Your Questions

Q: Dr. Eppley, I am interested in a head oval shaping operation. I would like to ask about the whole process. starting from the consultation ending with the operation. How does this process work? is an online consultation enough and after that I can make an appointment for the operation right away?

A:The first place to start is to get some pictures of your head and a description of your shape concerns and objectives. Based on this information I can determine if what you want to accomplish it Is possible. Then we can move onto a more in depth discussion via virtual consultation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr  Eppley, I am a 20 year old woman with a naturally slim build, but despite being pretty skinny, my clavicles are not visible or pronounced in the way I would like them to be. This has been a long-standing aesthetic concern for me, and I’m reaching out to ask about your custom clavicle implant procedure. I am particularly interested in whether such an implant could be made very prominent, as I am hoping for a more visibly defined clavicle contour — even at rest, without tensing or lifting my shoulders. I also have a few medical and lifestyle concerns I hope you can advise me on: 1. Is this type of implant safe and effective for aesthetic-only purposes (without previous trauma or asymmetry)? 2. Would I be able to return to sports and physically intense activities, such as weight training or even skydiving, once fully healed? 3. Where is the incision made, and how large is it typically? I unfortunately tend to develop keloid scars, so this is something I’d like to plan around carefully.

A:Thank you for your inquiry regarding clavicle enhancement surgery. In answer to your specific questions about it:

1) This is a very safe surgery that I have learned based on my extensive experience with clavicle reduction and clavicle lengthening surgeries. The clavicle can be circumferentially elevated from its external attachments immediately to its shoulder attachments laterally and then a predesigned implant can be wrapped around it much like a tube. Like all aesthetic implants the question is always how much size is needed to create the effect. In this case it is a matter of how thick the enveloping layer of the tube implant should be. As a general rule a 5 mm thickness Will increase the clavicle diameter by 1 cm which should be effective in a thin person for improving clavicle show.

2) Placement of such a wraparound clavicle implant will in no way impede any subsequent sports or physical activities.

3) The incision used to place the clavicle implant is the same as that is done for clavicle reduction surgery, a 3.5 cm incision behind the clavicle in the supraclavicular fossa. Such incisions heal extremely well with minimal visibility in my extensive experience with them. This is not an area due to the very thin skin that is prone to develop any hypertrophic scarring. Having performed hundreds of such incisions I have yet to see a bad scar result.

Dr. Barry Eppley

World-Renowned Plastic Surgery

Q: Dr. Eppley, I am interested in learning more about cosmetic skull reshaping procedures. I’ve been researching options for correcting certain head shape irregularities and would greatly appreciate your expert guidance.

Specifically, I am looking to address:

      •     A sloped forehead that I would like to make fuller or more vertically aligned.

      •     A flat back of the head that I would like to augment for a more rounded appearance.

I have a few key questions regarding the procedures:

      1.    Safety: How safe are these types of skull reshaping surgeries? Are there major complications to be aware of?

      2.    Risk Minimization: What steps do you take to minimize surgical risks or complications (e.g., infection, implant shifting)?

      3.    Materials Used: What materials are typically used for forehead and occipital augmentation, and are they permanent?

      4.    Cost: Could you provide a general cost estimate for both forehead reshaping and back-of-head augmentation?

      5.    Scarring and Healing: Where are incisions made for these procedures, and how visible are the scars over time?

      6.    Suitability: Are there any specific factors (head shape, scalp flexibility, skin condition, etc.) that would impact candidacy for this procedure?

I’m very serious about pursuing this and want to ensure I’m well-informed before taking the next step. Thank you for your time, and I look forward to your response

A:Thank you for your inquiry and sending your pictures. Based on these pictures I can see the flat upper back of your head but I can make no comment on your four head since it is not included in the pictures. In answer to your specific questions:

1) Skull shaping surgery is as safe as any other aesthetic surgery.

2) While all surgery has inherent risk I have never yet seen a skull implant infection or have an implant move or shift. This does not mean these postoperative events could not happen just thought the risk profile is obviously very low.

3) All custom skull implants are made of a solid silicon implant material to structurally permanent and can undergo no amount of degradation.

