Your Questions

Q: Dr. Eppley, My rhinoplasty questions are:

1. Is it possible to do a nose reshaping with results similar to the pictures I’ve attached? My main concern is how far my nostrils project into my nose tip. I would like to have more of a tip to my nose. I also would like my nose to be just slightly shorter. It is important to me that my nose would look very natural and not extremely narrow or perfect. 

2. I am also concerned about the look of my neck and jaw. I’d like to remove fat from around my lower cheeks, jaw, and neck. Could this procedure be done at the same time as my nose? Are there extra risks to doing both at the same time? 

3. What would be the cost to have both of these done? And the cost for them separately? 

4. Does your team provide financing options? What are the terms of the financing options? 

5. How far out would I have to schedule? 

6. I also have POTS and fibromyalgia, though not to a severe level. Would this affect my candidacy for these procedures? I have been under anesthesia before. 

7. How long would I have to stay locally for these procedures? 

8. How much pain could I expect for both of these procedures? Could I manage the pain with ibuprofen or advil alone?

A: Thank you for sending your pictures to which I can say the following:

1) While the general type of profile nose shape can be achieved the reduction in nostril length/exposure is probably overly optimistic.

2) Submental/jawline liposuction can be done at the same time as a rhinoplasty. Doing them together does not increase the risks of either procedure over being done alone.

3, 4 and 5) Will be answered by my assistant.

6) I am not aware that POTs or fibromylagia have any adverse effects in these facial procedures.

7) Most patients return home the following day.

8) These are not particularly painful procedures that require any narcotics.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m writing to ask your professional opinion on whether or not my goals are reasonable and obtainable with chin surgery. Ten years ago I had surgery to address my ptotic chin where there doctor removed an ellipse of tissue approx. 5 cm x 8 mm (there was no bone work done). He recommended a small anatomic implant be placed which I kept for 2 years and finally had removed in 2013 because it always felt a bit too tight. Since the removal, I’ve had both functional and aesthetic issues – there is less mobility in the center, and on my left side where the chin doesn’t move down as much as the right side so my mouth appears crooked when I speak. I’ve had Botox to try and help, but all it did was freeze my chin where neither side moved. Aesthetically, I still have a witches chin and on the left side there’s an area in front that’s flat, compared to the right side – this causes a shadow. I’ve added filler to it over the years, which helps a bit, but it takes multiple syringes and isn’t cost effective. I am now considering Smart-lipo and/or platysmaplasty to tighten the area under my chin as well to give me a better “chin-to-neck” transition. My question is will inserting another implant give my chin enough of a boost in front to help with the drooping and fill out the flat area (could more tissue to be removed with a submental tuck?) The doctor noted that I have little mentalis muscle so I’m not sure if that could be contributing to my overall problem. Do you feel there is anything that could be done to address the functional issue – could the implant help at all in that dept? 

I’ve attached photos for reference. Thanks in advance – I hear you’re the expert so I value your opinion.

A: Thank you for your inquiry and sending all of your pictures to which I can say the following:

1) The need for the chin implant placement makes no sense to me.

2) Why was a submentoplasty never done as part of your original procedure as this is what you are imaging now.

3) Your imaging is probably a bit overdone/unrealistic but the concept in that direction is what can be achieved.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hi, I’ve come across your website a couple of times and saw the before and after of the patient who went through the brow bone reduction and forehead augmentation. The results look amazing and I had a couple questions about that because I am planning to get this procedure done. My forehead is too slanted and I have a brow bone that sticks out. It’s funny because I’ve been called a Neanderthal by a couple of people haha. Anyways these are the questions that I had regarding the procedure. 

1. I’m getting a nose job from another place and I don’t know if it will affect the procedure. That’s why my question is which procedure do you recommend getting first? The brow bone reduction and forehead augmentation or my nose surgery? I don’t know if it makes a difference haha. 

2. How long is the procedure? 

3. How long will it take to heal? And does it affect me playing sports for good or just a while? (Soccer in particular) like will I ever be able to header the ball? How long will I have to wait? 

