Your Questions

Q: Dr. Eppley I’m interested in the testicle enhancement surgery and have a question. I’m. 52 years old and my testicles have atrophied significantly over the years and at some point in the next couple years I would like to have the type enhancement surgery you offer. My issue is I also have severe testicle retraction due to a botched hernia surgery years ago in addition to extremely overactive cremaster muscles. This causes my testicles to ride extremely high or inside me and are basically impossible to pull down very much. I was thinking about possibly having the microsurgical cremaster muscle release procedure but is it even necessary if I have testicle enhancement like you offer which displaces my natural testicles? I’d appreciate any information you can provide me regarding this issue.

A: Your situation is not one that I have yet encountered. In theory one would think that retracted testicles would be very favorable for the implant displacement method for the obvious reason that they are already ‘displaced’ superiorly and any risk of postoperartive testicle show would be greatly reduced or eliminated. On the other hand a hyperactive cremaster muscle may not necessarily relax after implant placement and may be a potential source of pain or chronic discomfort.

In short without actual clinical experience  I can only speculate about the risk:benefiit ratio.

Dr. Barry Eppley

Q: Dr. Eppley, I am seeking a consultation regarding calf implants. My legs were always thin but following an Achilles rupture my left ower leg is significantly disproportionate and I cannot seem to rebuild the muscle despite years of training. My left is roughly 12.5” and my right is roughly 13.5”.Thanks!

A: Thank you for sending your pictures. Despite the asymmetry you have very thin lower legs and they are so thin that I initially thought you might have had congenital clubfoot. The first key question is whether the goal is to have the smaller calf match the larger calf or to enlarge both calfs.  For now I will assume it is the latter. Your calfs are so small that I don’t think you can successfully have implants placed under the muscle fascia in the traditional location. Your calf muscles are very small and tight and not much of an implant could be placed under them. You would have to have subcutaneous implants which need to be different sizes due to your asymmetry. These needs require custom calf implant designs.

Dr. Barry Eppley

Q: Dr. Eppley, I have been getting lip filler for eight years and have tried numerous types of filler, numerous techniques and numerous injectors, and I always suffer from lip migration. To be honest, I was not blessed with lips and my goals are to have more “lip shape” than volume because I love the look of large full lips that are flatter than projected. I’ve been researching for the past two years about the lip advancement technique, and your work is stunning! I wanted to know if I would be a good candidate for upper and lower lip advancements  being someone who is naturally tan and not naturally blessed with any kind of lip whatsoever. I have not done lip filler in 2 1/2 years, but I still feel as though I have some residual filler in my lips. I always used Restalyne Kysse or Juvederm. Thank you kindly for your help!

A: Compared to many lip advancement patients your lips are very full by comparison (even minus the residual filler) But even fuller lips can undergo vermilion advancements. Having intermediate skin pigmentation slightly increases the risk  of more visible scarring. But the real risk factor in that regard is how much vermilion advancement is being done and does it need to cross the cupid’s bow area. It seems like your lips are most ‘deficient’ laterally more than centally (see attached picture) which would also be the safest approach to minimize scarring. 

Dr. Barry Eppley

Q: Dr. Eppley, Where can I find more information on the total cost of a pelvic plasty?

A: The pelvic plasty procedure has three variations to it, 1) titanium crest plate alone, 2) titanium crest plate +silicone hip implant and 3) titanium crest plate + hip fat grafting. Which method is determined on an individual basis. But the most commonly used  technique is #2.

Dr. Barry Eppley

Q: Dr. Eppley, I have had a facial fat transfer to the cheeks and am unhappy with the results. Is removing transferred fat graft something that cam be done?

A: Removing fat from the cheeks is very challenging to do. It is easy to inject the fat, far more difficult to reverse or remove it. Whether some improvements can be made and what procedures are needed to do it depends on knowing the following information:

1) When was the procedure performed?

2) How much fat was injected?

3) Evaluating before and after pictiures

4) What area of the cheeks is the most bothersome (draw on a picture to show it)

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I had Medpor infraorbital implants placed back in 2024 to correct my negative vector, and the outcome is poor. The scar tissue around the implant has created visible deformities under my eyes, is slightly pulling my lower lids down, and causes a constant feeling of tightness and discomfort. Several oculoplastic surgeons have assessed my situation and none recommend removal at this time, however the appearance and sensation are causing me a great deal of distress. What would you recommend? Thank you.