4) Cost estimates will be provided to you for a custom back of the head and custom for head implant.

5) The incisions used to place custom skull implants are very small compared to the diameter of the implants. An incision is placed at the bottom of the hair line for the back of the head and another small one behind the frontal hairline for the four head implant. While all incisions create permanent scars these have never been viewed as a significant postoperative aesthetic issue.

6) Given the areas of skull augmentation that you are considering there are no limiting factors that would not lead to a satisfactory augmentation result.

Dr. Barry Eppley

World-Renowned Plastic Surgery

Q: Dr. Eppley, I have attached a photo, and I drew blue lines. I am concerned that my skull bulges out laterally, whereas the angle in most females goes toward the center as the blue lines indicate.  It is less apparent in photos and more noticeable in person.  But hopefully this helps.  Please let us know if there are other angles you would like to see.

A:Thank you for sending your pictures and marked illustrations. You have the classic wide forehead and large anterior temporal muscles. It is important to recognize that the enlargement of the temporal muscles makes as much contribution to this appearance is that of the bony for head with. This is treated by narrowing the fore head by reduction of the bony temporal lines and subtotal reduction of the anterior temporal muscles. To do so this requires hey scalp incision placed either at the frontal hairline or behind it in a more coronal fashion. One can debate whether you should also vertically shorten the long fore head which, on one hand seems appropriate given its length, but on the other hand shortening the forehead works against making it look more narrow.

Dr. Barry Eppley

World-Renowned Plastic Surgery

Q: Dr. Eppley, am I a good candidate for hip implants?

A:To determine if you are a good candidate for hip implants I need to have the following information:

1) current pictures of your hips

2) pictures that show your desired hip augmentation goals

3) prior surgical history that may include fat grafting and/or synthetic filler injections to the hips

This information is relevant because the most successful hip implant augmentation patients who have the lowest risk of complications have modest hip augmentation goals (not too large of an implant) and have no prior history synthetic filler injections into the hips in particular which is an absolute exclusion for the procedure.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am interested in glagella furrow reconstruction. I recently had a brow lift and filler but still no improvement.

A:The surgical treatment of a deep glabella furrow that is refractory to Botox, injectable fillers, an endoscopic release is a direct excision of the furrow with a placement of a glabellar implant beneath it. Between the muscle removal and the placement of an implant beneath it the furrow is significantly reduced or completely leveled. This does, however, create a small fine line vertical scar in its place which is the length of the original furrow. Thus usually this procedure is reserved for older patients with extremely deep V shaped single midline furrows. You are a bit younger than most patients who would have this procedure and your likely goal of a smooth glabellar area that is wrinkle free may not be achievable.

Dr. Barry Eppley

World-Renowned Plastic Surgery

Q: Dr. Eppley, My head is not evenly shaped and I want to explore options for contouring.

A:Thank you for sending your pictures as this is the first I’ve seen them. What day demonstrate to me or two issues. First there is hey left sided top of the head asymmetry where the parasagittal area is lower and the bony temporal line is more per truce then the other side this is undoubtably the most major issue due to the asymmetry scene. Secondly, on the back of your head there is an exit little knob with a small scalp roll which may or may not be of any concern to you.

In looking at the primary school shape issue hey successful outcome would be based on augmenting the left depressed parasagittal area as well as reducing widen bony temporal line. The first is very straightforward to do with the custom skull implant which is done through a very small scout implant which would leave virtually no significant scar.. The widened temporal bony line, however, is more challenging from an incisional standpoint as to adequately reduce the widened bone this needs to be burred down along its length from the forehead all the way to the back of the head. While this can be done my aesthetic concern would be the necessary incisional length to do so.

Considering both procedures the attached image is what I think your  skull reshaping goal would be.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I always desired a pointy chin. I did two surgeries already to add a silicone implant, but as usual, there are no available silicone implants which are pointy

In this picture I am with the new implant which doctor has placed on my chin (purple hair) But I would like my chin to be more pointy.. or projected in the frontal area only, not on the sides

Actually I have spoken with my doctor and he said that maybe in my situation I should go for a bone reshape surgery, because in my situation, not only the implants are not giving the proper result, but also the bone has a masculine shape. And I would like to have a more feminine chin

Those above are my pictures before the implant surgery. So you can see that my chin was always a bit more masculine because of my chin bone. So what does doctor suggest? I would like to know an honest opinion if in my situation better to do bone reshaping or if a pointy implant would work.