4. Around how much is the cost? 

5. I’m also planning on getting laser hair removal, because my hairline is really low and so I wax it off, will the laser hair removal affect my skull or my bone after my brow bone reduction and forehead augmentation? 

I’d love to hear back from you, thank you! 

A: In answer to your questions:

1) It does not make a difference as to whether the forehead or nose procedure comes first. It really depends on which one has the higher priority if either one does.

2) A combined forehead augmentation and brow bone reduction procedure is 2.5hrs.

3) Good healing would take 6 weeks. I would not head a ball for at least 3 moths after the surgery.

4) My assistant will pass along the cost of the surgery to you.

5) Laser hair removal is superficial, it will not affect the bone beneath it or anywhere else.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am post facelift ( one month) with my 3rd chin implant.  The implant just doesn’t seem right and I would like you to give me your opinion on what size I need. I feel it’s too wide and not feminine at all .  The prior implant shifted off the bone and was creating problems with smiling.

A: The most common problem in female chin implants is they are too wide (extended wings) and have too much projection. Many surgeons use the extended anatomic style for reasons that escape me. This style chin implant coupled with malposition off the bone (due to lack of screw fixation) magnifies the problem.

You can most likely modify the implant you have and secure it firmly in position to achieve a more desired result.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I had a buttock augmentation with implants elsewhere but the implants on the right side flips….I had a MRI but I really don’t know what can be done….some doctor say I can do nothing due my muscle is too thin…..someone say better to remove the implants and exercise it a lot before thinking to a new implant….someone says the muscle is broken, I need just to remove the implants and to ask for a total refund to my surgeon..who knows……I send you a pic with a panoramic view of the MRI but I can send all the files by mail….thank you. Kind regards. 

A: What your MRI shows is that the buttock implants may have originally been placed in an intramuscular position but now appear to be in a partial intramuscular position as the muscle has atrophied over the top of them. (this is not uncommon) With the right implant flipping this is not a problem likely solved by implant replacement. (the implant is not the problem although a bigger implant that is stiffer may help as you undoubtably have gel buttock implants) One other potential option is to lift up the lower capsule of the implant and place it under that next to the muscle. (implant pocket adjustment)

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have bone loss in my forehead. One dent is under my hairline going horizontally. It is approximately an inch and a half long (horizontally) and maybe an inch wide.There is another one going down vertically from that one that has now run into the first one that is approximately an inch long and perhaps 3/4 inch wide. Sort of a T shape, see photo. Slightly more to the left than the center of my forehead. I noticed these approximately 15 months ago and they have become larger. My doctor says it is bone loss that we all get with aging. I have osteoporosis. I’m wondering what can be done about this? I’m very concerned that they will keep getting larger. In your experience, what do you think the likely hood of that they will get larger? Thank you.

A: First it is extremely unlikely those forehead indentations are from bone loss. Regardless of how osteoporotic one is or their age you don’t get localized bone loss at random forehead areas. That is simply not biologically possible. These are discrete areas of soft tissue loss. Second, whether they will get larger I can not say. Third, the proper treatment is far injections to help restore lost soft tissue volume.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello! I had specific questions about the chin implant. I got 2ml of chin filler done this past month and I absolutely love the results! However chin filler isn’t a permanent solution, and it’s also a costly upkeep and migration is bound to happen. I was wondering if for someone in my case who only needed 2ml of chin filler for the desired look, is chin implant worth it? What type of implant is best? Medpor? Silicone? And can custom chin implant provide a v-shaped chin like the fillers? I do not like the regular look of chin implant because they are too boxy.

A: A chin implant is worth it unless you want to continue with ongoing fillers. The key is a silicone chin implant that has been made into a v-shape that provides the slight needed horizontal augmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m a young male that’s looking for some changes to my chin/jaw. I would like to have a more masculine and chiseled jawline and chin (I have included some photos of the type of result I’m looking for, as well as my own profile currently). I was considering a chin implant however I am aware that my labiomental fold is already quite deep, and I do not want to make this more apparent. 

