Your Questions

Q: Dr. Eppley, I would like to reduce the width of my cheekbones but I don’t want to break the bones to do so. Is there another procedure that make work instead?

A:There is no other procedures to reduce the width of the cheekbones other than zygomatic or cheekbone reduction osteotomies.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was hoping to schedule my jaw implant surgery for the fall however I’ve got another procedure that may conflict.

I’m having an MSE to widen the maxilla with reverse pull headgear to attempt to fix my class 3 underbite. This may be a dumb question but the headgear pushes on the chin, will that mean a no-go for the jaw implant until after?

A: If the headgear will wrap around the chin in any fashion and apply pressure, you are correct in that it would be necessary to wait to do the jawline implant until after the orthodontic treatment is over.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m having an issue after a (second) chin implant revision, and I have an unusual question. Is it possible to design/ fashion a small “lateral” chin implant (similar to the “wing” of an extended chin implant) to support/ fill in an area of tissue loss that resulted when I recently had a medpor implant replaced with a silicone central anatomic implant? 

I would compare what is happening to me as similar to what some people who have had a sliding genioplasty experience where they have a loss of tissue on the side of their chin that leaves a noticeable gap. 

In my case, to make matters worse, the tissue loss is also on the side of my mandible that already has less bone/width than the other side, and it is positioned in just a way so that when I animate my face/ smile, etc… the skin pulls up and the muscle bends in a really unsightly way. It’s terrible and really bothers me. 

HA filler is not hard like bone, so it just isn’t sufficient to hold the skin down when the muscle moves, and it doesn’t augment my jawline as well as an extended wing implant would. 

The problem is, I’m a petite female, and so I don’t really want to go back to an implant style that has wings, as that would make my small chin look too boxy again (my first implant was this style). 

If I could wave a magic wand, I would just add about a 2-3mm lateral extension piece to the current AC implant I have, but it just doesn’t seem to be possible to create such a tiny implant. 

Are there solutions like this that exist, or would I need to have a custom implant made? What would something like that even cost (if you don’t mind sharing)? 

Thank you so much for any advice you have!

A:I believe you are referring to a lateral chin implant which can be either custom made (see attached) or hand carved from a 2mm thick sheet of ePTFE. (Goretex)

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Is it possible to get nipple and areola reduction surgery? Also breast implants of my choice like Motiva or any brand I prefer? 

Thank you.

A: Certainly nipple reduction can be done at the same time as the placement of breast implants with no adverse effects. One has to be more thoughtful in regards to areolar reduction as the expansion of the breast mound from the implants may place abnormal stretching on the healing areolar reduction incisions and cause wider scars than would otherwise occur.

Motiva breast implants are not currently FDA approved for use in the U.S.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello. So, after blepharoplasty only on the left upper eyelid as you can see my left eye is much more open. I would like to avoid the skin graft for aesthetic reasons. As you can see my left upper eyelid is more hollow and the crease is more higher than my right eyelid. So here is my question. Is it possible “to create more skin” with fillers on the left upper eyelid? So the crease will be lower, i mean we will make bigger the distance between the brow and the crease so, the eye will have more skin and the eye will close and be symmetrical with the right eye. I don’t want to have any skin graft. The thought of that is really devastating bcz it will be visible and i want my eye to be normal. So that is why i thought about fillers. I also thought lowering the brow surgically bcz i have seen that you have performed that surgery. 

A: You are referring to whether injectable fillers can create enough stretched skin to avoid the need for a skin graft. I would doubt it but there is one way to find out…have some injectable fillers placed and see what happens. Also I do not think that lowering the eyebrow will be of much help either.

In my opinion the best thing to do is have a small skin graft placed, let it heal and then work out the skin graft later when the tissues are more healed and have relaxed.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am reaching out because I have some questions regarding an uncommon procedure that I am seriously considering, and that is shoulder widening. I am a male with noticeably narrow shoulders (even after working out for some time) that measure just barely under 17 inches across which takes a hit to my confidence. Anyways…. 