A:Creating a pointy chin in a female can be done at one of two ways. If one is not opposed to implant you simply take the standard implant and modify it to be pointy or make a custom implant design. If one as opposed to an implant then you can do a T-shaped bony genioplasty to create that effect. Because an implant can create the most V-shaped change to the chin this will likely have a better effect on creating a pointy shape than even a T-shaped bony genioplasty. Just because there is no standard implant that has that effect there are many ways around the implant design issue as I have already mentioned and you have already attached a picture which shows how to address such a chin implant design.

Since you already have a chin implant and clearly are not opposed two an implant I would think the simpler and most effective solution would be to do it to a proper implant design.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello, I’m interested in Injectable cranioplasty. I was diagnosed with Gorham disease, causing two dents/indentations on my forehead.

A:Injectable cranioplasty as a skull contouring technique was abandoned years ago due to the high incidence of irregularities and edge contour issues which then required an open approach to solve. It was  replaced by custom skull implant designs which offer more reliable contouring results and equally small placement incisions. How any of this applies to you requires a picture assessment of your forehead indentation contour issues.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello, yes in my case it wouldn’t even be forward growth, it would only be horizontal. I have a crossbite and mild sleep apnea, so it would just be for tooth crowding. I’m not sure I want to go through with it, but I was wondering if I did, if it would affect the implants placed on my midface. I still want to go through will all the procedures we have discussed, I just want to know if in the hypothetical case I did marpe, whether I should, proceed with the planned procedure, divide the current procedures into two surgeries, or wait to do them.

A:I don’t believe that MARPE therapy would have any impact on mid face implant argumentation whether it was done before, during, or after implant placements.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I had a genioplasty almost 6 months ago and then I had to get a revision in April or 2 months ago exactly because the bone was not healing. When I touch my chin it feels fleshy, so some of the volume is soft tissue since it was reduced from the first genioplasty. When I see people who have chin implants I feel so envious since I feel like the implants give such a contoured and tapered look. Here is my question. Based on what you see do you think I could get a very very small implant just to give it a shape that is more contoured and tapered? Is there an implant small enough for this?

A:As a general statement one can always add a shaped implant to the end of the chin bone even though one has had prior genioplasty. The key question is the more implant projection the implant creates the more a tapered shape is going to be seen. However that may or may not be more projection then you can aesthetically tolerant. A ‘very very small chin implant’ which can have a very V-shaped tapered shape may not necessarily create much of a difference externally if you have a thick soft tissue chin pad.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, For my potential side of my waistline reduction the line I have drawn on the first picture indicates how my skin sits when I’m not wearing any clothes (or pulling on it) this part of skin hangs over when i’m wearing basically anything that sits fitted on my waist, for example leggings, gym shorts, jeans, bodycon skirts etc.

The other photo is the approximate markings of where the loose skin starts and finishes when being pinched and ideally would not like any more taken off in height.

I am also assuming that upon the rib removal and partial muscle removal there will be additional space there to remove more skin, due to the rib no longer sitting in that space any more? please let me know if this is correct or not. Thank you

A:Thank you for sending your illustrated pictures. I have marked on them the pattern of excision taste upon your markings as well as the length of the resultant scar line that would result from doing so. Given it’s comparatively shorter lengths come compared to vertical back lift I can certainly see why this is a consideration. This also provides excellent exposure for maximum rib and muscle removal. You’re also correct even though this is an excisional area in which the closure is always under sound tension the removal of the underlying tissues helps alleviate some of the tension on the closure which is favorable for a long term scar appearance. However, like all body lift procedures you hope for the best scar result but you mentally plan that you may need a secondary scar revision for optimal appearance.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I would love some information on the crescent knee lift. I have attached pictures of my knees.