A: Thank you for your inquiry and sending your pictures. If your goal is to undergo chin/jawline augmentation and not make your labiomental sulcus any deeper then you are not going to have any augmentation procedure. The labiomental sulcus is a fixed anatomic structure. By definition then any form of chin augmentation will make it somewhat deeper so this is unavoidable. There are concurrent strategies (fat injections) to treat the labiomental sulcus at the time of chin/jawline augmentation to try and prevent that adverse aesthetic change.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was hoping to get your input on a nerve injury. I had jaw reduction surgery 2 months ago. The square sides were cut and chin shaved (no genioplasty). Now my mouth is crooked when I smile. I marked the numb area on my chin in the attached photo. From looking online it seems this is a mandibular nerve injury. Was this a surgical error and avoidable? Can it recover? Are there any treatments available? 

A: While there was no attached picture, this sounds like weakness of the marginal mandibular branch of the facial nerve…which causes weakness of the lower lip depressor muscle making the smile asymmetric. This is a nerve injury that only time has a chance to recover of which the final outcome may take up to a year to see what degree of nerve function returns.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, My son has Occipital Plagiocephaly and his head is flat on one side of the back of his head. He is only 8 years old but when he’s old enough to understand I want to talk to him about possibly correcting the shape of his head by having cosmetic surgery. How much does the procedure cost and would h still be able to play football for years after the procedure or should we wait and consider the procedure after high school/football?

A: As a general rule I wait until after puberty to place custom skull implants. One can have the procedure and then go on to play football.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I suffer from my neck, and after researching I concluded that it is called webbed neck, so I contacted one of your assistants on Facebook and gave me this website. I want to know how successful this surgery is and how dangerous it is, will the suture effect remain with me, and how long my recovery will be . And to be honest with you, I am very afraid of this surgery. I also want to reshape my ears.

A: Thank you for your inquiry and sending your pictures. You indeed have a webbed neck deformity presumably of the mosaic variety. There is the classic low hairline that follows the upper webs and as well as the ears which are pulled down a bit and have some conchal hypertrophy.

This is one of the hardest webbed necks to improve due to the tightness of the neck tissues. This is first time I have ever seen a male with a webbed neck so the midline location of the posterior neck scar is more problematic than it would be in a female with longer hair in the back. This poses a unique challenge. The success of webbed neck corrections depends on how loose the skin is on the back of the neck and how easily the webs can be pulled inward.

Dr. Barry Eppley

Indianapolis, Indianapolis

Q: Dr. Eppley, Hello! I have read quite a bit about the external occipital protuberance, I am very interested in the procedure; Although the size of my head is somewhat wide, however, I present said protuberance and when sliding my fingers over the area the nuchal lines feel very pronounced, all four stand out together with the inion. Can you help me resolve the question about whether I am suitable for the procedure?

A: Thank you for your inquiry. One is a candidate for occipital bump / nuchal ridge reduction if one feels it is too prominent. This is a procedure that is most often performed on men due to their short hairstyles, where the prominences of the occipital bones are more clearly seen. But this does not exclude women from undergoing the procedure if they find it bothersome.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a few questions about clavicle lengthening.

1. If the clavicles are lengthened without lengthening the scapula, will the scapula follow and become wider naturally or pull the clavicles back inwards eventually and will it look natural aesthetically?

2. How much can each clavicle be lengthened by?

A: In answer to your questions:

1) There is no known impact of lengthening or shortening the clavicle, at the bone lengths that are typically done, on adverse scapular position or function.

2) Clavicles are generally lengthened 1 inch or 2.5cms per side.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I would like to pose the questions my son has regarding the logistics of the plastic surgery and what is achievable and what it not as his guardian. 

In his email he asked the following questions : 

1. Is it possible to shorten the vertical length of the nose by 5 mm, while reducing it in size (in how much it protrudes outwards,  the width of the nostrils, straighten the bridge and sharpen and lift up the drooping tip)

2. Is it then possible to perform a lip lift to reduce the space between the eyes and mouth

3. While operating on the mouth is it possible to 

                    3a. Perform a corner of mouth tuck to reduce the width of the mouth by 5 mm on each side) 

                      b. Do a lip reduction so as to reduce the thickness of the lips

A: In answer to your questions:

1) It is not a question as to whether in rhinoplasty surgery all of those dimensional movements can be done but whether the degree of change (e.g., sharpen, reduce in size) that the patient desires can realistically be achieved. Not knowing what the patient’s nose looks like now or what their exact nose shape goals are I can not say.