A: I think it is clear that these infraorbital implants you have in  are better out than in, regardlrss of what any surgeons have said. They likely did not recimmend remnovals because they are either inexperienced with removing Medpor implants or didn’t know what to do once thet are out.

The latter concern is the key one. The question is not whether they can be removed…as they can…but what are going to do in their place. This is very relevant for two reasons:

1) There is a reason you and them initially placed (negative orbital vector), and

2) The soft tissue around the lower orbits and cheek is going to be worsened than before they were placed. (lower lid retraction)

Thus there has to be a concomitant plan for replacement. Whether this is custom infraorbital-malar implants , dermal-fat grafts etc remains to be determined.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, would I be able to talk to you about skull reshaping? In terms of vertical height. Its the vertical height for me that I really don’t like

A: I believe you are likely referring to the posterior sagittal bump which would be the highest part of the top of your head. (see attached pictures) That can be reduced based on the thickness of the bone which is preoperatively assessed by a 3D CT skull scan with color thickness mappning to ensure an adequate but safe reduction can be achieved.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I’m interested in an extended corner mouth lift for my downturned mouth. One year ago I had a corner lip lift procedure done in Dallas Tx. Unfortunately it did nothing to help my droopy dog problem.

A: What you previously had was not a corner lip lift. It was a lateral vermilion advancement, which can create some increased lateral lip fullness, but is not intended to provide any corner lip lift. The cutout pattern used had no chance to create that effect. To achieve that type of mouth corner change the cut out pattern must resemble that shown in the attached imaging.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I do have an area of spongy tissue centered below lower lip vermilion c/w involuted hemangioma tissue. Tissue with some irregularities and Mild transverse crease between involuted tissue and vermilion. I hate it.. It’s residual from hemangioma from when i was infant. Told by numerous plastic surgeons in Beverly Hills that surgery is dicey because it may not look good enough.

A: I don’t know what that area below the lower lip looks like when you are not pursing your lips (as seen in the current picture) but it is already an irregular tissue area….which is typical for an involuted hemangioma. Thus the issue  is whether an open excision would make the area look better (less projected and smoother), heal with the same irregularities in the long run but not as full or projected or look worse (more irregular). If you were only looking at these three potential outcomes on an even statistical basis only one of them makes it really better. This is what the term of ‘dicey’ really means.

But beyond a theoretical even statistical basis for each potential outcome I suspect that making it look worse is unlikely. The real debate  is how much better in appearance can surgery make it…..a little or a major improvement in appearance. Unfortunately that is a question that no one can really answer. The only way to know for sure is to actually do the surgery.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I have deep-set eyes, and I wanna ask if there is a surgery to make my eyes actually forward? My eyes’ surroundings are not deep but the eyeballs as what I see, and it’s been like this since I was young. It affects the appearance of my eyes a lot. And I’ve read about Orbital Implants/Surgery, and Orbital Volume Augmentation, where something is put behind the eyes making the eyes appear actually forward. I don’t know if it’s actually possible, but for cosmetic reasons. I also read that it can be possible for cosmetic reasons but a very small number of surgeons offer it for cosmetic purposes. And it’s making me so confused. Please let me know if it’s possible or not

A: There is no safe and/or effective procedure for bringing the eyes forward. Certainly not for the aesthetic patient who has had no prior orbital injuries or surgery.

Dr. Barry Eppley

Plastic Surgeon

Q:Dr. Eppley, I want to get a full head reduction , back of head reduction and forehead reduction as well as top of head reduction, can Dr Eppley look at these and be able to help with this?

A: Thank you for your inquiry and sending your pictures. In skull reduction surgery, particularly those that involve multi-surface areas, the two key preoperative considerations are: adequate bone thickness to permit an effective and safe reduction, and 2) enough incisional length to successfully perform the procedure.

