Your Questions

Q: Dr. Eppley, I am a 21 year old male, and I have had an overly high forehead from birth (mature hairline without recession, although it will potentially recede in the future). It seems forehead reduction procedures are contraindicated in my case because of the risk of the hairline receding and revealing the scar. Hair transplants are the other option, but I’m not old enough for that yet and would prefer to save donor hair for any real balding that occurs later on. Can anything be done in the implant space, or with other methods, to reduce the vertical height of the forehead in a male? Thanks for your help!

A: As you have noted the concern with hairline advancement in a young male for vertical forehead reduction is what becomes of the frontal hairline scar. That potential concern remains a valid one for which there is no way to subvert that issue.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello, I’m interested in getting buccal lipectomy and perioral liposuction down to the jawline for a less chubby, more angular and masculine look. I had buccal fat extraction done 20 years ago and submental fat lipo. I don’t need submental lipo again but feel I need buccal lipectomy again because it’s still chubby. I really need perioral mound lipo down to my jawline the most. I live in Tampa and would have to travel. How much would this typically cost me? Thank you.

A: Once you have had buccal lipectomy once (provided they really removed the true fat pad), it does not regrow back. So there is no benefit to trying to repeat it.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, thank you for responding to my last message, you said with custom chin implant, it is possible to achieve this result. 

Is there a way for me to know whether my soft tissue can theoretically hand this kind of immediate change? 

I also went to a mirror and used a mirror to side of my face, and put a ruler to my chin, my ideal forward expansion of chin would be at most 10mm (ideally if I get an implant, it should line up right below lip when my profile is perfectly horizontal axis as shown in both photos). 

From my observation, my skin is pretty elastic and youthful when I squeeze my chin area to imagine an implant result. 

A: Since you have provided a reasonable estimate of how much dimensional change is needed (10mm horizontal movement), I can say with added confidence that such a change is within the possibility of an immediate implant placement. My general rule is that the amount of stretch provided by the ‘average’ soft tissue chin pad can tolerate a total number 12 to 14mm, which applies to any combination of dimensional change. (horizontal + vertical) Since your chin augmentation need is right below that number I know by experience that adequate incisional closure can be obtained with a 10mm horizontal chin implant.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m planning to visit you after my jaw surgery in a few months for this specific concern. I would just like to ask a few questions, if that would be okay? 

I have horizontally short eyes (30mm palpebral fissure, but I measured this myself so it’s not accurate) and a negative canthal tilt, would a lateral canthoplasty be able to elongate the width of my eyes and at the same time raise the corners up so that the NCT would be eliminated? I have heard from other surgeons that raising the corners up can make the eyes shorter so I’m just worried? Any other eye surgeries that I would benefit from? 

TLDR: would a lateral canthoplasty elongate my droopy eyes and make it upturned? any other eye surgeries that I would benefit from? 

Sorry for the bombarding of questions! I attached my pictures if that helps a bit.

A: As a general rule a lateral canthoplasty changes the tilt of the outer corner of the eye but will not create a longer palpebral distance. And it is a good thing that it doesn’t as separating the corner of the lids from the eyeball (increasing palpebral length) would generate a lot of eye irritation symptoms. There is an intimate relationship (contact) between the eye corner and the eyeball which should not be anatomically disrupted.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, About one hear ago I had infraorbital rim/cheek implants placed. I had them removed 2.5 months after placement, and I am currently about 9 months post removal. 

I see you write extensively on how the soft tissue can lose its support and sag. However, while I can’t fully rule out sagging, I feel the biggest issue I have is residual puffiness that makes my mid face look bloated. 

My implants were not very thick (about 2mm), but they were large and covered a lot of area. Also my doctor told me he had to detach basically the entire mid face in order to get them in. I think as a result of this I have bloating even in areas below where the implant was. I’d say the worst area is nasolabial fat pad. 

In short though, I don’t feel that sagging is my issue because when I lift up my cheek tissues it doesn’t look natural and that does not seem to be the solution. I think the issue is simply that midface—particularly the fat pads—are more augmented than they were before. 

I imagine it’s a combination of scar tissue, capsule, and tissue stretch. 

