I had my first surgery when I was a few months old. I would love to have matching legs. Does insurance cover this since it is a bitth defect?
A: One of the aesthetic sequelae of a club foot deformity, which is one of the most common birth defects, is that of calf asymmetry. Due to the foot deformity, the calf muscle of the involved leg does not develop to the size of that of the normal opposite leg. This results in one calf being smaller than the other which causes an aesthetic imbalance of the lower legs. This can be improved with a calf implant which is placed from an incision on the backside of the knee. While the small calf size can be improved, it rarely can become exactly as big as the opposite side as the calf skin is very tight and will only expand so far. This is done as simple outpatient procedure that takes about an hour to perform. Calf implant surgery for club foot is not covered by insurance even though it is being done to correct a congenital deformity. This is because the implant is not improving the function of the leg (medically necessary) but is being done to improve how it looks. (cosmetic) The lower leg will not work any better as a result of the implant but it will look more symmetric to the opposite side.
Dr. Barry Eppley
Indianapolis Indiana
Tags: calf implant for club foot, dr barry eppley, indianapolis, plastic surgery of the calf
Posted in Your Questions | No Comments »
Saturday, February 26th, 2011
Q: I had liposuction done on my neck when I weighted 185 lbs with about 15% to 16% body fat. I had a good immediate change in the shape of my neck from that procedure. I am now 170 lbs and about 12% to 13% body fat. The great results from the liposuction have persisted as I would have suspected. What I am wondering is what will happen if I gain weight back to where I originally was around 185 lbs. I am not planning to but I am curious as you never know what the future holds. Does it matter if my weight fluctuates between 170lbs and 185lbs? Will the fat return in my neck if I gain weight back?
A: The long-term results of liposuction on most areas of the body are highly dependent on the stability of one’s weight. The neck may be a slightly more privileged site (resist fat re-accumulation) than the stomach or flanks for example, but fat can definitely return there if one gains enough weight back. I think as long as you stay under your weight at the time of your original surgery, then your neck liposuction result should be unchanged. The percent body fat and weight ranges that you are talking about are not significantly large (170 to 185 lbs) so that change will likely not make much if any difference in the neck. However, it behooves you to keep the weight off as the amount of fat that was originally in your neck was there for a reason…so don’t give it a second chance to come back to an area that it once enjoyed.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, indianapolis, neck liposuction, plastic surgery of the neck
Posted in Your Questions | No Comments »
|
|
|
|