That information is acquired by: 1) a 3D Skull CT scan with color mapping of bone thicknesses, and 2) patient acceptance of a bicoronal scalp incision which is necesary to have adequate exposure of the front, top and back of the skull bone surface areas.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I recently had full FFS. I was not aware that brow bossing reductio  would remove my bone around my eyes removing the sultry look I once had leaving me looking skeletal. I see that you do implants around the eyes and I’m hoping maybe you can help me. I would also love to see outcomes of people with similar issues and if these implants would last for life. I left some new images where there’s clearly missing bone and some old pictures where you can see how nice my eyes used to look.

A: Brow bone reduction by bone flap setback is the most common procedure performed in FFS surgery. Restoration of the lost brow bone projection can only be done by a custom brow bone implant. As  the popularity of FFS continues the need to partially or full reverse brow bone reductions is also be done more frequently. Ideally the implant design is done using the preoperative FFS surgery 3D CT scan if it is available.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I used to have braces and my teeth have a good alignment, however my lower jaw/chin go further back than I would like it to. When I stick my lower jaw past my upper and my bottom teeth are more forward than the top row, I like that appearance better. Is this something a sliding genioplasty could achieve? (Photos attached include me biting down normally and me forcing my lower jaw forwards for the desired look)

A: What you are doing by jutting your jaw forward and biting down is creating a total jaw augmentation effect. (chin and jaw angles) This is more than just a chin augmentation effect alone. A sliding genioplasty can certainly create the chin augmentation but not that of the masseter muscle enlargement.

Dr. Barry Eppley

Q: Dr. Eppley, I’m writing to inquire about medical or aesthetic options to improve the width and overall fullness of my lips. I naturally have relatively small lips and would like to understand what safe, effective treatments are available to achieve a wider and more balanced appearance. Could you please let me know: What procedures you offer for lip widening or enhancement (e.g., fillers, surgical options, or other techniques)? Whether these treatments primarily increase volume, width, or both How natural the results typically look Any risks, downtime, or long-term considerations

A: Thank you for your inquiry and sending your picture. The fundamental aesthetic lip issue is the mouth size or a lack of adequate horizontal lip width. Without more lip width you can’t have any vertical lip size increase without looking disproportionate.

To create more lip width, aka mouth widening, the vermilion around the mouth corners has to be advanced by removing skin and relocating the vermilion corner in to it. This creates fine line scars around the vermilion edges in so doing. There is a delicate balance between how much the mouh is widened and the resultant scars.

While scars are always a tradeoff for many aesthetic procedures, in any form of vermilion advancement that is always a significant consideration.

Dr. Barry Eppley

Q: Dr. Eppley, I had hip implants placed  and you can visibly see they’re not long enough or wide enough and aren’t the right shape or size for my hip area. I would like new hip implants to be thicker, longer and wider. Covering the entirety of my hip area and wrapping around the back as much as possible. 

A: Thank you for your inquiry and sending your pictures. I would have to now some more information about your hip implants (dimensions, when placed, surgical incision location) but I can certainly see your concerns/objectives. These are hip implants that are isolated to the subiliac hollow area of which the outlines of the implants can be seen.

While the aesthetic outcome of the hip augmentation may be less than ideal, it is important to recognize that they were placed and have healed uneventfully without medical complications (infection, chronic seromas). When you consider replacing such implants for a larger and improved result those surgical risks are going to be reincurred and you may or may not be so fortunate the next time.  While this is relevant to all implants it is particularly poignant in hip implants which have the highest complication rates of all aesthetic body implants due to their more superficial tissue pocket location.

Thus in considering hip implant replacements with a focus on trying to minimize these risks it is important to not get ‘greedy’…meaning keep the replacement implants reasonable in surface area coverage and thickness. Don’t try to make them do too much. Some more is better, a lot more could be disastrous.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I submitted paperwork online for a virtual consult with Dr. Eppley regarding custom jawline implants and I just wanted to follow-up about scheduling an appointment. My understanding is that I’ll likely need a ~3D CBCT scan of some sort for him to take a closer look at my jaw and assess how plausible my goal/plan is, so if that is indeed necessary before a consult.

A: While a 3D CT scan is needed for the designing of a custom implant it is not necessary for the initial virtual consultation. The scan is the platform on which a custom implant is designed but it does not tell us how to design it. That guidance comes from imaging of the patient’s pictures.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I just retired and I’m built like a brick house.Now I would like to be much more feminine looking figure wise. I’ve seen people who received rib contouring and I wasn’t impressed with the results. I have only seen one Dr. Eppley’s patients who had the procedure and they looked great, 100 times better than rib contouring.