I imagine with time a may still see slight improvements, but I was wondering if there is any non surgical solution to make my face look more chiseled and less bloated. 

Would C02 laser, thermage, or ultherapy help in tightening the soft tissue and making it more firm/less augmented and tighten the skin? And if so, which of these procedures would be best? 

Also, at 9 months post op is there even any chance more improvement will come with time? 

Thanks! 

A: While you may not think it is tissue sag (it is definitely not tissue ‘bloat’) that is because pushing on the skin on the outside does not replicate moving up the scarred and lowered internal tissues (periosteum and SOOF tissues) from the initial dissection and release. They have slide down and are what creates the fullness. The proper time to prevent this issue was when the implants were removed (SOOF lift/resuspension) to avoid what could be predictably known to happen when the implants were removed. (the thickness of the implants does not matter, it is their surface area coverage and the tissues that needed to be released is what counts) What you have by now it what it is going to be. There is no non-surgical treatment that is going to solve this problem…although there is no harm in trying.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I had a surgery recently that was supposed to correct some unevenness of my native chin bone (underneath my chin), but found out afterward that the surgeon cut off one corner of my medpor chin implant rather than file the bone. I was happy with the placement and size of the implant and given that I have already had revision surgery and the risks associated with removing medpor, I wonder if it’s possible to simply replace/ restore the material that was removed rather than replace the whole implant. The surgeon who did this seems unwilling to help (and I honestly don’t trust him anymore anyway), but its hard to find anyone else who is knowledgable about Medpor, so I’m unsure about restoration. Also, if I had to replace it, would removal and replacement with a silicone implant be advisable in the same surgery? Some surgeons have wanted to take it out and let it heal for six months before replacing it. I want to avoid two surgeries, and obviously going six months with a deflated chin would seriously impact my social and work life. Thank you.

A: It would seem most logical to simply replace the missing segment of the Medpor material….if you knew exactly where and what amount of material was removed.

The second approach would be to remove and replace with the identical chin implant that was revised.

Removing and then awaiting any period of time for replacement is to put it succinctly….insane.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have had 3 genioplasty operations and the most recent (the third) is because I had orthognathic surgery 5 weeks ago where surgeon had to do double jaw surgery and insisted I needed genioplasty again because of the new position of my jaws, and my face is still swollen from it.

But the issue is, I feel I have too much lower teeth show and want my lower lip to lift up like 3 or 4 mm, along with the chin pad. Could mentalis muscle resuspension work for me? I heard the success rate is not good?

The surgery was in Korea and he used titanium screws in my chin and jaws. Here is a photo and video to demonstrate the lift of chin pad and lip I want, is it even possible?

A: You are correct on both counts….mentalis muscle/chin pad resuspension is the proper corrective approach for your resultant lower lip sag  and it has a high rate of failure.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, To visually have a shorter, more convex and feminine face. More round, soft wider foreheads, hoping to use forehead implant to open up forehead and elevate eyebrows as well. Mid face projection with cheekbone implants for projection and width, considered maxillary implants and dental corrections or orthognathic surgery- Main concern if we had to pick one- forehead implant. Need to see a few examples of results.

A: Thank you for your inquiry and sending your pictures. Since you have focused on the forehead the type of augmentation you need is a custom implant that provides  some width into the temporal area and some correction of the backward slope. You may find the attached implant design and patient results helpful in understanding how that type of forehead shape change is achieved. This could be combined with a brow lift done concurrently.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I had a sliding genioplasty two years ago and 5 days post op, the Doctor asked if I feel numb esp on the left side of my lower lip/chin and I said yes. He said it’ll be gone in 6 weeks or it’ll take years. I waited but 2.5 years after, I still have numbness on the left side of my lower lip. I am experiencing tightness and weird sensation on the area. I now have a crooked smile and I can feel it get tighter when I talk. Is this nerve damage, impingement or muscle weakness? Should I do a revision or remove screws?

