Your Questions
Your Questions
Q: Dr. Eppley, I have problem with my masseter muscle.(Masseteric muscle hypertrophy). I heard about electrocauterization procedure in your clinic. Is that a permanent solution? What is the average cost of the treatment? Can i try to become pregnant soon after the procedure? or how long should I wait?
A: Electrocautery reduction of the masseter muscle is a permanent procedure as it shrinks part of the muscle due to the thermal injury. This is done through an intraoral approach with elevation of the muscle off of the mandibular ramus bone. Electrocautery is then applied to the internal surface of the muscle throughout its entire length and width. A portion of the muscle will then eventually shrink down as some percent of the muscle fibers/cells die due to necrosis. This is a process that will take a full three months to see the final result when the muscle atrophy is fully complete. This is a masseter muscle reduction procedure that is less commonly performed than Botox injections or external radio frequency treatments.
Trying to become pregnant immediately after a masseter muscle reductionprocedure is not a concern as the masseter muscle has nothing to do with that process.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a rib reshaping surgery question. I was just wondering if its possible to alter the total size of the ribcage, like to make it narrower or wider at the bust point? I’ve heard you perform rib removal surgeries, but as far as i’m aware that only affects the lower part of the ribcage towards the waist.
A: I have been asked that question may times over the years about ribcage modification or rib reshaping surgery and the answer is no. Rib removal surgery is done for either horizontal waistline reduction or vertical waistline elongation. But the middle and upper portions of the ribcage can neither be narrowed or augmented as this portion of the ribcage is important for lung function. Any ribs that lie below the apices of the lungs can be reduced for a body contouring effect. But any ribs that wrap around the lungs are needed for support to allow the lungs to expand and contract through the muscular action of the intercostal muscles and the diaphragm.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am wanting to do a Mommy Makeover. I would like to do the procedure the week of March 12th because my daughter will be home from grad school and will be able to help me. I am very serious about making this happen then because I have a lot of important events happening in my life this year and I want to look my best. I have the money so no financing will be needed. Please let me know as soon as possible what you have available for I am researching others. I would like to do the (gummy bear) implants and because of the size of my breast I am sure a re-positioning of my nipples will need to be done. As far as a tummy tuck I would love to have the least invasive procedure, however if that is not possible, I want the one that is recommended best for me.
A: Thank you for sending your pictures. In looking at them I can give you some specific insights and recommendations about the breast and abdominal procedures that you really need.
From a breast standpoint, you have significant breast ptosis (sagging) where the nipple sits below the lower breast fold. Your entire breast mound, including the nipple, needs to be repositioned back up on your chest wall. This is going to require a full breast lift with the resultant anchor pattern scars. You also have some significant breast tissue so, unless you are only looking for a very small breast implant to just create some greater upper pole fullness, you can not have implants placed at the asme time as the lift. A big breast lift with larger implants is a recipe for complications as a combined procedure. I do not know what you breast size goal is so this is an issue yet be be determined. (staged or immediate breast implant)
From an abdominal standpoint, you are in need of a full tummy tuck combined with flank/waistline liposuction. With your anatomy there are no effective less invasive procedures. You simply has too much fat and skin for anything less to make for a satisfying result.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, Would you mind telling me if I am correct in thinking that a smile line lip reduction would basically work in the opposite way as a lip lift in the sense that during a subnasal lip lift, a cut is made and a portion of skin is removed which essentially pulls the upper lip up, closer to the base of the nose, and alternatively a smile line reduction would be cutting out a portion of the upper lip on the inside of the mouth, pulling the lip inward, and thus appearing smaller?
If this is the case, would it be fair to say that this procedure is not reversible? My only concern is that my lips at present are relatively thin, so how much smaller would you expect my upper lip to get? would it be comparable to the amount that appears to make a lip look larger during a subnasal lip lift?
Would lip fillers be an option after this procedure should a fuller lip be desired?
Also, if one had this procedure done, would a subnasal lip lift still be an option for the future at any point down the road?
Would it also be fair to say that you feel that I am not an ideal candidate for the more popular subnasal lip lift at my present age with my present facial aesthetics? As best as I can measure, I have figured that the length from the base of my nose to the lowermost part of my cupid’s bow (or at the center of my cupid’s bow) looks to be exactly 1.5 cm.
A: Your concept about the subnasal lip lift and the smile line reduction is correct. They both achieve some increased upper tooth show by removing tissue but do it at different ‘ends’ of the upper lip. The increased central upper lip size from a subnasal lip lift woule be equivalent to the upper lip reduction achieved by a smile line reduction. Any form of tissue removal on the upper lip is irreversible. Lip fillers can always be placed later into any such lip lift or reduction procedure.
Numbers aside whether one is a candidate for subnasal lip lift depends exclusively on whether the patient thinks they have too much skin between their nose and the upper lip.
Dr. Barry Eppley
Indianapolis, Indiana