Posts Tagged ‘indianapolis’
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
Tuesday, January 31st, 2012
Q: Dr. Eppley, I think I may have ruptured one of my saline breast implants. I had them placed seven years ago and they have been great since surgery. They look fantastic and they have given me some much more confidence. I was running and slipped and fell on my right side. My right breast ended up bruised for several weeks. Now that the swelling and bruising has gone away, my right breast looks smaller. What should I do now? Will I have to pay for a new breast implant and surgery all over again?
A: Low impact trauma is an unusual cause of shell failure in breast implants but it is possible. If you have noticed a breast size change after such an event, then you should return to your plastic surgeon and have it evaluated. Generally a saline implant failure is easy to detect because breast size will change. Loss of saline volume is the only reason one would have a delayed change in breast size. All breast implants from either manufacturer, either Allergan or Mentor, have lifelong replacement warranties should they need to be replaced due to shell failure. Since you are within 10 years from your original surgery, you will get a new pair of breast implants at no charge and up to $3500 towards the cost of surgery to replace them. So while the bad news is that your breast implant may have failed, you will not suffer a economic hardship to have them replaced.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: breast implant replacement, dr barry eppley, indianapolis, saline breast implant deflation
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
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
Posted in Your Questions | No Comments »
|
|
|
|