A: At this prolonged time after sliding genioplasty surgery the left mental nerve numbness can be assumed to be permanent. Removing the plate and screws will not make any difference in the numbness as they are located far from the mental foramen. Persistent tightness may be improved by release and placement of a fat graft.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a long midface. The length from the eye to the end of my nose is too long. I didn’t found a surgeon who can reduce the Part of my midface. I wanted to know is it possible to reduce the bone of my midface from the eye to the nose? And if it is possible who much is the average price. Thank you for your time and help.

A: You are asking for a midface procedure that does not exist. While the midface bone can be shortened that will change nothing on the outside. The only two midface soft tissue  ‘shortening’ procedures are rhinoplasty and lip lifts. There are no midface narrowing procedures between the eye and the nose.

Dr. Barry Eppley

Indianapolis Indiana

Q: Dr. Eppley, I suffer from a condition known as occipital deformational plagiocephaly. I’ve seen that you have significant experience in the correction of this issue through a variety of different methodologies. 

Unfortunately, I reside in Canada. Do you conduct procedures on individuals who travel across the border? If not, would it be possible for you to point me to a Canadian surgeon who has experience in correcting this issue?

A: A significant part of my practice are patients who do not live here. Most occipital plagiocephaly skull deformities are treated by building up the deficient side with a custom skull implant made from the patient’s 3D CT scan. I would assume based on your description that the same would apply to you.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a weak chin and a jawline that while pronounced, is also quite steep. I had spoken with you through video consult previously in regards to a custom wrap around jaw/chin implant to fix my jawline along with a buccal lipectomy and perioral lipo to rid myself of genetic chubby cheeks. 

My question is would the wrap around jaw implant alone make my face look chubbier than it already is or would it stretch out may face enough to where I do not have to worry as much about fat removal?

A: The tissue recruitment effect that a custom wrap around jawline implant has comes from the neck and not the face. Thus I would not expect a cheek reduction effect to occur as a result of it. But there is always one way to be certain of that effect…do the jawline augmentation first and see how you feel about the cheeks afterwards.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Can I fax your office operative notes to get your opinion on how complex my otoplasty reversal would be. Please

A:While I am happy to read the prior surgeon’s operative notes, and more information is never a negative, any form of otoplasty reversal comes down to the same two principles…..adequate cartilage/soft tissue release and an interpositional cartilage graft to hold it. These same two intraoperative techniques must be done regardless of how the ears were pinned back.

Dr. Barry Eppley

Indianapolis, Indiana

Q:Dr. Eppley, I would like to know what procedures/implants are required to achieved hollow cheek like those male models. I know body fat plays a big role but besides that if any implant is needed about how much mm is needed?

A: You are correct in that one needs to have very little facial fat to achieve that hollow cheek look. But when it comes to midface implants achieving that look it is far more about the implant’s shape and surface area coverage than it is about millimeter’s of implant thickness.

Dr. Barry Eppley

Indianapolis, Indiana

Q:Dr. Eppley, I have a question about skull reshaping. In the attached pictures you can see I have two bulges on my forehead, while the one on the right is more prominent than the left one. I think it is bone, as I had this head shape since I was a young boy, but the bulges seemed to grow more throughout puberty. I’m now 22 years old and guess, that they won’t grow much further. Anyways they really disturb me and I don’t feel comfortable with them being so large. 

Do you think this is something you can correct? 

A: Thank you for your inquiry and sending your pictures. You have the classic forehead horns of which your history of them is also classic….grew bigger after puberty. Such forehead horns can be completely reduced by burring. Their method of elimination is straightforward and 100% effective. The vexing question, however, is how to get there and not create scarring that might be considered just as aesthetically disturbing as the horns themselves. This is a common issue in males with higher hairlines of indeterminate long term stability. (indirect hairline incisional approach) The direct forehead wrinkle line approach subverts this issue but then one has to ponder how well the wrinkle line scar will do.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was wondering if I would be a good candidate for a buccal lipectomy, perioral liposuction and/or buccinator myectomy. I’m 26, 5″6, and weigh 115 pounds yet my face has always seems bloated because of fat cheeks genetics and probably thick skin. I was hoping that maybe with these 3 procedures would a be a good start to get rid any facial fat and have the more concave look in the mid-face. Thank you for your time. 