1.) Do I qualify for this type of procedure? I am pretty young, turning 20 in a month so I do not know if that plays a factor for such a procedure like shoulder widening. As far I know, I have completely settled and stopped growing. 

2.) What is the overall cost of the procedure? I have done some research but I keep getting different answers. 

3.) Of these two techniques of shoulder widening, (Bone graft and Split Sagittal Osteotomy) how many inches in total width can one one expect to gain? 

4.) Does one technique produce more shoulder width length than the other? 

5.) Is one technique more risky than the other? 

Thank you so much for taking the time to read this, It would mean so much to me to be able to work with you in the future Dr. Eppley. With all that set and done, what would be the next step in advancing? 

A: In answer to your shoulder widening questions:

1) As long as one is 18 years or older shoulder widening surgery can be performed.

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

3) As a general rule one inch per shoulder is achieved with either technique.

4) Both clavicle lengthening procedures produce similar results…but differ greatly in recovery. (bone graft harvest is longer)

5) I don’t think the two techniques differ greatly in risks. But one involves three surgical sites while the other one has only two.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Is the jaw angle flare on this gentlemen achievable with an implant? I suspect he has had work done, his canthal tilt is sublime, my guess is orbital rim/cheek and jaw angle and chin combo.  it is extremely rare to have a jaw angle wider than one’s head, Brad Pitt is perhaps the only other person I have seen this on.

Years ago, I went to another surgeon who said he would shave my mid jaw area before  attaching the posterior mandible angle porex to achieve the flared out Y look I desire. I really have no interest in shaving down my jaw angle in case of complications etc. A picture of my current jaw is below enhanced by Radiesse, One injection point to the posterior mandible down to bone. Any lower and it rounds out my face, too high on the jaw bone and it blends in with the malar I think and defeats the purpose. Attached is a custom implant from your website where I imagine mine would have to be shorter, not extending past the mid mandible and also not as tall, really hugging the edge of the jawline.  Ive read about cryogels potentially being the future of filler and facial implants, but that’s not getting approved  anytime soon. I grow tired of my confidence being based on the status of my jaw angle. Please advise.

A: Most certainly he has had jaw angle implants as no one can look that way naturally.  (we recognize that he is also biting down causing the masseter muscles to bulge) The implants would be of the widening style probably in the 15mm range if not more. They are also positioned very high on the bone almost abnormally so. Your conjecture about the jaw angle design sounds correct to me. I don’t have any idea about ‘jaw angle shaving’ combined with an implant to achieve that look which makes no sense to me.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, How long do skull implants last and are there any long-term side effects? And how much big cut is needed for a complete head augmentation?

A:Skull implants last a lifetime and never need to be replaced due to device failure as they are solid and do not degrade over time. Their effects are aesthetic in nature and they are not associated with any other side effects other than those that are associated implants placed anywhere in the body. The concept of ‘complete head augmentation’ can have different meanings but I will assume it is an implant that covers the majority of the skull in which case a near complete coronal scalp incision would be needed.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hope you are doing well! I was just curious, when you perform Adam’s apple augmentation, does the grafted cartilage heal and become one with the preexisting Adam’s apple? And just in case you’re able to answer this as well, is the cartilage is only grafted from the rib area? Thank you so much for all you do!

A:When performing Adam’s apple augmentation there are two techniques to do so….rib cartilage (which is the only donor source that provides enough harvest material) and an implant material. (Medpor sheet) Since you asked about rib cartilage it is important to understand how rib cartilage (as well as all cartilage grafts) heal as it is very different than bone grafting from a biologic standpoint. Cartilage is an acellullar and inert tissue. Thus when it is grafted it is largely non-dynamic…meaning it just sits there. It becomes encased in scar but does not really blend in and become part of the natural cartilage bed on which it lies. Unlike bone it does not got through a process of breakdown and incorporation. Its remains fixed onto the site in which it is implanted but never becomes truly integrated into the recipient site tissues.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am experiencing some jowling in my lower face and my cheeks are slightly sunken. I still look okay, but tired some days. My face can seem drawn down with the mild aging. I am 51 and am trying to figure out the best solution. I am trying to decide among the following: Sculptra for my cheeks, Fat transfer to face (mainly cheeks), or a mini face lift just for the jowls. Cost is a factor, but I will consider financing. Attached is a fairly recent picture. Would you please help me with this decision. Anything you can provide information/estimate of costs would be appreciated. Thank you.

