Archive for the ‘Newspaper Articles’ Category
Monday, January 16th, 2012
Today’s patients are more concerned about treating the early signs of aging and unwanted fat than ever before. Women and men alike are looking for faster, less invasive procedures with little if any downtime that can reduce their wrinkles and improve their figure. While many devices have been touted over the years, most have failed to produce satisfactory results for many patients. But a new technology is now available that offers the latest advancement in nonsurgical, pain free therapy for the reduction of targeted fatty deposits, skin tightening, and sun damaged and/or wrinkles skin anywhere on the face and body.
Exilis is an FDA approved device that offers a non-surgical solution using radio frequency (RF) energy for fat reduction and tissue tightening anywhere on the body. The procedure uses safe radio waves to heat your skin and targeted fat cells. This thermal energy speeds up the metabolic activity of the fat cells causing them to shrink. At the same time it stimulates and strengthens the collagen network which improves skin texture.
Exilis is one of the first systems that produces actual circumferential reduction. By combining RF energy with cooling, all areas of the body where stubborn fatty deposits persist or tighter, firmer skin is desired can be treated. While Exilis is heating the tissues, patients remain relaxed and comfortable. Having no pain alone is a real advancement in non-surgical device treatments.
The most frequent areas treated with Exilis Therapy in men are the love handles, chest, abdomen, face, jowls, and neck. In women they include the face, jowls, neck, decolletage, arms, bra fat, thighs, hips, breasts, buttocks, stomach, and knees. Exilis requires a series of treatments, usually four, to get the best results. The results from Exilis Therapy are gradual and may take from two to four months to see the maximal effects of the treatments.
During the procedure the Exilis computer-controlled delivery device is guided over the treatment area. One feels a deep heating sensation as the Exilis RF energy is delivered to the deeper layers of the skin. The therapy causes the collagen support tissues to remodel and tighten. The applicator provides cooling to the skin’s surface as the energy is delivered, keeping one comfortable during the treatment. Many patients report the treatment similar to a ‘hot stone massage’. Exilis therapy is performed in the office and takes from 15-30 minutes depending upon the size of the treated area.
The highlights of this new Exilis therapy is NO downtime and NO pain, NO anesthesia, NO numbing creams and NO after care, reasonably quick treatment sessions, progressive results that last, able to treat all areas of the face and body and is scientifically proven and FDA-approved.
Exilis offers a revolutionary non-invasive form of treatment for the reduction of wrinkles and for the reshaping of unwanted fat deposits. Exilis also provides a method of after surgery smoothing and skin tightening from invasive liposuction procedures. Exilis treatments can postpone or eliminate the need for invasive surgery particularly for patients with mild to moderate fat deposits and who may not want liposuction surgery. As the only provider of Exilis therapy in Indianapolis and the state of Indiana, I am very excited to offer my patients a real alternative to fat reduction and skin tightening surgery.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, exilis fat reduction, exilis skin tightening, indianapolis
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Monday, October 17th, 2011
Cosmetic plastic surgery is now more than a $10 billion a year industry in the United States that has seen increases in number of procedures across all age groups. The largest growing population of patients, however, are those in their later years. Due to Americans being healthier, living longer and being more active later in life, millions of them want their looks to keep pace with how they feel. As a result, many are turning to cosmetic surgery to help them look younger and feel better about themselves.
In 2010, over 600,000 Americans age 65 or older choose to undergo some form of cosmetic surgery. Compared to ten years ago, that is a five times increase in number of procedures done. However a significant of these procedures, and a big reason for the large surge in numbers being done, is not actual surgery. In the interest of of wanting to look younger and fresher, many are going the injectable route choosing such popular products as Botox and Juvederm. While not as effective as surgery, they do help give one an extra edge in their appearance by decreasing frowning and plumping up certain wrinkles and folds.
Such injectable procedures involve only a minimal amount of discomfort by being placed right under the skin. Between wrinkle reduction and tissue plumping, these injections help give the face a smoother more youthful appearance. These are all procedures that can be done fairly quickly with a limited recovery time and are more economical options compared to surgery. When combined with a variety of available skin refreshening procedures such as chemical peels and light laser resurfacing, one can really take off a few years with next to no recovery or downtime.