I researched both rib contouring and rib removal and I think removal is the best option for me.

A: Thank you for sending your pictures. Rib removal surgery works best and should only be performed on lean patients where the only obstruction is structural (bony). In patients that have some significant skin laxity and a thicker subcutaneous fat layer procedures that address those issues should be done first. In your case an extended tummy tuck with lateral oblique plication with flank and back liposuction will get much better results than rib removal alone.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I have a narrow face and would like to add facial width. Is this possible through implants? It’s just overall narrow and would like for it to be a bit wider. Also if there is are there risks? Like will it ruin facial harmony since the facial features stay the same but the bone seems widened?

A: The only way to increase facial width is with implants. The best way to assess those potential widening effects and as to determine how much widening you prefer is imaging predictions based on your own pictures. To do so I would need a non-smiling front view facial picture.

Dr. Barry Eppley

Plastic Surgeon

Q:Dr. Eppley, Hello! I found your practice online because I have been researching sliding genioplasty reversals. I am interested in having a sliding genioplasty reversal. I had a sliding genioplasty 7 years ago with a 4mm advancement forward. Unfortunately, it made my face look significantly longer and wider. I would like to learn more about sliding genioplasty reversals and go over which options would be best. I would ultimately like to have a shorter more narrow chin. Please let me know if I am a candidate and if a reversal or chin shaving surgery would be best for me. Thank you.

A: As you have metioned there are two methods for ‘chin reduction’ after a sliding genioplasty, submental chin shaving and secondary sliding genioplasty, both of which can create vertical height reduction and width narrowing. Each method has their advantages and disadvantages. Chin shaving avoids an intraoral osteotomy approach at the expense of a submental incision/scar. The osteotomy method avoids a submental scar but is prone to increased risks of bony irregularities and some redundant submental tissue laxity.

In essence there is no perfect way to do it without risks/tradeoffs. Augmenting the chin is ‘easy’ but reducing introduces new issues that were not as pertinent as the first surgery.

One major consideration is what degree of changes are needed.  If there are only minor amounts  (a few millimeters) vertical and width change then the submental shaving method would be more appropriate. However if the changes needed ar more significant then the osteotomy method may be preferred.

Dr. Barry Eppley

Plastic Surgeon

Q:Dr. Eppley, ı wanna learn about this iliac crest reduction.I got wide hips and ı wanna change that.

A: On the basis of your pictures it looks like you are referring to the whole of the iliac crest, both anterior and posterior portions. Iliac crest reductions are typically done on the widest anterior portion of the crest as the posterior portion is not usually visible and is harder to access (see attached image) I suspect in a thinner patient where the posterior portion may be more prominent/visible it could be reduced as well…but I have never yet done it.

Dr. Barry Eppley

Q: Dr. Eppley, I have a facelift last year and my tragus was removed. I would like to reconstruct a new tragus.

A:This is a far bigger problem to correct than you think. This is a classic example of a facelift that was done were all of the tension has been put on the skin level at the ear resulting in loss of the tragus, a pixie ear and hypertrophic scars behind the ear. The only way to approach correction is to redo the facelift and re-elevate  the skin flaps to create more skin around the ear which may be able to support a cartilage graft for the tragus, reduce the pixie earlobe while keeping the scar underneath it as well as narrowing the scars behind the ear. Whether you now have enough skin to be able to do that depends on how far out you are from the original facelift surgery as well as is there any residual skin laxity

Dr. Barry Eppley

Q: Dr. Eppley, Hello I have interest in possible solid tear trough implants. I see one pic showing before and after from profile view of tart trough implants can you please Share more pics of tear trough implants? It seems everyone just does fat transfer or filler but I don’t understand why. Does this implant get screwed in under the eyes? Please advise thank you

A:Tear trough implants are a very specific type of iinfraorbital implant and the only type of infraorbital mplant that is available as an off-the-shelf item. By its history it Is designed to treat, as the name indicates, tear troughs which are grooves are indentations limited to the inner half of the infraorbital rim. They should be distinguished from under eye hollows which affects the entire infraorbital rim and are treated by custom infraorbital rim implant designs. Thus the first question is what are you specifically trying to treat as that will determine whether standard teardrop implants are appropriate for you.