A:Thank you for your inquiry and sending your picture. You have mentioned two main areas, cheeks and jowls/jawline. In looking at the best ROE (return on effort) there is no question that the jowl tuckup procedure (aka mini facelift) would provide the greatest aesthetic benefit. This is what is creating the heaviness and drawn down appearance.  You only consider Sculpra for the cheeks if surgery is not going to be an option. Fat injections is still a surgical procedure and would be done during a minim facelift so fat injections done alone seems the least likely of the options you have mentioned.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, As a male I would like to increase the length of the skin of my upper lip as I find it too short. How could this be done?

A:You can not increase the actual external skin length of the philtrum. What you can do is roll out the internal mucosa of the upper lip (V-Y mucosal advancement) which can effectively bring down the central part of the upper lip smile line. This could also be combined with a lowering vestibuloplasty, all of which is designed to bring down the inner portion of the upper lip to cover tooth show at rest.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley,Hello, I got a buccal fat removal and I am not happy with the results my cheeks look hollow and I would like to see if there’s something I can do about it?

A: Since fat removal is the source of your now hollow cheeks, fat replacement would be the logical treatment choice. The debate for this type of far grafting is whether it should be done by injection vs an intraoral enbloc solid fat graft placement. There are advantages and disadvantages with either approach.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a couple questions regarding style 2 custom cheek implants. I am scheduled to have a rhinoplasty in November 2021 and hope to perhaps pursue cheek implants in 2022. 

1. How long post-rhinoplasty do you recommend patients wait before getting custom cheek implant surgery? 

2. In addition, can you provide an approximate estimate for the cost of style 2 custom cheek implants? Does cost vary depending on the size of the custom implants? 

3. Can style 2 custom cheek implants also augment the cheeks, or are they limited to the infraorbital rim and zygomatic arch? 

Thank you!

A:In answer to your custom cheek implant questions:

1) I would allow three months after a rhinoplasty to get any form of facial augmentation surgery.

2) The cost of style 2 custom cheek implants is the same regardless of their size or surface area coverage.

3) By definition a style 2 custom cheek implant is an infraorbital-malar implant style that augments the cheeks.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello, how much shoulder width reduction s possible to reduce on a man? Just 1 inch or is it more? I work as a Speleologist/Spelunker and I would like my shoulders narrower for obvious reasons.

A: Shoulder reduction surgery reduces each side  by 1.0 to 1.2 inches based on the patient’s height. This is the same for men and women.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I want to ask you just a very quick question about brow bone reduction surgery. I have seen all articles on your website related to this – brow reduction, contouring, augmentation etc. In my case it has to be definitely just brow bone reduction (like on the first picture you send me) But would you take a look at my picture again and tell me which method could work best for me. If it´s with a complete bone flap or without complete bone flap replacement, or even if in my case 2 mm endoscoping shaving can´t be enough. I don´t know, tell me which method you think could be best for me,,, and then we can set the conversation and plan the surgery, because I´m from Europe so it´s little complicated these times.

A: The brow bones are caused by an over expansion/aeration of the underlying frontal sinus cavity…thus much of the central brow bone is ‘air’ and only a thin covering of bone exists over it. Thus only 1 to 2mms of bone can be removed by shaving since one will thereafter create a large bone defect. Shaving would only be effective in your case if you were willing to accept half or less of the current imaged result. This is why the bone flap technique is almost always the best for men.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley,I have done extensive research and have discovered the genius Dr Eppley! I am very impressed with his work and also the army of positive reviews online about him. 

