Posts Tagged ‘dr barry eppley’
Tuesday, January 31st, 2012
Q: Dr. Eppley, I have a dent in the back of my head and it looks like where the anterior fontanelle is. I have had it as long as I can remember. I like the shape of my head but I want this dent filled so I have a shape that is no longer embarassing. I talked to my GP doc and he couldn’t do anything to help me because it would not be for medical purposes just cosmetic. What would this procedure be called and what specialty of medicine/cosmetics would a doctor be who performs this procedure?
A: What you appear to have is a skull indentation cosmetic deformity in the upper part of the back of your head. This may be where the original posterior fontanelle (not anterior) was. Regardless of why it is there, it is likely a simple contour defect over solid skull bone. This can be treated fairly simply with a variety of onlay cranioplasty materials. Some are placed through small scalp incisions and one of them can even be placed through a minimal incision injectable approach. These procedures are usually performed by either plastic surgeons with craniofacial training or neurosurgeons. When skull defects are purely cosmetic in nature and have no neurologic basis, it would be treated by a plastic surgeon.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cosmetic cranioplasty, dr barry eppley, indianapolis, skull dent repair
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Tuesday, January 31st, 2012
Q: Dr. Eppley, I had a septorhinoplasty done late last year and I just don’t like the way it looks now. I didn’t know that my bridge would be built up to be higher and more prominent. I went in to just have a septoplasty to try and help me breathe better. The doctor suggested that my bridge be changed and the tip narrowed a bit, both changes which I now regret. I used to have a nice slope to my nose before and it looks so different that the bridge is so high. Do you think this could be just swelling? Is there any way to reverse these nose changes?
A: It is extremely common for the outer appearance of the nose to be changed at the same time that the internal breathing function (septoplasty and turbinates) is being improved. While plastic surgeons may suggest these changes in the patient who just appears for breathing problems, such recommendations are often welcomed very enthusiastically. The convenience of having both nose issues addressed simultaneously is obviously appealing…provided that one does have some real concerns about their nose appearance and they are very clear on what is going to be done. It appears you now have some early ‘buyer’s remorse’. This could be premature regret since it has only been a few months from surgery and swelling is most certainly present. It may also be that you did not have a clear understanding of what the objectives of the rhinoplasty were. This could have been avoided by computer imaging analysis before surgery. While you may have a rhinoplasty revision to try and reverse some of these changes,it is too early to consider that now. You should give your nose up to a full year after surgery for all swelling to go away and you to adapt to the new look. It could very be how you feel now may change at this time next year.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, rhinoplasty revision, septorhinoplasty
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Tuesday, January 31st, 2012
Q: Dr. Eppley, I have always hated my high forehead, to the point where it depresses me. I really want to look into getting it reduced, however I am only 18. I was hoping to be able to do some sort of payment plan, it would be a big help! Email back if a payment plan would even be allowed. Thank you!
A: This is the type of surgery that has to be paid for up front, like all of cosmetic surgery. Many patients opt for financing their surgery through such companies as Care Credit to name the most well known. The typical cost of forehead reduction through hairline advancement is in the range of $5500 to $ 6500.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cost of forehead reduction, dr barry eppley, indianapolis
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Monday, January 30th, 2012
Q: Dr. Eppley, After breast feeding two babies my breasts have gone deflated. I know that I need a breast lift. My breast size now is a small 36C. Since the upper part of my breast (that part I see the most!) is flat, do you think I need an implant as well? I am not looking to be huge but think that it would help make my breast look fuller. If I get an implant with my lift, what type should I get? I’ve read that a silicone implant is more natural looking.
A: You have very astutely pointed out one of the most overlooked deficiences in breast lifts for some women. The fullness that it creates in the upper pole of the breast will likely only be temporary and often an implant is needed as well. When using implants in a breast lift, there are two general size considerations. A smaller implant can be used in which the goal is persistent upper pole fullness but not a significant change in breast size. A larger implant is used for both upper pole fullness and an overall breast size change. That is a decision that requires patient input. Whether the to go with a saline or silicone implant is matter of personal choice, the most significant factor is a cost difference (saline less costly) and the risk of eventual implant deflation (saline) versus silent implant rupture. (silicone)
Tags: breast lift with implants, dr barry eppley, indianapolis
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Saturday, January 28th, 2012
Q: Dr. Eppley, I had gastric bypass surgery in 2005 and I would love to have a tummy tuck. I’m sure this surgery would help me feel better due to other health conditions I have. I have severe depression, lower back bulging disc with nerve blocks and other health issues that have caused me to become disabled and last year I was approved for S.S.D.I benefits. A tummy tuck is a surgery that I have wanted for years because I have lost a lot of weight. But with the way my tummy looks it makes me feel incomplete and sad. I have pain with the sagging skin with my back and extreme rashes underneath the lower flabby skin around the panty line. Please help. I’m so unhappy with the way I look and feel. Thank you for your time.
A: Your abdominal situation with your weight loss after bariatric surgery is a common one. The weight loss has been great but the abdominal overhang (pannus) is now a ‘new’ problem. Your description of symptoms is classic and I would have no doubt that a tummy tuck would be of great benefit. Your biggest challenge is getting a tummy tuck is an economic one. By being on disability I would assume that your health insurance is through Medicare or Medicaid. This would require you finding a plastic surgeon who participates in those programs which I do not. Even with private health insurance, there are fewer and fewer plastic surgeons today who will perform this surgery through insurance anymore. In addition, there is also the issue of whether you would qualify for an abdominal panniculectomy/tummy tuck which is an insurance determination not a plastic surgery one.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: abdominal panniculectomy, dr barry eppley, indianapolis, tummy tuck after gastric bypass surgery
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Saturday, January 28th, 2012
Q: Dr. Eppley, I have concerns about my head shape. I know my head shape is not terrible but it bothers me enough to want something done. I know actually looking it over or feeling the shape would give better insight. The way it’s shaped makes it difficult for normal looking haircuts. I really want to try to do something about it so please try and help me. I think the one noticeable thing is that it’s not a smooth shape at the top, it divot’s a lot on the sides. I have attached pictures. Please let me know what you think.
