Posts Tagged ‘indianapolis’
Saturday, February 4th, 2012
Q: Dr. Eppley, I’ve heard of facelifts being done under just local anesthesia. How safe and comfortable is that approach for this kind of surgery? It is appealing to me but it makes me nervous being awake.
A: There is little question that limited or mini-facelifts are very popular today and are widely advertised. Many surgeons and companies have even named their own versions of these mini-facelifts. Their premise is based on being performed under local anesthesia for a quick recovery and usually a lower cost. While there is merit to this approach, the key is whether a more limited facelift result will meet a patient’s expectations based on their degree of neck and jowl sagging beforehand. While eliminating the risks, cost and recovery from anesthesia is appealing, that can be a poor trade-off if the ‘problem is bigger than the solution’. Such mini-facelifts are best used in younger patients who have early signs of facial aging or in older patients, while really needing a fuller facelift, simply doesn’t have the time, resources or desire to completely address the extent of their aging issues.
Local anesthetic facelifts can be made fairly comfortable through the use of oral or IV sedation drugs. The wonders of modern pharmacology allow one to reach a pleasant and relaxed state of mind so local anesthesia can be adequately injected for the facelift procedure.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, local anesthesia facelifts, quick recovery facelift
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Saturday, February 4th, 2012
Q: Dr. Eppley, I need some help in selecting the right breast implant size for me. I am 5’ 2” with a 32B cup size. After having breastfed two babies, I need some breast volume back. It has been sucked out of me.. I am going to get 500cc high profile gel implants. My doctor suggested 450cc but I want 500cc. Do you think this is a big difference. I don’t mind if they are a little big and look somewhat fake. I actually like that look. Are there any health risks from going big? I value your opinion.
A: On a volume ratio basis, the difference between a 450cc and 500cc implant is not that significant, around a 10% size difference. A sized difference in implants that is barely visible. Since you appear to have no fears about being too big, I would definitely go with the slightly larger 500cc implant. While there are no health risks with larger silicone breast implants, there is always the consideration however of loss of tissue support over time. When a breast implant becomes too big for the tissues that must envelop and support it, there is the risk of bottoming out or dropping of the implant position. Whether this is a potential issue with you can not be determined based on this discussion alone. The key determinant of that is whether the base diameter of the implant stays within your own natural breast base diameter. That is a simple measurement that can quickly be done in an examination. The use of HP or high profile implants is helpful in keeping a good implant-breast base compatibility.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implant size selection, dr barry eppley, indianapolis
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Saturday, February 4th, 2012
Q: Dr. Eppley, I have had two inverted nipple correction surgeries by two different doctors, both of which were unsuccessful. My nipples are grade III inverted. I am at a loss as to what to do. Do you think that breast implants would help in my inverted nipple correction. Would they help push the nipple out once it has been released?
A: Inverted nipple correction has a high rate of recurrent contracture/inversion after release. Your experience is not completely rare. Many methods have been described in plastic surgery for the correction of inverted nipples which speaks to the fact that it is both a difficult problem and that none of them work that well. Once the nipple has been released and brought out by suture traction during surgery, there remains a dead space or tissue deficiency underneath. I have found that filling this in with either a dermal-fat grafts or allogeneic dermis is the best way to prevent recurrent inversion. The fill must be immediately underneath the released nipple. The push from a much deeper breast implants will not work.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, inverted nipple repair
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Friday, February 3rd, 2012
Q: Dr. Eppley, I am interested in the Exilis device for my stomach area. I am only 5’4″ and weight about just under 120 lbs. Despite my rigorous workout schedule of running and working with a trainer 3 to 5 days a week, I just can’t get rid of my lower stomach fat. At 42 years old, I do not want invasive surgery so I believe this device currently offers me my best hope of solving this problem. Do you think I am a good candidate? I am going on vacation in March so I would like to have some tummy reduction before I get into this season’s swimwear? I am currently training for a marathon in the summer so would I still be able to run? Please let me know! Thanks so very much!
A: By your description, I could not imagine a more ideal candidate for Exilis fat reduction treatments. This is a spot reduction problem and undoubtably is not a large area. In addition, with your high level of physical activity you will helping the treatments work better by enhanced fat breakdown. One of the really nice things about Exilis is that there is no recovery or restrictions after any of the treatments. Each treatment is about 30 to 40 minutes so you can just get and go right afterwards. It usually takes 4 to 6 treatment sessions to get the best result and we like to space them, if possible, no more than a week apart.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, exilis fat reduction, indianapolis
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Friday, February 3rd, 2012
Q: Dr. Eppley, I am in dire need of a nose job. My nose is extremely wide and my profile slopes terribly, which explains my insecurity. I was hoping I could get an estimate for the surgery. I have attached pictures so you can see what needs to be done. Thank you for your time.
A: Thank you for sending your pictures. What you have is a a very specific type of aesthetic nasal deformity in which the lower alar cartilages are very thick and strong. They overproject beyond the tip of the nose making it very broad and fleshy. With that comes broad widely-spaced nostrils. Since the tip is so broad, the area above it (known as the middle vault) looks collapsed and sunken in on profile. This then makes the upper part of the nose where the bones are also appear wide. This can be treated by an open rhinoplasty procedure that narrows the nasal tip cartilages, narrows the width of the nostrils at their base, builds up the middle vault and narrows the upper nose by osteotomies. Together this will help change your nose to one that is less broad and more refined looking. This is a 2 hour rhinoplasty procedure done as an outpatient under general anesthesia. All costs combined place the price of such surgery between $ 6,000 to $ 7,000.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, rhinoplasty for broad nose
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Friday, February 3rd, 2012
Q: Dr. Eppley, I have had two children, the last one being two years ago. As a result of my pregnancies, I have some loose skin and stretch marks which are greatest right around my belly button. I would like to get rid of how my belly button area looks as I just hate it paticularly when I bend over or sit down. I know because I am very small and thin that I don’t have enough loose skin to do a full tummy tuck. But I want to have a completely flat stomach with no loose skin. I am thinking that if I have the skin cut out from around my belly button, rather than low like done in a traditional tummy tuck, that I will get the tightest result. I know this will leave me without a bellybutton but that would not bother me. Have you ever done a high tummy tuck like this?