Upon research, I also discovered he is an expert in custom jaw/chin + forehead implants- both which I am very interested in. Would it be possible for Dr Eppley to find a way to enlarge and round my forehead with a custom implant?

I have been getting filler in my chin and jaw for the last few years and have LOVED IT. Now I am looking for a more permanent solution with a possible custom jaw wrap if appropriate.

A: Thank you for your inquiry, sending your pictures and detailing your surgical history and goals. From a jaw augmentation standpoint you are correct in that a custom wrap around implant would be the ideal way to go. For females these are often more ‘petite’ type designs as one would imagine. The use of 4ccs of soft tissue filler is a good guide which translates to about 50% more volume when it is added down at the bone level and not into the soft tissue.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was interested in the total head widening procedure that you perform as I have a very rounded narrow forehead and browmridge and would like for them to be widened and advanced using implants. 

More specifically, I was interested in this specific model shown on the website. What would the pricing of this type of implant be? Also, is there a threshold for the amount of implant that can be squeezed in? I would require a fair bit of advancement so I’d like to know what the limits of such an implant are. 

A: The limits of any skull implant is based on its volumetric expansion. As a general rule scalp stretch can accommodate up to 125 to 150ccs in most people. The specific forehead implant to which you refer is 104cccc with a maximum thickness of 6mms.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m so impressed of your work to enlarge mouth, and I really want to do it for my mouth to make it wider (maybe 1″ would be the best). 

As you can see in the picture, I have a ratio between nose and mouth around 1:1, which is not good and I can’t have a good looking smile.

A: There are two factors you need to consider in mouth widening surgery:

1) The maximum amount per side done is 7mms.

2) Scars at the mouth corners are unpredictable and there is a relatively high rate of revision of them.

Dr. Barry Eppley

Indianapolis, Indiana

Q:Dr. Eppley, For context, I am a healthy man in his early 30‘s who wants mild-to-moderate enhancement of the chin as well as the jaw angles in the lateral dimension. I am going for a strong but natural jaw appearance. 

Regarding sliding genioplasty, what is the rate at which additional surgery is required, either due to functional problems (e.g. issues with talking or chewing, etc.) or inadequate cosmetic goal? Also, is it true that sliding genioplasty will yield a more natural look than a chin implant? 

Regarding custom jaw angle implants, I am again curious about the success rate for the procedure. What is the rate at which they require additional surgery for any reason (e.g. needing to be taken out perhaps due to infection, revision surgery due to inadequate cosmetic goal, etc.)? 

Thanks for the time you spend answering these questions. I am planning to make use of your services in the future.

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

1) Your chin augmentation would be best served by a sliding genioplasty because you need a combination of both horizontal and verticial dimensional increases…not because it looks more natural than a chin implant but because that is the safest method to do so with a small and tight overlying soft tissue chin pad.

2) The sliding genioplasty has a very low complication/revision rate in my experience. I have never functional issues like talking or chewing concerns as you have mentioned.

3) As for jaw angle implants the key question is whether standard or custom implants are needed and that would depend on one’s aesthetic goals which are yet to be determined. Unlike the autologous slidiing genioplasty operation jaw angle implants have a much rate of infections/asymmetries which is in the 10% range.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Hello! I am very interested in your iliac crest reduction procedure, and was simply wondering: when you shave down the hip bone what happens to the muscle attachments that connect to it? Hope this isn’t an impossible question! Thank you so much.

A:What is released when you do iliac crest reduction, which is done only in the central wing of the bone, is some the TFL fascial attachments laterally and some fibers of the external abdominal oblique muscle medially. Once the bone is reduced, these two attachments are put back together to provide some additional soft tissue coverage over the reduced bone.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have scheduled an appointment for rhinoplasty with you in the fall. Not sure if this is a question I should send to you but you told me to reach out with any questions.

I just want to ask if this procedure would not only improve the tip appearance but the overall nose (nostrils etc.) my primary concern is the drooping and bulbous tip but I just want to make sure I understand.