While injectable treatments have lead the way in number of procedures for older Americans, ironically they are not the most effective given the amount of aging changes that are usually present. Injectables are more effective in younger patients simply because they have less wrinkles, lines and sagging skin. This is why surgery is also growing in numbers for the Baby Boomer generation with popular procedures being eyelid tucks, browlifts, and face and neck lifts. These anti-aging facial plastic surgery procedures can be done alone or, ideally in combination with surgery, to remove loose and sagging skin that creeps its way across our faces as we age.
We all look for that extra something to look and feel better as we age. My older and more mature patients clients are traveling, playing sports, exercising and doing all of the right things in life to look, feel and stay young. But, unfortunately as we age, all of the activity and exercise won’t make your face look any better. Looking better requires a effort, just of a different kind than that of feeling better.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facial injection therapies, facial plastic surgery, indianapolis
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Monday, October 17th, 2011
The pursuit of the perfect or idealized female appearance is not a realistic goal for any woman, regardless of what plastic surgery has to offer. Improving your own body through diet and exercise, and perhaps a little plastic surgery if desired, is a more common sense approach. Women should only want to have a pleasing face and good body proportions that fall within what their natural genetics will allow.
The Barbie doll, introduced in 1959 and celebrating her 50th birthday in 2009, has always been a controversial figure when it comes to body image. One of the most common criticisms of the doll is that it promotes an unrealistic or unattainable body image for young women to try and emulate. Based on her 1/6 scale at a height of just under 12 inches, she would be the equivalent of 5’ 9” with a weight of 110 lbs with measurements of 36-18-33. Technically at these dimensions she would have a body mass index of around 16 which would classify her as anorexic.
While the Barbie look is not one young women should really admire, it is perhaps interesting to know what plastic surgery procedures one would have to go through to achieve it. In the October issue of O magazine, former model Katie Halchishick served herself up as a example of what she would have to do to achieve Barbie proportions. Posing for a photographer, she used her body to diagram out what she would surgically have to do to change her features to achieve the equivalent of Barbie’s proportions and shape.
Based on this photographic diagraming, it was shown that she would need facial plastic surgery consisting of a browlift, jawline reduction and thinning, nose reshaping, neck contouring and a chin augmentation. For her body she would need a breast lift, upper arm thinning by liposuction and a tummy tuck…and that is for just above the waist. And it was not like this former model didn’t have an attractive face and body to start with.
While this is an entertaining and even humorous bit of photographic morphing, it does actually have a serious message. Trying to have so called ideal body proportions, or even an unrealistic body shape like that of Barbie, is not a healthy pursuit…even if plastic surgery could make it possible. On a more common request, trying to look like a certain model or entertainer is equally unrealistic. Plastic surgery should be used to enhance the face and body shape that women already have rather than pursuing excessive surgery to try and achieve what one isn’t meant to be. This is a healthy and psychologically balanced approach to plastic surgery that many teenage and younger women would be advised to follow.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: barbie plastic surgery, dr barry eppley, indianapolis, plastic surgery for teens and young women
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Wednesday, October 12th, 2011
The thought of eating turkey at the upcoming Thanksgiving holiday brings together two inseparable images. While history does not show that turkey was ever actually served at the first pilgrim’s festival, it has become the featured culinary dish since. While many will enjoy the tasteful bites from a turkey leg, breast or stuffing, few will aspire to have the turkey neck.
While few want to eat a turkey’s neck, even fewer want to have one on of their own. The turkey neck or neck wattle is that well known fleshy fold of hanging skin that is unavoidable for many as we age. The loss of a once smooth jaw line and a shapely neck shows the persistent effects of gravity and time.
While creams and other potions promise much, the turkey neck needs a surgical fix. Forget about non-surgical options and other ‘lunchtime’ type procedures. They simply do not work no matter how hopeful one is. For the fuller neck in a young person, fat removal by liposuction alone may be enough. But when the neck skin is loose and floppy, and you can pinch a wad of skin and fat between your fingers, some method of actual removal is needed.
The removal of a turkeyneck requires some form of a facelift. While often misunderstood, a facelift is really a neck and jowl operation and does not change the face much above the level of one’s mouth. It is a poorly named procedure and the term necklift would more accurately describe it. It is really less extensive and easier to go through than most people think.
When it comes to necklifts, there are numerous options.Which one is best for any particular person is determined by how much loose neck skin one has. Some jowling and a little loose neck skin may only need a limited facelift. If there is a lot of loose neck skin, then a fuller form of a facelift is really needed. This is a powerful neck changer and can produce some really dramatic results. For those that want the least invasive amount of surgery but with a dramatic change, the turkeyneck can also be directly cut out in a procedure appropriately called the direct necklift.