A: I have reviewed your pictures and read your concerns. The exact area to which you refer is the transition zone between the superior attachment of the temporalis muscle and parasagittal bony skull area. There are many people who have an indentation or steep transition between these two aesthetic skull zones. In some people it is more severe and noticeable. That area could be augmented, it is a question of how that can be done. The method that would provide the smoothest and best contour result is an open skull augmentation (cranioplasty) using either PMMA or hydryoxyapatite. The use of an open cranioplasty involves a croronal incision and resultant scar may not be acceptable in many male patients. An alternative approach is an injectable cranioplasty using Kryptonite bone cement. While this does not have any scar concerns, there is a potential issue of visible edges in the anterior aspect of the defect in the upper forehead.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, skull augmentation, skull reshaping
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Friday, January 27th, 2012
Q: Dr. Eppley, Can you please tell me the cost of a subnasal lip lift? I am not interested in having surgery on the muscle. I only want the lip lift where the skin is removed.
A: A subnasal lip lift should never have the muscle manipulated in any way. That leads to problems such as tightness, columellar base retrusion and an unnatural upper lip movement and smile appearance. In my hands, it is always a skin only procedure. While this may be associated with a 1 to 2 mm relapse in some cases over the first six months after the procedure, it does not in any way affect how the upper lip moves or alters one’ smile.
A subnasal lip lift for most patients is done as an outpatient procedure in an office setting under local anesthesia. The typical cost would be in the $2,200 range.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, subnasal lip lift
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Friday, January 27th, 2012
Q: Dr. Eppley, I would like to send some photos so you could tell me the most appropriate surgery to have. I would like a wider face, a less pointy chin, a chin lift and jaw implants. I wore braces to correct an underbite and I had a mandibular osteotomy and genioplasty – the result is a long face. What can I do to bettr improve my overall appearance. I am 39 years old and terribly unhappy with my profile and double chins etc.
A: You have many of the sequeale of orthognathic surgery of the lower jaw which occur from both the surgery and aging. While a sagittal split mandibular advancement osteotomy and genioplasty have undoubtably done wonders for your bite and improved your facial profile, there are some skeletal deficiences from that surgery that have either been created or unmasked with aging that have affected your lower face. Your face has become narrower with that surgery as the jaw angles are usually lost from the ramus osteotomy and the chin becomes more narrower as its u-shape comes further forward. There also appears top be some asymmetry of the lower jaw with the left angular area being more deificient than the right. There is also the effects of aging as the neck has become fuller and dropped down due to soft tissue sagging. Collectively, all of these give you a narrow and longer appearing face with a double chin and obtuse neck angle.
This could be improved by a single procedure combining a chin-prejowl implant, mandibular angle implants, neck liposuction and a limited or short scar facelift. I have done some computer imaging from the front and sides to illustrate what changes may be possible through this approach.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, jaw implants, mandibular angle implants, neck liposuction, short scar facelift
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Friday, January 27th, 2012
Q: Dr. Eppley, I am 19 years old and very thin. But still the skin on my face is very loose. When I pull my cheek and jaw skin towards my ears, my face looks chiseled. Otherwise it looks round and slight chubby. I want to know if a facelift is good for me? If not what I can do to improve my face?
A: It would be hard to imagine under any circumstance that a facelift would be warranted on someone your age. Pulling one’s facial skin back does make everyone’s face look more defined as the bony prominences, particularly the jawline and chin, become more pronounced. But that does not mean that a facelift (neck-jowl lift) is warranted. A facelift’s primary objective and indication is for skin laxity and sagging not to make the face appear more sculpted. (although it can create that secondary effect) You are likely in need of facial procedures that provide enhancement of your facial bone prominences, such as the chin, cheeks or jaw angles. Such facial implants can help create a more defined or chiseled face. But a facelift is definitely not what you need.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, facial implants, indianapolis
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Friday, January 27th, 2012
Q: Dr. Eppley, I am 36 yrs old and have been wearing padded underwear since I can remember. I am ready to have a bottom of my own that I can feel good about.This is my only insecurity and I am ready to do something about it. I want to be able to for the first time fill my jeans out and not have a belly that hangs over them.
A: There are two types of patients that seek buttock augmentation. The first and by far the most common is the patient who simply wants to make larger what they already have. They do not really have buttock hypoplasia or underdevelopment but want to enhance what they already have. This is very common in certain ethnic groups, particularly African-Americans and Hispanic women. The second group and the least common is the patient who really has not buttocks at all. They are completely flat and may even have resorted to padding as you have described.
This second group is the most challenging to treat because they have little to no subcutaneous fat in the buttocks and small gluteal muscles. This makes the recipient site for the most common method of treatment, fat injections (aka Brazilian Butt Lift), very limited. Often they may be quite thin as well without adequate fat donor sites. This leaves them the only option of an actual silicone buttock implant. Such implants can be very effective but they are associated with a longer recovery and other implant-related risks.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brazilian butt lift, buttock augmentation, buttock implants, dr barry eppley, indianapolis
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