A: Most nose tip reshaping changes do affect the nostril shape, usually favorably, particularly when a droopy and bulbous tip is reshaped.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, My lower lip is slightly behind my upper lip maybe 2mm, I’ve had double jaw surgery in the past and it’s definitely better than it was, but it still bugs me and I find myself biting my lips a lot because of it. I know the only way too truly fix that is with a BSSO which I will get again in the future to fully correct it. In the meantime though I’m curious would filler be able too push it out a bit too meet the upper lip? 

A: I would think it would as that is how injectable filler works…volumetric expansion of the injected tissues.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, We had a consultation a few months ago and I got X rays done locally (not the cone bean scan you requested but similar). I was curious if you see an issue with my airway, in that its very narrow? I was told this could lead to sleep apnea/other breathing problems and a jaw surgery could help remedy this. 

A: You don’t decide if you have an airway problem that requires surgery based on x-rays. If someone told you based on this x-ray that it might lead to airway problems they are not providing you with proper medical guidance. If you have some form of sleep apnea that you are aware of you get it properly evaluated by a sleep medicine specialist as the first step and get a sleep study to quantify its significance.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have an existing chin implant but I do not like the effect it has. I am interested to know more about sliding genioplasty and possible some jaw angle implants. I have attached images of what my chin and jaw profile looks like today with the existing implant, and what I would ideally like my results to look like (poorly photoshopped so please forgive me). 

My existing implant has brought my chin profile forward a little bit but it has also widened and rounded my jawline from the front and the side. I would like a sliding genioplasty and some jaw angle implants to provide more chin projection, more defined jaw corners, and more of a V shape from the front. 

Please let me know what you think and if you need any more information! 

Side Note: Patient 27 on your Chin Surgery gallery page seems to have a similar case to mine although I realize every case is unique I believe this is the type of procedure I am looking for?

A: Thank you for your inquiry and sending your pictures. As often happens in a female with a significantly short chin the use of standard chin implants ends up widening/rounding the chin regardless of how much horizontal projection the implant provides. I believe you have come to the more appropriate procedure for you of a sliding genioplasty as you need about 10mm of horizontal chin projection. (+ the current amount of projection your indwelling implant provides…based on your own imaging) But in do doing it will also make the chin more narrow rather than wider. From the side view alone it is hard to draw conclusions about the style of jaw angle implant needed (widening vs lengthening) but that is an issue that will require further imaging from the front and oblique views to ascertain.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Am I a good candidate for rib removal surgery? As you can see in my pictures I am very thin but have no shape.

A:Thank you for your inquiry and sending your picture. Perhaps a surprise to many, the typical rib removal patient looks like you with the identical story…thin female who has maximized their waistline reduction with their own efforts. (diet and exercise) Also interesting they are also the patient that gets the best/most noticeable waist narrowing results.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, How can I get rid of this lower fullness in my midface that did not exist prior to a LeFort I osteotomy?

A: In regards to trying to reduce lower midface fullness after a LeFort I osteotomy, a significant maxillary advancement does create a bony shelf that was not there previously. This bony shelf combined with the indwelling hardware can create some projection after surgery that was not present before where the face of the maxilla was concave and now has some bony ledge in the middle of a normally completely concave maxillary surface. In these cases removing the hardware and burring down the bony ledge to recreate a completely concave maxillary surface may help reduce some of the lower midface fullness.

As this relates to you, it can be seen that you have four plates and 16 screws and that your maxillary advancement probably was no greater than 5mms. (as judged by the bend in the lateral plates) This is not the type of maxillary movement that creates a large bony shelf. But it is possible that removing the plates and screws and burring down any existing bony ledge will provide some reduction in your lower midface fullness. But probably going back to exactly what it was before your surgery is not possible as some of the fullness is related to irreversible soft tissue changes.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m considering face implants with you but I also have thick skin, so not sure if this is the correct procedure for me, fellow researchers have said bimax and other bone cutting surgery’s are more effective in providing a non bloated face. These two people below with thick skin got implants placed and they look bloated instead of angular after, could it be a design issue?