But regardless of the type infraorbital rim implant they are placed through lower eyelids incisions and are secured with small micro screws.

Dr. Barry Eppley

Q: Dr. Eppley, Hello, I am interested in infraorbital and submalar facial implants. I have done a CBCT which I can share. 

A: A CBCT scan may or may not include adequate data on the infraorbital rim area so I would have to see some pictures of it to see if  it does. Regardless the scan does not provide information on how to design the implants, it is merely the platform on which they are designed. Design information comes from analyzing your pictures and doing imaging to determine what your desired aesthetic midface augmentation goals are.

Dr. Barry Eppley

Q: Dr. Eppley, Hello, I am scheduled for CCW jaw surgery 7 weeks from now. Movements will be approximately 10 mm lower jaw, 5 mm upper, and 5 mm sliding genioplasty. I have also been losing facial fat lately as well I am interested in.custom infraorbital-infraorbital-malar implants and have done some imaging and is what I believe to be an ideal result. The projection is not extreme but it looks more angular and gaunt but also natural. I would like you to tell me how realistic this result is for custom infraorbital malar implants paired with any other treatments such as facial liposuction for someone with my anatomy. The closest results I have seen few online results both aesthetic goals and rough magnitude of change that I am seeking. What are the odds a similar outcome could be achieved in my case to mimic my idealized but sensible outcome?

A:The quality of your facial pictures that you have edited with the eyes covered is poor and I can tell little front them. One of the main reasons you cannot find many results of IOM implants on the Internet as for the very reason you have your eyes covered. The average age range of the patient who gets IOM implants is between 18 and 35 and most are extremely secretive and never want to show their pictures on any public forum. I have done over 500 pairs of IOM implants and I cannot name on one hand anyone that was willing to have their before-and-after pictures shown. If you block the patient eyes you’re essentially blocking much of the effect of IOM augmentation.

That being said it is fair to say that by definition if you’re moving your maxilla/mandible and chin forward as well as losing weight any amount of IOM implant augmentation is definitely going to create a more skeletonized midfacial appearance.

Dr. Barry Eppley

Q: Dr. Eppley, Hello I am interested in cosmetic hip implants. I would like my hips to be as wide as possible something like this if at all possible

A: Thank you for your inquiry and sending your pictures. Hip implants are unique amongst all the body implants for  variety of reasons including the inability to replace them deep in the hip tissues as well as their vertical elongation augmentation effect over a movable joint area. As a result hip implants have a fairly high rate of aesthetic complications (edging, implant show)  so patients have to be selected very carefully to try and lower those risks. There are two major risk factors, 1) thin patients with little subcutaneous fat (inadequate soft tissue cover) and 2) implants that are too big. (too thick for the tissues to adequately support them) Both of which exactly apply to you as determined by your pictures as well as your stated goals.

The key to lowering these risks is to avoid putting too big of an implant both in terms of length and projection as well as potentially skeletal anchorage of teh implant to the iliac crest. What that means visually is shown in the attached imaging. I have learned through  many painful experiences, both for the patient and myself, that doing with the patient wants often leads to major issues as opposed to doing what I believe is safe with the lowest risk of potential complications.

There’re two basic philosophies I have about the aesthetic implants anywhere in the body after having done thousands of them which is the following:

1) implants can achieve changes many times no other treatment option can do and it can have some spectacular effects.  But when it has problems the solution to them more times than not is implant removal and all is lost.

2) With implants In it is often better to have 50% to two thirds of what you want with no problems then it is to have 100% of what you want with one….for the reason stated in #1.

Dr. Barry Eppley

Q: Dr. Eppley,  Ive attached 2 photos one i usually see and other flipped. My main concern is the jaw/chin asymmetry ideally I would like to lengthen the shorter side of jaw and straighten chin, I also have a crossbite. Would love your advice on what my options could be, thank you.

