Your Questions
Your Questions
Q: Dr. Eppley, I am interested in getting chin and jaw angle implants.I want to be an actor, and I have always been considered attractive however I feel that I need to have a wider jawline like Brad Pitt or Stephen Amell as well as a chin implant in order to balance out a bit of a weak chin and achieve the male model look. I was wondering, is this something that can be achieved for me and be considered extremely physically attractive? Also, when it comes to recovery, what can I expect? Will I be able to have the same smile and live my life the same way after everything is healed? Is it possible to participate in sports or boxing after a procedure such as this? Have many actors and male models had procedures such as these done to help them get to where they are today?
A: First and foremost, the most important thing to realize is what jawline augmentation (chin implant and jaw angle implants) can physically do for you. You can never look like someone else and you can never have their jawline or other facial features. All you can do is make the most of what you have. I have done some imaging of chin and jaw angle implant augmentation to help you see what that potential change would be on you. Expect three weeks of complete physical recovery and three months to finally see the healed and settled look as well as enough time to psychologically adapt to the facial changes. Chin and jaw angle implants will not affect your smile, facial movement or any other physical activity once fully healed. There is no problem participating in sports afterwards. Whether this type of surgery will make you more attractive or successful in whatever endeavors you do in life is more of an internal issue rather than what is seen exclusively on the outside.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I was interested in a chin reduction surgery, perhaps rhinoplasty (although I really don’t mind my nose). I am very comfortable with my appearance, and don’t mind it much although I find my chin to be too large! I think I would be much more attractive and feminine if I had a smaller, less gaunt/obvious chin. I was wondering if you could possible let me know if I would be a good candidate? I know most doctors suggest a traditional ‘almond’ shape, but I don’t mind my jaw square-ness, I just wish my face were shorter. Thank you, I can’t wait to hear your reply!
A: Your chin reduction request is a bit uncommon as what you have is a horizontally short chin that is vertically long because of its retrusive position. This type of chin reduction would actually be performed by a sliding genioplasty technique where the vertically long but horizontally short chin bone is cut at an angle and moved forward. (with a wedge of chin bone removed in the process) I have attached some imaging to illustrate that type of change. What actually happens is that as the chin bone comes forward it is vertically shortened as it is horizontally advanced.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in a facial scar revision. My facial scar is three years old and is the result of a sharp tool attack. It was thinner after the attack but has grown considerably larger with time. It also appears more indented now. What are my scar revision options to make it less noticeable? I have attached several pictures which shows the scar as it cross the cheek and goes below my eye.
A: You have a very classic scar pattern that occurs when a long scar horizontally crosses the cheek area. Since it runs perpendicular to the relaxed skin tension lines (RSTL) of the face in that area, it is very prone to widening over time no matter how well closed it was initially. This creates scar widening and an indentation along its course as the weight of the facial tissue pulls down on it over time. Your long facial scar can be improved but its appearance can not be completely eliminated. It needs to be excised along its length and then put back together in a broken line closure pattern. Such interdigitations prevent the recurrent scar widening that you now have. While in some cases of facial scar revision it would be followed months later by light laser resurfacing or dermabrasion, your darker skin pigmentation would preclude that final touch-up after your scar revision.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in a tummy tuck which is needed after my bariatric surgery. After my bariatric surgery I’ve had this horrible itching and burning under my skin flap over my c-section scars. Do you thing my insurance would help pay for me to get a tummy tuck? I am too embarrassed by my body to swim or dress in front of anybody. It really is horrific on my life.
A: For the sake of clarification, you are specifically asking about an abdominal panniculectomy not a tummy tuck. An abdominal panniculectomy is a potentially medically indicated procedure to treat a flap of overhanging skin that causes dermatologic problems underneath it due to chronic moisture. A tummy tuck is a purely cosmetic procedure that removes loose abdominal skin and fat that may or may not have some waistline overhang.
Only your health insurance company can truly answer the question of whether an abdominal panniculectomy would be a covered procedure. That needs to be obtained through what is known as a predetermination process. This involves a consultation from a plastic surgeon from which a predetermination letter with picture and medical documentation would be submitted. From this information, your health insurance company will then determine whether they authorize coverage.
While only the insurance company can make that decision, there are very specific criteria that they look for in determining that eligibility. Without all of them, it will most assuredly be denied. They include photographic documentation of an abdominal pannus that hangs over the groin crease onto the upper thighs, photographic documentation of redness/skin irritation under the abdominal pannus, and medical records that demonstrate there has been a history of skin infections that have been treated by topical methods that have recurred despite these treatments.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in getting some information on scar revision. My daughter has a lip scar from an injury 5 months ago. Is there anything that can be done to fix the misalignment of the vermilion border and to minimize the white scars on the red part of the lip? Attached are some pictures of her upper lip scar.
A: Your daughter’s residual lip scar is classic for what happens in many lip lacerations that cross the vermilion-cutaneous junction. There remains a residual misalignment of the vermilion edge, white scars on the vermilion and thickening of the involved lip area with a knotty feel to it. This can be improved by a lip scar revision in which the scar tissue is removed by vertical excision and the lip elements then anatomically realigned. The question about the timing of a lip scar revision is determined by when after the injury one is certain that a revision is needed. That is most evident now so it can be done anytime moving forward.
Dr. Barry Eppley
Indianapolis, Indiana