The turkeyneck is not a desired culinary item on the bird and many people don’t like it on themselves either. While year round turtlenecks are always an option, a little skillful carving may be a better solution.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, necklift, turkeyneck surgery
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Sunday, October 9th, 2011
Shopping for discounts as an innately human characteristic. Most people like to negotiate or are attracted to sales as the need to feel like one has gotten the best deal is sometimes as important as the item of interest. At no time is this more evident than in economic downturns. While I think the Groupon concept may have been successful at any time in history, it has really taken off since our recent recession started.
While Groupon had its origin in retail items such as restaurants, spa services, and clothes, it has more recently spread to medical procedures such as cosmetic surgery. Groupon discounts now exist on a wide range of cosmetic procedures from Botox to breast implants. These elective medical procedures for some appear to fall into the mindset of any other retail purchase.
While cosmetic surgery today is commonplace, it begs the question why anyone would be willing to buy cosmetic surgery based on a doctor who only offers the lowest price. Choosing cosmetic surgery on price seems to be a poor health decision. Almost all of these cosmetic procedures can cause serious problems if done improperly…and may cause injuries that are hard to correct later.
But beyond this concern, there are other issues that underpin serious problems with the Groupon cosmetic surgery concept. One of these is that not every patient who buys such a discount may be a good candidate for surgery. While Groupon does make a footnote that services are dependent on being qualified, making an online purchase creates a level of provider obligation that may be difficult to reverse. In this discount coupon approach, eligibility is not done before one purchases the procedure. This is the exact opposite of what occurs in common medical practice.
Unlike a meal which you don’t like or a purse whose clasp falls off weeks after you have purchased it, what happens when you don’t like your cosmetic surgery result that requires a revision or a complication that requires further surgery or medical care? Who is going to pay for it? Who is financially responsible? I can assure you that it isn’t Groupon even though they took a hefty profit on the transaction. Having cosmetic surgery because you could afford it due to the discount unintentionally exposes the enthusiastic shopper to a financial risk that they are completely overlooking.
Equally relevant, why would any cosmetic surgery provider offer an expensive surgery at half price? Would a well qualified plastic surgeon with lots of experience offer cheap cosmetic surgery? More times than not such, cosmetic surgery Groupon offers come from doctors of dubious backgrounds and training for the procedures that are touting. The Groupon concept makes it easy for such providers to find new patients who don’t look past the dollar signs.
Cheap cosmetic surgery may sound attractive…but the consequences later may be anything but cheap.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, groupon cosmetic surgery discounts, indianapolis
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Sunday, October 2nd, 2011
Botox remains a popular and effective method of reducing unwanted facial expressions and wrinkles. While it is a highly desired anti-aging facial treatment, it must be introduced by a needle and preferably in a doctor’s office or a medical facility. While the injections are not terribly uncomfortable, if there was a way to avoid having needles put into one’s face these anti-wrinkle treatments would likely become even more popular.
The quest to find a ‘topical Botox’ or cream that would penetrate through the skin to reduce the source of facial wrinkles has been much like the search for the Holy Grail. There is a strong belief that such a cream exists but it has remained elusive. Many topical creams and serums claiming to have a Botox-like effect have been touted, but the real beneficiary of those products has always been the manufacturer .
At this year’s annual American Society of Plastic Surgeons meeting in Denver, a new botulinum toxin-based gel was presented that showed promise. Reporting results from a recent prospective double-blind clinical trial of nearly 100 patients, near 90% of those that had the active gel had observable reduction in crow’s feet wrinkles. This compared, interestingly, to just under 30% in those patients that have been treated by a non-active or placebo gel. In a second study that involved nearly 200 patients about 40% of those treated with the botulinum toxin gel had good results. In either study, the effects of the gel lasted around four months which was comparable to that of injectable Botox.
These study results are the first to show that dynamic facial wrinkle reduction is possible through topical application or a cream. It is no surprise that the studies have been done for wrinkles in the crow’s feet region to the side of the eye. This skin is very thin and the most easily penetrated down to the orbicularis muscle underneath. This is unlikely in the substantially thicker forehead tissues where an effective topical cream would be much more challenged to penetrate deep enough.