A: Thank you for your inquiry and sending all of your pictures. Certainly you already have some slight concavity to your midface so I think the three procedures you have mentioned would go a long way in helping you maximize that potential type of facial change. The other procedure that you didn’t mention which will really help is a chin augmentation, particularly a sliding genioplasty. As the chin bone moves forward that helps provide an upper facial slimming effect as well. This would also helps your facial proportions as lower third is smaller compared to your larger cheekbone structure.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am looking to have facial surgery. I know I definitely want rhinoplasty, but I also want to look similar to a particular celebrity. I have attached pictures and would love to know what you think changes can be done. The first pictures are me, and the other pictures are Saweetie. The picture of her in the black blazer is the nose that I want. I hope to hear from you soon!

A: Thank you for your inquiry and sending all of your pictures. While I think it is good to have a very specific goal it is always fair to say one can never be made to look exactly like someone else’s facial feature. I do not consider your goal wildly unrealistic but in rhinoplasty it is all about how the skin will shrink down around the reshaped bone and cartilage framework. Thicker nasal skin is more unpredictable in that regard.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Thank you so much for the quick response. I can have the previous surgeon send my records, as I’m confident that he didn’t reduce the size of the extended wings of my Medpor chin implant, and only the main portion of the chin. 

If that’s the case, I’d prefer to just have the wings altered since I’m happy with the rest and really want to avoid a complicated/risky procedure. 

Please let me know if that’s an option. I hope it is, as I’m terrified to have another procedure and will likely only pursue a mild alteration than an entirely new implant. 

A: What I am trying to say is that with a Medpor chin implant you can’t just trim the wings in place. The tissue ingrowth that this material creates makes that very difficult and dangerous to the branch of the facial nerve which crosses over the tissue right above the implant. It has to be completely extracted to safely do so. And getting it out will likely result in it being removed in pieces. This is the downside to have an implant that has vigorous tissue ingrowth. It is only great if you never need to modify or remove it.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I underwent a cosmetic surgical procedure roughly 2 months ago. It was a forehead contouring surgery to reduce the prominence of my forehead and eliminate the “bony horns” to give it a smoother and less bulging appearance. Since I am a male, it was decided to go with a bicoronal incision from ear to ear instead of a hairline incision just in case if I experience a receding hairline down the road. They used the trichophytic suturing technique so that way my hair can grow back through the incisions and it would be virtually unnoticeable. Well, as I stated it’s been about 2 months and there are still patches of the scar where I see no or very limited hair growth and when you look at my head from the side, you can see a clear line in my hair where the scar is. I attached some pictures and was wondering if you can give me some feed back and tell me what you think.

A: I am not exactly sure what commentary you are seeking. To perform that forehead procedure I would have never used a bicoronal incision in a male as that is exactly the scar outcome I would have expected.  Bicoronal incisions notoriously become visible in the temporal regions no matter what technique is used to close them. They do much better across the top of the head between the temporal lines but always widen below that line on the sides of the head. (and hair is not going to grow through the scar) That is why a much more anteriorly based scalp incision that does not go below that line is always a better scar risk. At some point scar revision is in your future for any improvement in its appearance.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Over two years ago I had chin reduction surgery. The surgery went without a hitch; however, my results were mixed. My chin is now asymmetrical, though probably not because of bone. Right below my chin are what I call “pockets of fat” that stick out, making my chin appear asymmetrical. I don’t believe the raised skin is caused by fat—I just don’t have another word for it. I’ll provide pictures and you can judge for yourself. My goal with this message is to find out what is causing my asymmetrical chin and what actions I can take to fix the issue. Hopefully with you as my surgeon. I am hoping I don’t have to go under the knife but if that’s required then so be it. 

Picture 1: Sorry for the stupid pose. As you can see my chin sticks out at the bottom and causes an impression on one side of my chin and jaw. 

Picture 2: From this angle you’re able to view the “pockets of fat.” Rather than a flat neck the fat sticks out casting a shadow, even. Right under my chin in full view. 

Thank you for reading, doctor. 