2) A subnasal lip lift reduces the distance between the base of the nose and the upper lip. That may create the appearance that the midface is a bit vertically shorter.

3a) While the mouth corners can be brought in 5mms per side, the tradeoff for doing so is a fine line scar from where the old mouth corner was to where it is now. That can be a dubious tradeoff for many patients.

3b) A lip reduction can be done to decrease the thickness of the lips. As a general rule lip size can be reduced in the 25% to 33% range.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello I don’t have pictures to upload I’m just looking for your opinion on this: In your opinion is it ever really necessary to place malar or submalar cheek implants in through an eyelid incision? Or could this be accomplished intraorally.

A: While a lower eyelid approach is one method for placing any form of a cheek implant, that is more commonly done by Eye surgeons as that is what they are most comfortable performing. However, the intraoral approach is far more commonly performed.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Ive been looking into cranial implants for some time to add some width to the shape of my skull and finally decided to do something about it. I’ve been doing some research and most surgeons seem to use medical grade PEEK or titanium implants. The quotes I’ve received have come up particularly expensive for one implant alone. I saw that you use silicone for larger cranial implants, how to they compare to PEEK or titanium? And are they more affordable? The implants from your pictures look great, my only issue is I don’t seem to be able to find any other medical providers, establishments or distributors anywhere that use silicone for their cranial implants. Is there a reason for this? And do you print your own, using your own materials? And is it standard rubber silicone? Sorry for all the questions! Would really appreciate your insights. 

A: A silicone implant for aesthetic onlay cranial augmentation is far superior and more affordable than either PEEK or titanium. It is completely erroneous to think that a very rigid material is needed for aesthetic skull augmentation. You are confusing replacement of lost skull bone with aesthetic onlay skull augmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hi, I recently had sliding genioplasty surgery and I’m very unhappy with the result. My surgeon has told me revision is impossible and he refuses to do it, despite me crying in his clinic saying I want one. He told me that revision is dangerous and if anyone tried my entire jaw would shatter. Is this true? I’m really worried and upset that I’m going to hate my face forever. 

A: All sliding genioplasties can be revised whether it is shortly after surgery or years later. Doing a sliding genioplasty revision does not put the jaw at risk for fracture. (shattering)

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am writing to get your opinion on whether I should pursue a genioplasty with you vs. jaw surgery. I have sleep disordered breathing and after having a CT scan and seeing how small my airway is — it’s only 3mm wide at the narrowest — I feel like I’m a textbook case for MMA with counterclockwise rotation. However, I’ve seen six or seven different doctors with this problem and have been essentially dismissed by all of them. I have a consultation with a surgeon coming up in October but after that I’m about ready to throw in the towel and seriously consider other options.  

I am curious whether you think a genioplasty would be able to provide enough augmentation considering how small my chin is, and whether it would make an appreciable difference in my breathing. My other concern is about the upper lip. I’m self conscious about how long and flat my philtrum is, and I’m guessing jaw surgery would help support it whereas a genioplasty wouldn’t make any difference. A lip lift would help, but I don’t want to make my gummy smile or lip incompetence any worse than it is. Would you suggest any other options?  

Thank you for any advice.

A: Thank you for your inquiry and sending your pictures and x-rays. Why you would not be a candidate for bimaxillary advancement for your OSA I can not say. But your chin can probably support a 12 to 14mms horizontal advancement. Usually if one gets above 10mms there is some modest OSA benefit as that is very similar, if not more, than a genioglossus advancement OSA procedure.

A sliding genioplasty or orthognathic surgery has no impact, positive or negative on the upper lip shape or length. That requires a direct upper lip lift approach, which if kept in the rule of thirds, will not create a gummy smile or lip incompetence.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, last year we had contact because I was really interested in skull reshaping. I would like to ask for your advice again.