A:Thank you for sending all of your neat pictures. Unfortunately, I question how good of the candidate for a kneelift procedure you are. The knee lift is a classic example of understanding the concept of being careful about trading off one aesthetic problem for another. The obvious trade-o the knee lift is that of the scar. One has to be certain that they don’t choose an aesthetic problem that they may dislike just as much if not more than the original problem. Because of this scar concern most successful knee length patients have a lot redundant suprapatellar skin folds. While you certainly have some of that it is not excessive like many of the knee lifts that I have done. How well the scar would do in your case and whether you would consider that better than what you have now is the unknown question. Given its location and visibility one has to give careful thought to this consideration

.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi there. I was doing some research and I came across your website. I have a misshaped head, very flat on the back and a little lob sided. I would like to know if and what my options are in order to fix this. Thank you in advance and I look forward to hearing from you guys 👍

A:Thank you for sending me your pictures. You have a common back of the head flatness which often has some asymmetry to it as well. Both back of the head issues are ultimately addressed by a custom skull plant-based on a 3-D CT scan of your skull. While there are limits as to how much the scalp can stretch to accommodate an implant I do not see that as a limiting factor in your case is illustrated in the attached imaging.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am getting a double jaw surgery for my underbite next year and my surgeon has told me he thinks i need some sort of zygomatic augmentation to make it all look the best. Do you think i’m a good case for a zygomatic implant? Targeted to improve lateral and anterior projection for ear and flat midface. (and more obviously). 

A: Rather than take any word or opinion as to what is best for you, you need to have imaging done to show the effects of any facial structural change and see what you think. You wouldn’t have double jaw surgery without some preop simulations then why would you have zygomatic augmentation based on someone else’s perception of aesthetics.

Remember that most surgeons are technicians who do operations…the more the better. Executing an operation is a different skill set than knowing if it is a good operation to do.

Dr Barry Eppley

World Renowned Plastic Surgeon 

Q: Dr. Eppley, I am interested in the chin reduction surgery. I would like to ask more questions.

A: Your chin is long because it is horizontally short. It needs to be brought forward and vertically shortened by a sliding genioplasty procedure.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, Can I see how custom facial implant designs would look on me by 3D modeling before my surgery?

A: While implants are designed using the patient’s 3D CT scan there is no accurate 3D modeling of the potential changes that may occur in any implant design. That is a common misconception about custom implants. No one has ever established a database to create these predictions accurately. These can not be extrapolated from cephalometrics, facial proportions or any imaging program.

As a result you use the patient’s desired Photoshopped/imaged changes and create an implant’s footprint and its dimensions based on experience.

But yes all such work can be done virtually and that is always how I do it.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, I’m currently doing myofunctional therapy and I was recommended to get a marpe device, which I have a consult for next week. I’m not sure if I will be getting it, but I was wondering how this could potentially impact the midface implant?

A: No matter what they say a MARPE device is not going to stimulate forward midface growth in any appreciable way if at all.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, Hello, As you can see my ipd is wide. Does Dr. Eppley perform some sort of z-plasty or medial canthoplasty? Where the tendons are reangled or made longer in any way? Is there any way to reduce or fraud the eye spacing? Also would a lateral canthoplasty be possible for me? My downturned eyes bother me.

A: I know of no soft tissue technique that will make the eyes look closer together. Soft tissue corner adjustments can be effective for making the eyes appear further apart but not closer together.

Conversely, soft tissue adjusgtments or lateral canthoplasties can effectively lift up the outer eye corners. Depending on the amount of movement needed a lowe eyelid space graft may also be needed for a sustained change.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, Regarding cheek shaving Is this only good for reducing zygomatic protrusion and does it necessarily have to do so? Is this a good procedure good for giving an illusion of higher set cheekbones?

A: Cheek reduction by shaving is almost always an ill-advised procedure as it has a minimal effect and runs a high risk of soft tissue cheek sagging. 