A: Thank you for your inquiry and sending your pictures. While you did not say what type of chin reduction procedure was performed I assume by the scar under the chin it was a submental chin bone shaving procedure. While it would take an x-ray (panorex) to demonstrate that there is or is not any bony chin asymmetry, the most likely culprit is redundant soft tissue. When you reduce bone there always the need to reduce/redrape the soft tissue chin pad as well. That is the trickiest part of the procedure partly because of the need to limit the extent of the submental scar. It is not rare, even when one thinks enough soft tissue has been removed, that it becomes evident later when full soft tissue contraction occurs that there are remaining redundancies. What you most likely need is secondary submental tissue excision.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am looking for advice about getting a forehead implant (and heightened nose job to match) on my very flat and wide Asian face. Could you tell me what order makes more sense to do the surgeries in—find a forehead shaping surgeon first to get my forehead implant in (likely bone cement or maybe Goretex), and then find a rhinoplasty specialist to do my nose to match, or should I do this the other way around?

I also plan on getting chin implant or genioplasty with chin liposuction but I don’t know what order makes the most optimal sense from the point of view of the surgeons being able to optimize ratios.

A: Ideally you should have the forehead and nose done together so the design of the custom implant can be used to also help create the nasal shape as well. But if done separately the order really doesn’t matter, it would be personal preference.

You would definitely do the chin augmentation and submental/neck liposuction together. There is no reason to ever separate these two completely synergestic procedures.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m quite unhappy with my lower eyelid shape and sclera show. Naturally I did some research and checked my options including canthoplasty which brought me to your homepage (very informative). with interest I read the following article of yours: 

Case Study – Lateral Canthopexies for Changing The Corner Of The Eye

The following questions occurred to me: 

1. do you offer this surgery and do you also treat foreigners? 

2. how long lasting will the result be? i heard that canthopexy is opposite to canthoplasty and isn’t really permanent? 

3. can you specify what do you mean with ” A lateral canthopexy technique is less likely to round out the eye shape and shorten the horizontal length of the lower eyelid.”? Does that mean the whole eye will get shortened horizontal and the palpebral fissure length will decrease when i would choose a canthoplasty? 

4. is there a way to actually increase the palpebral fissure length? if yes, do you offer such surgery? 

Best regards

A: Thank you for your inquiry regarding lower eyelid reshaping surgery. In answer to your questions:

1) I do not write about procedures I do not do. About 15% of my prepandemic practice was from outside the US.

2) Canthopexy can be permanent based on how it is performed and secured to the lateral orbital rim.

3) By definition either a lateral canthopexy or canthoplasty derounds the lower eyelid through altering the position of the junction of the upper and lower eyelids at the outer corner of the eye to a higher position. This does not constitute increasing lower lid length.

4) There is no effective procedure for increasing the palpebral fissure length as you can’t pull the lid corner away from close contact to the eyeball. That tight relationship is of critical functional importance.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a Medpor chin implant that I’ve been unhappy with for years. Approximately a year after the initial surgery I had the same doctor shave it down and it’s better but still too masculine. I’m desperate for a slight alteration to narrow it a bit, if possible. Please let me know if I can schedule a virtual consult. Thank you!

A: If you had it shaved down in place then those results are going to be very limited. As a female if you are trying to get rid of the extended wings (which many females are as that style of chin implant is usually not appropriate for most women) it is much better to extract the implant and replace it with a better implant style. This is the more assured corrective approach.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, The back of my head is small and narrow. The front too is narrow. It doesn’t look good when I tie my hair in the lower back of my head. Can an implant be placed at the sides as well as at the back bottom of the head?]I feel like the top of my head is really flat making the hairline flat and the upper back of my skull feels elongated. What corrections would you suggest, please?

A:When designing a head augmentation implant consideration must be given to how much the scalp can stretch to accommodate it. Thus you can’t cover all sides of the head and the front and back unless one has a first stage scalp expansion first. By your description you have essentially described the entire head as deficient. For a one stage skull implant you must keep its coverage to just three sides of the head.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m looking for several implants for my future surgeries and was wondering if you would be able to help me. I have some questions. 

Can I order cust9m facial  implants in advance for when I am able to have the surgery? Or would it be best for them to go directly to the surgeon. 