Today I still struggle with the same problem and I still always wear bun to hide the shape of my head. To wear hair down is my biggest wish and this is why I am reaching out to you again.

I have a vague memory of what you recommend but the one thing I do remember is that int as just so expensive for me that I will never have the ability to ever do the surgery.

I found a clinic here where I live and had a consult with a surgeon and they recommended to get volume in the crown space of my skull with a fat transfer treatment. This is more affordable for me.

My question is whether you think this is a good solution for my skull augmentation problem.

A: Injection fat grafting is usually a very inferior approach to skull implant  augmentation unless the area is very small. But it is harmless to try and given your described economic limitations this is your only treatment option.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Can a customized wrap-around jaw implant be designed to give a chin an additional vertical projection (downwards) or do one need to perform it with a sliding genioplasty for a vertical projection effect to be included?

A: It depends on the amount of vertical chin length needed as well as how much horizontal chin projection is being done. It is a balance between these two types of dimensional change to ensure that the soft tissue chin pad can wrap around and safely close over the newly projected chin. As you can see the answer to your question is more complex than a simple yes or no.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Please see pictures of my face attached for you to look at. I also like to ask you if I would need orthognathic surgery because it was brought up by my dentist if that is the case can I do that at the same time as my jaw line implant and cheek implants. Thank you

A: The question is not whether you need orthognathic surgery (to bring your lower jaw forward) but whether you want to pursue that route which requires before and after orthodontics as well as a total lower jaw advancement surgery. This is a discussion that is best had with an orthodontist who can assess your bite and what type of change could be done. You can’t make an orthognathic surgery judgment based on external pictures alone.

While you can do cheek implants with lower jaw orthognathic surgery you can not do a jawline implant at the same time.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m interested in a jaw reshaping / reduction procedure. I’ve considered a trip to South Korea but don’t love their V-line approach. 

My biggest concern would be sagging skin as a result but looking at your results, I believe there are techniques to address that. Possibly fat grafting under eyes and temples and a brow lift.

I’d like to discuss details and learn what else you would recommend based on my facial proportions analysis. I’m attaching a few pictures in different angles /lighting. 

A: Thank you for your inquiry and sending your pictures. I would agree that traditional v-line surgery in your case would not only leave you with loose skin but would have disfigured your lower face. That is too radical a jaw reduction procedure for what you really need. Desquaring the chin through lateral tubercle reductions and perhaps some jaw angle width reduction is what is appropriate for your anatomy, all of which can be performed through an intraoral approach. These procedures maintain the vertical length of the reduced bones and thus the support to the attached soft tissues.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, if I decide to get a open browlift with hairline lowering (if it stretches) can I later on get a skull implant or will that make it harder or undo the lift?  just confused as to which sequence I can do these and what is a big no no etc.

A: Getting a skull implant or doing a hairline advancement are usually mutually exclusive procedures. Both require the need for scalp tissue so you can have one but it will likely prohibit the other from being done.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am interested in getting custom hip and buttock implants and fat transfer from my abdominal area to my legs. Would all this be possible at one time?

What are the recommended post operation procedures, in particular, how long would I need to be away from my home? As for the follow up, how long after surgery will I need to return back?

A: I think it is important to realize that hip and buttock implants combined is a very challenging recovery of which I would be hesitant to do anymore than that at one surgery. Such recoveries become even more challenging in the patient who must travel for surgery. While the efficiency of doing liposuction/fat transfer at the same time seems appropriate on paper it is does not medically.

How soon one returns home after such surgery depends on whether they are coming by themselves or with someone to assist them. Assuming the former I would anticipate at least a week before returning home.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have always had a hereditary lack of volume under my eyes. My eyes have thin, purplish hued skin under them that lacks fat and creates significant dark circles. I am quite frankly tired of looking tired and believe having the appearance of raised cheekbones and a fuller midface will greatly enhance my appearance and, in turn, self confidence. I have considered fillers as they are cheaper but their impermanence makes me consider more drastic, longer lasting measures.