While it is encouraging that a botulinum toxin gel has been shown to noticeably soften crow’s feet wrinkles without needles, it remains to be seen how practical it will be. Does the gel work better than injectable Botox? Would it’s cost be similar, less or even more? This information awaits further clinical study which undoubtably is ongoing. Getting rid of some wrinkles may truly be just a dab away in the near future.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, topical botox
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Sunday, October 2nd, 2011
Being overweight is a well known health risk. Accumulations of fat, particularly around one’s midsection, contribute to the risk of heart attacks, stroke, and diabetes. Losing this weight through a sustained diet and exercise program is the best way to improve one’s health. There is a large number of medical studies that would support the health benefit’s of overall body fat reduction.
It has long been theorized that the surgical removal of body fat rolls through liposuction may offer some similar albeit less significant health benefits. To date, there has been no medical evidence that would support this belief. It was presumed that the amount of fat removed in most liposuction procedures was simply too small to make a difference. In addition, it has always been believed that the fat that really matters, from a health standpoint, was visceral or intra-abdominal fat. Subcutaneous fat or that which lies right under the skin only mattered because it made up those unflattering outer body rolls.
A recent study given at the 2011 annual American Society of Plastic Surgeons meeting in Denver presented some interesting findings on potential health benefits from liposuction surgery. In over 300 hundred patients who had either liposuction, a tummy tuck or both combined, blood levels of triglycerides, cholesterol and white blood cells were studied both before and after surgery. Triglyceride levels in patients with normal levels before surgery were unchanged. However, in patients with elevated triglyceride levels before surgery (defined as greater than 150 mg/dl), they showed a triglyceride level reduction of over 40 percent. Such significant level reductions are usually associated with drug therapies which often are even this effective. White blood cell counts, viewed as an indicator of chronic inflammation and disease inducer, dropped an average of 10 percent.
Does this mean that liposuction is good for your overall health? That is a stretch at this point but this study clearly shows that liposuction causes blood chemistry changes that reduce certain disease risk factors. Much more work needs to be done but it does provide some proof that subcutaneous fat may have a greater metabolic role to play than previously thought. It is not just an idle depot of excess fat whose only relevance is as the creator of undesired body rolls and bulges. At the least it may be comforting to know there may be some benefit, small as it may turn out to be, that liposuction removal of abdominal and waistline fat may also be good for more than just how you look.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, health benefits of liposuction, indianapolis
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Friday, September 30th, 2011
Breast augmentation remains a popular body contouring procedure for women. In as little as one hour, a woman can dramatically change her body shape in a very favorable way. Only breast implants can produce such a significant body change in such a short period of time. When it comes to breast implants there are two types currently available, saline -filled and silicone filled. Since 2006, silicone breast implants have returned which are filled with a new cohesive gel formulation that is much better than that used in the past.
Given these two choices, how does one decide which type of breast implant is better for them?
In reality, neither saline or silicone breast implants are perfect. If one was truly better than the other, there would be only one choice not the two that we have. Each type of breast implant is safe (FDA-approved) and has its own unique set of advantages and disadvantages. Both of them will do the job and do what they are intended to do… make the breasts bigger. But there are some differences between them and understanding these differences helps you make the best implant.
Saline breast implants have the advantages of a lower cost and can be placed through a small incision high up in the armpit that is not on the breast. That incision location may be an advantage in the Hispanic woman who may be concerned about any scarring around the breasts. Saline implant disadvantages are that there may be some implant rippling that can be felt on the bottom or sides of the breast and the risk of immediate deflation of the breast should the implant rupture.
Silicone breast implants have the benefits of a slightly more natural feel (no rippling) and the breast will not go flat should the implant rupture. However, they do require an incision in the lower breast crease and have higher implant costs.
Other than these implant differences, everything else about the breast augmentation procedure is the same including recovery time (one week or less) and how long the breasts will be swollen. (two to three weeks)
What is the best type of breast implant for you? I tell patients to make their choice based on which of their disadvantages you can live with the best. Both saline and silicone implants work for breast augmentation…which of their disadvantages is more acceptable to you?
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, saline breast implants, silicone breast implants
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Sunday, September 25th, 2011
Inadequate training and poor judgment account for a disproportionate number of complications and unsatisfactory results that occur from cosmetic surgery procedures. With so many different types of doctors doing cosmetic surgery, how can one make a safe choice? Historically, the use of the terms ‘board-certified’ and ‘specializing in’ were enough to demonstrate a doctor’s expertise, but today that is not enough.