A: It is very common that many of the stretch marks and loose skin that results from pregnancies is around the belly button. This is because this is the region of the stomach that undergoes the greatest amount of skin expansion. After delivery, wrinkling and belly button deformities are common. While the type of ‘high’ tummy tuck that you are describing can certainly be done, I would advise against it. Regardless of how flat and tight the abdominal skin would be, having a horizontal scar across the center of your stomach without a bellybutton would create a secondary cosmetic deformity of its own that would not be very natural looking. You would be better served by having a mini tummy tuck with an umbilical float technique. This would create a very low horizontal scar just about the pubic hairline and keep a belly button that is positioned lower with less wrinkled skin around it. While this may not create the supertight abdominal skin that you desire, you would have substantial improvement but having a more natural look.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, mini-tummy tuck
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Thursday, February 2nd, 2012
Q: Dr. Eppley, I am interested in lipodissolve or laser liposuction of the lower abdomen. I am having a breast reduction done next month. My question is when is the best time for me to have the lipo procedures performed, before surgery or after surgery? I was informed that the best time would be during the same time as my breast reduction surgery. However, my insurance is covering the breast reduction and it does not cover the liposuction. I am also unsure if the doctor performing my surgery performs the lipo procedures I am interested in receiving. I was hoping for a lipo procedure that was less invasive such as lipodissolve or laser lipo.
A: Let me clarify some misconceptions that you have about various ‘lipo’ procedures. Lipodissolve injections are only useful for very small fat collections, no more than the size of one’s hand. I suspect your lower abdominal issue is bigger than that in size. Laser liposuction (aka Smartlipo) is simply an advanced form of liposuction and is just as invasive, it is not a minimally invasive procedure. In short, there is no non-surgical way to get rid of your abdominal fat concerns that would be as effective as liposuction. You could try Exilis radiofrequency treatments which does have some fat reduction effects.
In reality, there would be no better time than doing abdominal liposuction with your breast reduction and this is a common combination of cosmetic procedures. Otherwise you will have to have liposuction done separately where the out of pocket expenses will be higher.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: abdominal liposuction, breast reduction, dr barry eppley, exilis, indianapolis
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Wednesday, February 1st, 2012
Q: Dr. Eppley, I am considering skull reduction done through an open approach and have afew questions about the scar. In your opinion is the scar with very obvious to you. I always grow my hair out so with that, what level do you think it may affect me? I am not bald or shave my head so I assume the hair will help hide it. More in depth, could I see pictures of the scars from open cranioplasty? How long are they and such. I’m really leaning towards this, would like to know all about it.
A: It is important to recognize that there will be a scalp scar in any open cranioplasty procedure. That does not mean, however, that it is necessarily a bad scar that is wide and highly visible. It almost never is. But in men, whose hair pattern is less than stable over their lifetime in over 50% of the male population, it is important to consider this aesthetic trade-off. It is obviously a lot more relevant issue in men who are bald or shave their head. You do not so this is one favorable factor for you. I harp on this issue so every patient gives it careful consideration. The incision/scar usually runs from about one inch above the ear across the top of the head. It is hard to get good pictures of the scalp scars to show since most patient’s hair obscures it.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, open cranioplasty, scalp scar
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Wednesday, February 1st, 2012
Q: Dr. Eppley, my head is mildly deformed looking from the side. The forehead bulges out at the top and makes my head look too long from the side view. I want my forehead to have a more curved look that angles backward. I have attached a side view which shows me before and after I have done some computer imaging to show the forehead shape I am after. Can this look be surgically achieved?
A: Thank you for your inquiry and sending the photo attachments. What you are talking about is a cranial reduction/forehead reshaping which would be done by a burring removal technique. The important question is whether it can be reduced enough to achieve the result you are looking for. That is best answered by knowing how think the outer table of the cranial bone is. That can be evaluated by simple plain x-rays of the skull (AP and lateral views). From these films the amount of bone that can physically be removed (outer table) can be measured. There is no question some reduction be done, I (and you) would want to know the best we can beforehand if it is enough to justify undergoing surgery for it.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cranial reduction, dr barry eppley, forehead reshaping, indianapolis
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Tuesday, January 31st, 2012
Q: Dr. Eppley, I am considering a chin osteotomy as opposed to a chin implant for my weak chin. What I am most concerned about, however, is the complications that may be involved (numbness around the area and using titanium plates/screws inside my bod). As I have decided not to correct my overbite, would you still recommend that a sliding genioplasty would be a good option for me? Thank you very much.
A: In my opinion, the sliding genioplasty is and has always been your best solution. It solves all your chin issues at the same time. I would not concern about titanium being implant and in your body for the rest of your life. Titanium is the most biocompatible metal that is known in medicine and will be completely overgrown with bone anyway. I have never had to remove titanium plates and screws from a chin nor have I ever seen it to be a problem. This is the best place for such metal materials in the face because it is has a thick bone and soft tissue cover and is not exposed to the stresses of mastication. While there is always the risk of some feeling loss from chin osteotomies, my experience is that it is very low. The key is to do the osteotomy at least 5mms below the mental foramen if not lower to avoid any risk of permanent loss of sensation to the lip and chin.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin osteotomy, dr barry eplpey, indianapolis, slifing genioplasty
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