No form of cheekbone manipulation can create a higher cheekbone look. That requires an augmentation approach.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, I have a fairly deep labiomental groove (~6mm) and acute labiomental angle (~100 degrees). I also have a noticeably recessed (about 5-6 mm behind bottom lip) though still prominent chin. I was hoping to do a sliding genioplasty but don’t want to seriously worsen my labiomental angle and depth. I had three questions (feel free to answer any or all): (1) can vertical lengthening, combined with horizontal advancment, minimize changes to the labiomental angle in genioplasties? (2) does labiomental depth matter on its own for aesthetics, or only the angle? and (3) if you feel the answer to q1 is yes, do you have reccomended ratio of vertical to horizontal advancement that you feel maintains the inital angle? Thank you in advance for any reply or assistance you can provide.

A: In answer to your questions:

1) Any amount of vertical chin lengthening when done with horizontal chin advancement will help mitigate any deepening effect on the labiomental fold.

2) The appearance or depth of the labiomental fold is one of personal aesthetic taste. But most people, regardless of gender, do not like an excessively deep one.

3) An equal amount of vertical:horizontal lengthening (45 degree) or greater will usually keep the labiomental fold depth from getting any deeper.

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, Hi there. I was doing some research and I came across your website. I have a misshaped head, very flat on the back and a little lob sided. I would like to know if and what my options are in order to fix this. Thank you in advance and I look forward to hearing from you guys.

A: Like all mishappen heads that have deficiencies (flat areas that lack projection/more rounder contour) augmentation is needed which is done by a custom skull implant designed to do so. How that applies to you requires evaluating pictures of your head taken from different angles that show these contour deficiencies. 

Dr Barry Eppley

World Renowned Plastic Surgeon

Q: Dr. Eppley, Repaired Cleft Lip Vermilion Realignment and Insurance Inquiry Dear Dr. Eppley and Team, My name is Jessica and I am reaching out to request a consultation regarding a potential lip procedure. I am an adult with a repaired bilateral cleft lip and am currently seeking options to correct residual asymmetry and misalignment of the vermilion border. I have reviewed Dr. Eppley’s experience with lip advancement techniques, including the gull-wing approach, and I believe his expertise aligns with my needs. In my case, the concern is primarily reconstructive and stems from prior cleft surgery, rather than a purely cosmetic desire. I would appreciate the opportunity to schedule a consultation to discuss: • Whether vermilion border realignment via a gull-wing lip lift would be appropriate in my case.

A:Thank you for your inquiry and sending your picture. Amongst all cleft lip deformities the bilateral cleft is unique in that in almost all cases there is a fundamental shortness of skin between the nose in the upper lip as the pro-labial lip segment is fundamentally short/deficeint. As a result this would negate the use of any type of lip procedure whose result is dependent on skin removal such as a subnasal lip lift or vermilion advancements. While a central vermilion advancement would create more of a cupids bow shape this would also shorten the skin segment of your upper lip in an unnatural way as that skinned segment is already marginally adequate in length.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Dr. Eppley, i have a very flat forehead and protruding brown bone, the front top of my head is also flat.

A:With a flatter forehead and upper top of the head (these two always go together) this can make the brow bones look artificially protruding. Whether the brown bones should be reduced can be debated but the major benefit comes from augmentation of the flatter for head in front top of the head. (see attached imaging)

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I just want ur opinion as somebody who’s is attuned to facial aesthetics. I have vertical optical dystopia where my eyes are uneven, you confirmed this earlier this her. It’s hard to gauge from my own perspective. Do you think something like an optical rim augmentation would have a significant and noticeable benefit to my looks?

I just want to know whether you think it would be a worthwhile benefit to my looks? I want to become as good looking as I possibly can. I’m not sure how sigbicant my VOD is or how much a correction would knelove me, but I would really appreciate your professional opinion. If I get this survey done it would be with you. I would be interested in a virtual consultation with you to get your insights,A:In most cases of vertical orbital dystopia a combination of procedures are necessary to provide adequate improvement of the entire bony and soft tissue Perry orbital complex. That’s improvement of vertical or rectal dystopia is often not as simple or straightforward as it seems from the procedures needed to correct it. In your case however you may be the one rare example where bony augmentation of the infraorbital rim and anterior orbital floor could be effective on its own. To make a more complete assessment of this possibility I would need to see pictures of your face from different angles so I can get a true appreciation of the soft tissues around the as well as how different it is from the opposite eye. These pictures should be in the non-squinting facial posture is that distorts the eye area.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello doctor I hope you’re doing well I was wondering if you provide any surgery for a barrel chest deformity for more feminine contour without and bulge or excessive broadness as it’s causing me significant social embarrassment and dysphoria thank you so much. 