A:With a left shorter side of the face jawline and chin on the side going to be shorter. Hey 3-D CT scan will certainly confirm the skeletal deficiency. The most effective way to treat it, provided you do not have any concerns about the crossbite is a custom jawline implant to create symmetry to the opposite side. However, if the crossbite is of concern this is going to require double jaw surgery to correct.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I did a chin implant recently and I chose EAC L, which doesn’t seem sufficient – things look smaller and thinner still and not tall enough. Flowers Glove offers 1.75 cm of height and significant mass, but people’s chin looks like a potato or golf ball and is not as athletic afterwards. I think my next move is a custom implant. To do this right, I need imaging (not 3D, on my real picture), to see what the custom implant will roughly do. My current surgeon does not offer such imaging – do you? Attached pics are from now, which is 2 months after surgery.

A:Thank you for your inquiry and sending your pictures. The fundamental dimensional problem of your current chin implant result is that it lacks vertical height. Vertical height refers to an extension of the inferior border of the bone. No standard implant really does that satisfactorily. You simply have had a chin implant which has been placed with no real consideration of the need for vertical lengthening in which you have always had a vertically short chin.

When it comes to imaging it is important to understand that its purpose is to determine the patients goals not to show a result that will actually happen as no one knows that for certain. Imaging determines the target which serves as the type of surgery that the surgeon thinks is most likely to come closest to achieving. In that regard I have attached an image in which I am demonstrating some increased vertical height to the chin augmentation results you already have which appears to be adequate from the standpoint of horizontal projection.

Ultimately you will need a 3-D CT scan so we can understand what your current implant is actually doing based upon the way it is positioned on the bone. Whether such an imaged change can be achieved by a custom implant or whether it may require a vertical lengthening bony genioplasty remains to be determined of which the 3-D scan will provide invaluable information on that decision.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have a question about mandible implant width size. To create an angular apearence on my jaw, would 5mm width do it? I have read thats very small when it comes to mandible implants. What size is needed?

A:To make the determination as to how much width  may be necessary in the jaw angle area it really takes imaging of the patient’s pictures to determine the result you were seeking from which an estimate can then be provided as to what that width number may be. As I don’t know what you look like I can only make a general statement of which it would be fair to say a 5 mm jaw angle width in most men is unlikely to create an angular jaw angle appearance. But every patient is different and must be evaluated on their own.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have a question about testicular enhancement. I would like to get this done as I’m not happy with my size and want them to be larger. I have had a prior vasectomy and I do not ever want children. I also have a family history of  prostate cancer too. I read somewhere removing testicles could help reduce risk. I really don’t want to get cancer ever. Would it be possible to remove mine and then replace them with much bigger implants? I wouldn’t want the side by side technique because I don’t want to have 4 balls in scrotum. I also don’t know about the wrap around thing. I think that would be harder to detect testicular cancer and I’m nervous I wouldn’t be able to tell if it was inside an implant. I wouldn’t be able to feel anything abnormal I think.  Would it be possible for removal for my goal of 100% sterilization and hopefully reduce cancer risk and also make room for the implants? I don’t mind taking a little bit of testosterone on the side to have some level of that. My levels are low anyway. 

Thank you very much. I appreciate it.

A:Thank you for your inquiry. In answer to your questions you certainly can have existing testicles removed and immediately replaced with implants that are larger than that of the natural testicles. That would achieve two of the three goals you have mentioned including assurance of 100% sterilization and to make room for implants. While removing the testicles will certainly eliminate any chance of testicular cancer I would not think that that would similarly reduce the risk of prostate cancer given that emanates from a different anatomic structure. There may be a correlation in terms of cancer reduction but I am not aware of it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I received a bilateral iliac crest reduction about 1.5 years ago and love the result! The reduction was approximately 1cm from each crest and the recovery was very speedy. I am highly interested in another reduction of both crests, but I do understand there are limitations of how much bone can be removed. My aesthetic ideal would be an additional 1cm removed, but is this feasible? If not 1cm, what is the feasible amount of bone an aggressive approach could remove? Thank you for your time!

A:Thank you for the long term follow-up and I am glad to hear that the initial iliac crest reduction was satisfactory. In regards to a second iliac crest reduction I can only speculate as to its feasibility since I have never yet done it. I think the question is not whether some more iliac crest bone can be taken but how much and can as much as an additional 1 cm be done. My conjecture would be…maybe. But I don’ t think one could every know exactly how much more bone can be taken until one is actually doing it in surgery.

Dr. Barry Eppley

World-Renowned Plastic Surgeon