A: Thank you for your inquiry and sending your pictures. I do agree that skeletal augmentation with custom infraorbital-malar implants would be of great benefit to your midface/periorbital appearance. Done through lower blepharoplasty incisions this would also allow for a little extra lower eyelid skin to be removed. Your lower eyelid skin is severely hyperpigmented and skeletal augmentation alone will not solve that completely. There will still be a need for some postoperative skin treatments to lessen that degree of pigmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello, I was looking online to see if anyone else had my condition. After shaving my hair I noticed how the back of my head is really indented got concerned. I realized my father also has this but it never bothered us. Aesthetically though, after shaving my hair, I don’t feel comfortable with the shape and would like some information on what and why I have this. If you could email back, it would be great! Thank you. 

A: That is a classic occipital knob/bun type skull deformity with a little extra roll of scalp skin. While usually mainly seen in men that may only be because it is not common for women to have shaved heads, at least compared to men. There is no pathologic reason as to why it exists, it is just a normal skull development in some people. It is treated by reduction of the prominent edge of the bone through a small overlying incision.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, My son (5) developed a flat head when he was a baby. My daughter (6) also had a flat head due to sleeping on her back, but it corrected itself pretty quickly. Because of this, I assumed my son’s head would correct itself, but it never did… and now I find myself haunted each day by his flat side head. I’ve mentioned it to his Pediatricians many times, but they essentially “write it off”. I have spent many hours researching what can be done at his age, and surgery seems like the only solution. I would love to hear back from you with any kind of information/ help/ support/ referrals. Thank you.

A: Such head shape corrections for flat spots or a flat head I do not do until the teenage years when skull growth is essentially complete.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m sending this email to query about some things I’m concerned about, iIjust saw a case of a patient that had a skull augmentation with 28mm amount of increase of skull height but somehow I still believe that wouldn’t be sufficient enough in my case to achieve the desired results, my skull is just too small, severely flat and noticeably slopped down that I need at least augmentation of 35mm up to 40mm in order to get the skull shape of my dreams, I think I will benefit from a 2 tissue expanders instead of just one during the first stage procedure and an ear to ear incision in order to achieve those amounts of a augmentation. So my questions are, are my esthetic goals attainable ? And what are the procedures taking in order to achieve an amount of augmentation of 34mm up to 4cm?

A: While you may be correct about the approach needed for your optimal skull augmentation results, there are safe limits as to how much the scalp can be stretched and tolerate a big implant load underneath it. What you are asking exceeds those limits and is at very increased risk of complications. Here is a good rule to remember that is particularly relevant in implant augmentations…’it is far better to have half to two-thirds of your aesthetic goals achieved without complications than it is to have 100% of your goals obtained with complications’. That is because most significant implant complications are usually only resolved by removing the implant, thus losing everything.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, How did the new implant feel relative to the testicle? Was it indistinguishable or slightly harder? And was it mobile in different positions would it move with the real one?

A: It will feel and move very similar to your natural testicle once the swelling and full healing has occurred. They are made of an ultra soft solid silicone material.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am interested in custom implants for my chin/jawline. and also for cheek augmentation. I am hoping to achieve a more chiseled, high cheekbone look, so I would also want all of the fat removed from my cheeks, and under my chin. 

My other area of concern, that I would like to consult with you about, is my nose. I had my 1st rhinoplasty when I was a late teenager and my 2nd one just 7 weeks ago. Adding length & changing the angle, of a short pug nose isn’t easy.

A:Thank you for your inquiry and sending your pictures to which I can say the following:

1) The jawline and cheek augmentation concept is straightforward and will help your face the most.

2) You can’t take out all of the fat from the cheeks or under the chin. You can take out some (buccal lipectomies, peorioral and submental liposuction) but not all. This effect is synergestic with the cheek and jawline augmentation.

3) The nose imaging shown is not realistic. You can’t drive down the tip of the nose that much as well as make as thin as shown. It takes a rib graft to supply the cartilage needed to drive the tip of the nose as much as possible.

Dr. Barry Eppley

Indianapolis, Indiana