A:The barrel chest deformity is not a problem yet amenable to any form of known aesthetic rib modification surgery. Theoretically ribs can be shortened higher up on the rib cage then is traditionally done for other purposes. But whether that would be truly effective and worth the surgical endeavor with a longer incision on the side of the chest wall to do so yet remains untested

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Would like to change the shape. I’m not sure what is the best option? The top of the head has a dip and is flat, not sure if could be burring or implant. Front forehead is also too large.

A:Thank you for your inquiry and sending all of your pictures. You really have a combination of two skull shade issues. The first is the classic coronal dip that can occur across the top of the head along the coronal suture line. This is treated with a sin custom scholar implant that goes from side to side to provide a dip correction. This is placed through an extremely small 2 cm scalp incision. The other problem, as you have mentioned, is that the forehead is a bit pronounced and you have prominent bony temporal lines along the side of the forehead that go up to the coronal dip area. This is a reductive problem, done by burning, and while effective, presents a major aesthetic concern in that the scalp incision needed to do it would be considerably larger than that of the skull implant placement and for most me who shave their heads would probably be viewed as an aesthetic trade-off that may not be worth the benefits.

Thus while  both skull reshaping procedures could be done and presents a minimal aesthetic liability the forehead reduction is very different.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr.Eppley, I had double jaw surgery back in 2019, and after the swelling had gone down, i noticed that my chin “button” or so my orthognatic surgeon called it, was able to be moved around easily, and protruded way too much, and when I smile, things look even worse, it gives a “witchy” look. I never had this before double jaw surgery. He moved both my upper and lower jaws forward, and i believe he shaved down the chin a small amount in order for me to not look too projected in that area… but now I’m left with this fleshy portion that I want removed. He told me it was near impossible and it would look worse than before if I had it removed or liposuctioned out, it would sag more. But now I see your website, and it seems possible? I’m in Canada, and don’t see anything on Submental Excision/Tuck for Hyperdynamic Chin Pad Excess available in this country…. Thanks so much for your response in advance on what I can do

A:Any time intraoral chin burring reduction is done laxity of the chin pad and ptosis often results. This is why this is a relatively poor choice for many types of chin reduction. You are correct in that this is remedied buy a submental approach to chin pad reduction by excision. This is a common and effective procedure and the stated concerns about it being impossible or would look worse than before are said based on a lack have any knowledge we’re experience with such surgery.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, The custom silicone skull implant is not soft when a hand presses on it? I am asking because the silicone implants look hollow and soft on the website and the Instagram account.It is not clear to me how the silicone can feel just like bone?

A:Like wall paper on a wall, it is flexible by itself but when placed on the wall it feels just like the wall. 9acquires the same feel mas what it rests on) You have to evaluate it in the situation in which it is applied not in isolation or free standing. It is no different than silicone chin and cheek implants.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, what happens when a skull augmentation procedure is two-staged as in my case? Would I be staying in the hospital this whole time? How is the scalp expanded? Would the whole procedure leave any visible scars? And where?

A:A two stage skull augmentation requires two separate surgeries spaced 8 to 12 weeks apart. The first stage is the placement of a Scout tissue expander in which the patient goes home the next day. The patient inflates their own tissue expander over several months to get to the desired volume of Skull augmentation they want. We provide all of the supplies and instructions to do so. The second stage is where the tissue expander is removed and the larger skull implant is placed. The patient usually stays overnight and will go home within 3 to 4 days after the surgery.

There will be a necessary incision for the placement of both which is done through the same one placed on the upper back of the head and usually 7 to 8 cm long. The scalp scar usually heals very well and is a minimal aesthetic trade-off.

Dr. Barry Eppley

World-Renowned Plastic Surgeon