How much would it cost me for the following masculine implants: 

Square Chin Implant 

Jawline Implant (Squaring the Jaw) 

Brow Ridge Implant (to make it more prominent)

A: In answer to your facial implants questions:

1) Either standard or custom facial implants are shipped to the surgeon, not the patient.

2) Both jawline and brow bone implants are custom designed and made off of a 3D CT scan of the patient.

3) Custom implants can be designed and manufactured (without having a surgery date or paying the fees to install them. (which I think is the question you are asking) You have to pay, of course, the design and manufacturing costs to make them. This is not an uncommon request.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I spoke with you earlier regarding my daughter’s issue with her jaw. You could see it’s protruding and too prominent for her face. We would like to see what her options are. Her teeth are straight but we don’t know if it would help with her bite and jaw structure m, if she would get braces. We did have a consultation here and they recommended she get braces to align the bite and then proceed with jaw reconstruction but we don’t know? She’s 18 and I don’t want her to go through the extremities of this particular surgical procedure. We took her to a plastic surgeon and that’s when the doctor referred me to you.

 A: The major consideration you have at this point is whether you are going to treat the facial skeletal disharmony (which is really a combination of upper jaw deficiency AND lower jaw excess) with 1) orthognathic surgery (upper and lower jaw surgery which requires before and after surgery braces….braces alone are inadequate) or 2) a facial camouflage technique of chin reduction and midface implant augmentation.(with or without rhinoplasty) There are arguments that can be made for either approach. Because she is so young this is the time to conclusively rule in or rule out the orthognathic surgery approach.

I can’t see her bite but, more importantly, you have seen an orthodontist who has. It will be helpful to see the digital records that they have taken.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, How realistic would getting the measurement for both ears at 2 inches exactly be? I do understand that extra unilateral scapha underneath the helicle rim could be removed, but would reducing the lobe so that it connects with my skin be a complexity? (as seen in demonstration with hand) Appreciate your time. 

A: The question is not whether you can remove essentially the entire earlobe (which is devoid of cartilage) but whether the small vertical scar line that will result is an acceptable tradeoff. Because you have an attached earlobe (as opposed to unattached) any reduction of earlobe length will leave a vertical skin closure line beneath it.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am looking for an implant to get the High prominent male model cheekbone, must of them have a flared out look on the sides of the ears and creates a hollow cheek look . With a custom cheek implant with the right size and a long zygomatic arch extension can create that look? Also I heard removing bucal fat is not recommended for young people because ageing we lose face fat and we can end up really thin afterwards but is it necessary to create this look.

A: The custom infraorbital-malar inplant is the only method I know that can potentially create that type of midface high cheekbone look as you have described and shown. Whether a buccal lipectomy would offer a benefit towards achieving that goal depends on what your natural face looks like. I assume none of the pictures you have attached are you so its necessity in your case remains indeterminate.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am a 25 year old man and I believe I had scaphocephaly as a kid that wasn’t noticed or treated. Regardless, I have some temporal and prominent forehead. I would like my forehead to be smoothed or shaved down. The temporal narrowing bothers me but not as much as my forehead. What would the price range be and what’s the recovery time? Please get back to me asap.

A: Thank you for your inquiry and sending your pictures. I don’t think you have form of scaphocephaly to account for your temporal/forehead concerns. While temporal narrowing can be improved with subfascial implant augmentation in a virtual scarless manner, such is not teh case with forehead reduction narrowing. While that can be effectively done the exposure to do so requires a long scalp incision which ultimately has its own aesthetic drawbacks. I would question in a young male like yourself the wisdom of that aesthetic tradeoff.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was just wanting to confirm whether jaw implants were available to fix asymmetry in the jawline? I have been to see an maxillofacial surgeon who has advised me that one side of the jawline is “shorter”. 

I am hoping to avoid double jaw surgery as I am in my mid 20s and I have been told it is a very invasive procedure which has not been recommend to me for my slight asymmetry. 

Thanks

A: Custom jawline implants are done all the time to fix vertical length jaw asymmetries. (see attached) That can be done alone or often as part of an overall jaw enhancement as well.

Dr. Barry Eppley

Indianapolis, Indiana