A: In answer to your questions:

1) Let’s first get the concepts correct. A full bloated face is NEVER going to end up with a thin sculpted face…so that end goal should be eliminated as unrealistic. 

2) The better question is the how much improvement/slimming effect can be achieved which is a function of tissue stretch (implant augmentation) and tissue reduction. (defatting) The degree of facial change is going to be a function of these combined effects. In the thicker skinned patient both of these diametric tissue changes must be maximized.

3) While I have no idea as to why the implant was designed for the particular patient you have shown, it is an implant design that has its greatest effect in the chin area. The jaw angle portion is so small that it would not have much tissue stretching effect. (But this may be what the patient wanted) It is also unknown what facial defatting procedures were done, if any, for this patient.

4) Orthognathic surgery and custom facial implant augmentations are done for very different reasons. They are not comparative operations and thus their aesthetic effects are going to be different.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Is Medpor implant removal more difficult if they are placed long time ago ? Thank you.

A: The time duration of implantation (short of a few days after surgery) does not affect the ‘difficulty’ of Medpor implant removal. I have removed hundreds of them from months to years after they have been placed and the time differences of how long they have been in there does not seem to change how they are removed. In other words, whether it is months or years they offer the same amount of tissue ingrowth. They never get direct bone ingrowth into the material. (some times there is some bone overgrowth but not ingrowth)

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I currently have 1350 cc saline implant with internal bra(alloderm)my implant is under the muscle i would like to get around 1800-2000cc and i would like to get a lift too but many doctor have told me that its not worth it if i do a lift because I have a poor skin quality (my skin is too thin and too elastic)and my breast will always get saggy  no matter what I do…

Do you think you could help me?

A:An increase in implant volume fights against any lifting effecting effect as well as vice versa. You have to pick one or the other. A lift risks wound dehiscence and poor scarring when done on a very expanded breast skin envelope. It would be more predictable and safer to go with the volume increase only.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, Many years ago I had an endoscopic brow lift that left my brows significantly higher than expected, leaving me with what is typically described as a startled, or ‘deer-in-the-headlights’, look. I’m researching as to whether my brows can be lowered and, if so, how much? I have read where, yes, brows can be lowered through reverse brow lift brow surgery, but my case is perhaps more difficult. 

Subsequently I underwent FFS (Facial Feminization Surgery). My FFS was somewhat extensive, leaving me to wonder now whether reverse brow lift surgery is even possible. 

Besides a brow lift I also had a scalp advancement to bring my hairline forward, rhinoplasty, and supraorbital rims were shaved to reduce brow protuberance. This left me with 2 post-surgical effects I find particularly bothersome: 

1. I cannot frown; that is, I have no ‘down’ muscle control. I can raise my brows, but I cannot lower them. 

2. I still have a fair degree of numbness in my upper forehead region, extending into my scalp to such an extent that the top of my head feels like I’m wearing a bike helmet. 

To both of these concerns I was told by my surgeon that they would self-resolve over a year or so. They did not. 

So I leave you with this question: do you believe I’m a candidate for reverse brow lift surgery? 

Thanks for your time.

A: Thank you for your inquiry and sending your pictures. Normally a reverse browlift is based on the concept of an epicranial shift…meaning the entire scalp is mobilized and brought forward rather than back as in an endoscopic brow lift. But having had a hairline advancement as well as a browlift (and having lost some forehead skin in the process) would suggest that this approach would not work. You need a more reliable solution to release the scarred tissues AND create more scalp tissue (or at least stretch it better) and that would be a scalp tissue expander. Placed on the back of the head and gradually inflated you would create enough tissue mobilization to get a reverser browlift effect as well as improve the tightness across the top of your head. This would, however, not change the lack of depressor forehead/brow function.

Dr. Barry Eppley

Indianapolis, Indiana