Are they board-certified in plastic surgery or another specialty? Many new cosmetic surgeons are board-certified but not in plastic surgery. Their board certification may be in General Surgery, Dermatology, Oral Surgery or Ob-Gyn to name a few. Some may even have an additional board-certification in cosmetic surgery. But this self-created board should not be assumed to be equivalent to those certified by the American Board of Plastic Surgery. There is a significant difference between board-certified plastic surgeons and board-certified cosmetic surgeons that makes them not equivalent at all.
How experienced in doing your procedures of interest is the doctor? This can be a hard piece of information that is not easy to ascertain. Certainly asking the doctor is an obvious way to learn how many the doctor does, but that is not the exclusive source I would use. Look at their websites and see how many before and afters of the procedure are posted. Ask for before and after photographic results and to talk to some more recent patients. (done in the past 3 to 6 months) Word of mouth still remains as a good method of recommendation. Willingness to easily and quickly divulge this information is a good sign. Hesitancy or avoidance of doing so would be of concern.
Hospitals are obviously certified and have to meet highs standards of care and comply with stringent regulations. Surgery centers can be quite different and you want to have your surgery in one that has been accredited by either the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This accreditation and a state license to operate means the facility adheres to safe operating conditions. Doctor’s office are fine for minor surgery but most are not accredited for more significant surgeries and any anesthesia that may be needed.
The cost of cosmetic surgery is always of concern and no one wants to overpay for their procedure(s). But the cost of cosmetic surgeries is influenced by market factors just like any other retail business. This makes a fairly consistent price range for procedures in any given geographic region. If after getting several consultations one price is considerably lower than another, the question should be why. Where are the costs being reduced to offer such a lower price? This is what makes the whole concept of Groupon and other discount programs for cosmetic surgery so unnerving.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, qualifications for cosmetic surgeons
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Monday, September 19th, 2011
Aging is inevitable and it begins to appear first around the eyes. While eyelid and brow lifts provide immediate and significant improvements, many would prefer to lessen these eye flaws without the costs and recovery of an operation.
There are a variety of non-surgical eye treatments combining neurotoxins, fillers, lasers devices and topical products. Which ones are used often follows the age of the person. Those in their 30s and 40s usually just need Botox to control their frowning and squinting wrinkles. Fillers and light and laser treatments are added for those in their 40s and 50s. At age 50 and beyond, surgery is needed to remove extra upper eyelid skin and lower eyelid bags. But these non-surgical treatments are still needed to preserve one’s surgical investment.
Botox is the most known name when it comes to facial wrinkle reduction by injection. But it is not alone as two other injection drugs, Dysport and Xeomin, are also available. While there are some that believe one is better than the other, they all are really comparable. They all take a few days to a week to start working and their effects will last from three to four months. One is not more powerful than the other nor does one cost less. These injections are given by the unit and the cost per unit varies for each one but so does how they are prepared. As such their treatment costs are all about the same.
While Botox is the most common non-surgical eye treatments, injectable fillers can also play a role. Many people will develop shadowing and tear troughs under the lower eyelid, sometimes as early as the late 30s. This can be treated with fillers to plump the area out. While they are over a dozen types of injectable fillers, the hyaluronic acid-based fillers (e.g., Restylane and Juvederm) are preferred. They can be delivered under the thin tissues of the lower eyelids with a low risk of lumps and irregularities.
While eye wrinkles can be held in check with Botox and fillers, they can not reverse certain skin problems. Blood vessels and brown spots can be removed with pulsed light treatments. These are often confused with lasers which they are not. When it comes to improving skin texture and reducing fine lines and wrinkles, laser resurfacing can provide improvements beyond what an eyelid lift can do.
Topical skin care products complement eye the benefits of injectable and energy treatments. The skin around the eyes is so thin that it responds well to many Vitamin C, retinoid and antioxidant-containing products. A new topical product, Latisse, is great for thinning eyelashes and eyebrows and it works like nothing else. Eyelashes and eyebrows can become one-third longer and thicker in a few months.
While surgery may be needed or inevitable for some, younger and less tired looking eyes may be just a few injections or the wave of a laser wand away.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: botox, dr barry eppley, indianapolis, injectable fillers, laser resurfacing, latisse
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