Your Questions

Q: Dr. Eppley, I have hollow cheeks, but the hollows are far too small. In the edited version of my own photograph, the highest point of the line I’ve drawn in red aligns horizontally with the lower part of the corner of my lips. In contrast, on most people’s faces, this line falls somewhere between the upper lip and the nose. I’ve provided some examples using celebrities. I have two questions.

1) What anatomical feature determines how high this line extends? Is it the concavity of the zygomatic-maxillary complex?

2) Is there a surgical procedure that could make this line extend higher?

A:They have a more pronounced inferior edge of the zygomatic– maxillary complex while yours is more flat. The combination of a more evident bony edge by implant or ZSO osteotomy and a subtotal buccal lipectomy should work for you.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Interested in head augmentation. Sides are concave and right more than left. Back of head is flat with no projection.

I prefer B-TCP for safety + bone integration. Priority is natural shape + strong fixation.

No CT or measurements yet – I’d like to come for consultation so you can assess me. Hoping it can be kept as simple as possible.

Do you recommend sides + back in one surgery or split?

Thank you.

A:Thank you for your inquiry and sending your pictures. Just based on your description I can provide you with some initial comments and insights.

1) The use of tricalcium phosphate (TCP)  or any other form of hydroxyapatite bone cement for skull augmentation is problematic in many ways which include:

      a) It would require a full bicoronal scalp incision from ear to ear to place since it requires an open field that is completely dry to shape and set up

      b) The cost of such cements are extremely expensive in the volume needed to do the back of head alone and would have a material cost of at least $25,000 which does not include any other costs of the surgery.

      c) Bone cement cannot be used on the side of the head since this is covered by muscle and the material must be placed on bone.

      d) You can now appreciate that it takes a very motivated patient to consider this form of skull augmentation even though it does have a biologic appeal to it. The question is not whether it can be done but whether it is a viable economic option for the patient.

      e) In addition custom made skull implants from the patient’s 3-D CT scan also offers a better aesthetic outcome with more shape and volume.

2)  it is common to perform multiple areas of skull augmentation during the same surgery.

3) I don’t know what the statement ‘hoping it can be kept as simple as possible’ means.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I weant to get the “hunter eye” aesthetic. Deep setted eyes, and no scelara show. Can you achieve this. I plan on getting an eyelid retraction surgery to achieve this but I feel like cancelling and having you do it. What do you think is it achievable. I included examples of eyes that are desired.

A:Thank you for your inquiry and sending your pictures. I don’t really think that type of result is achievable in you from any type of eyelid surgery. If you look at the examples they have very prominent and low brow bones which you do not have. This is more of a structural bone issue than a soft tissue one. While brow bone augmentation may not get you there completely either (see attached picture) but the lack of brow bone projection is more of the ‘problem’ than that of the eyelids.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley,  I had genioplasty when I was 20 years old and since then I feel that my chin is crooked and I’d like to have it fixed.

A:I am assuming when you refer to fixing a crooked chin after a sliding genioplasty that you want the bone repositioned rather than a camouflage implant overlay. To properly evaluate the chin and plan for such bony repositioning a 3-D CT scan is needed to have a clear visual understanding of the nature of the asymmetry and how best to cut and realign it.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, if I get sliding genioplasty +/- jawline shaving and a facelift, but the result is underwhelming, would I be able to get a continuous jaw implant afterwards?

A:The first key question is what are you trying to exactly accomplish. Based on your description it appears that you are trying to reduce your way into a more defined jawline (AKA V line surgery with a facelift)  which will never work. You can’t create definition by reduction as the soft tissues will never allow it to be seen. Furthermore there is no such thing as ‘masculine’ V line surgery. V line surgery is largely an amputation procedure which by definition is feminizing only.

That being said, having V line surgery does not secondarily eliminate the possibility of augmenting it with an implant. I have done many V line surgery reversals due to the patient’s regret having done it in the first place.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I have below average testicle size. I want them to be bigger. I have taken Clomid before and that helped them be fuller and appear bigger but I had to stop.

I want them to appear bigger. In the gym showers If guys see my junk I want them to be like”dang that dude has big nuts”

What are the risks of developing a 4 ball appearance?

I had looked at the wrap around, but there is the risk that these can come off so I done want to do that because I still run and exercise pretty heavy

A:Besides the usual surgical risk of Infection, the biggest aesthetic risk is whether the size of the testicle implants chosen adequately camouflage your existing natural testicles (push them up and out-of-the-way towards the penile base). In my extensive experience with the side-by-side testicle implant technique if an adequate implant size is chosen, 70% or greater over that of the natural testicles size, there is no chance of having a 4 ball appearance.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, My primary concerns are close set eyes and flat midface. Is there a single surgery that can address both simultaneously or is it better to have two separate surgeries?

A:Potentially inferior orbital box osteotomies and a custom-made midface mask implant could be done at the same time. However depending upon the location of the bone cuts and the implant ’s footprint coverage this may or may not be advised. This is going to require a more comprehensive evaluation to make that determination which includes a 3-D CT scan and pictures of your face.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I got lip implants years ago and the problem is a lot of scar issue has formed around the,m and now I feel like my smile is very distorted. I hate absolutely hate taking pictures because I look really bad. I feel like I used to have a really beautiful smile but now it’s terrible. Sadly, it’s of my own doing.

A:When considering removal of lip implants in which the material has allowed soft tissue attachment this can be very challenging and often requires an open approach to do so. … or at least multiple small incisions along the pathway of the implant. But besides the surgical access the other very important issue to be aware is that once the implants are removed there’s going to be scar contracture and the appearance of your smile may not be really improved. Thus it is important to replace the lost volume of the implants with fat grafts to prevent scar contractures and even a worsening appearance of your lips both at rest as well as smiling.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I would like to know about head reduction surgery if my head is large and hurts my shoulders. Could you call me if this is something I could have done.

A:I would doubt that any form of head reduction surgery would alleviate your shoulder pain. Skull reduction is about reshaping areas of contour access of which there are defined limits. Any amount of change in its shape is not going to result in a head that weighs less.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Can plagiocephaly skull should be treated?

A:Such occipital asymmetries as you have are commonly treated with a custom made skull implant to build out the flattened side. So if the question is whether it can be treated that is an absolute yes. If the question is whether it should be treated, as stated in your inquiry, that is a matter of personal preference based on how much it bothers the patient.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I am interested in a brow/forehead implant. I think my eye area is too feminized and believe that brow augmentation could give me eyes a more deep set hunter appearance. I’m inquiring regarding the cost of this procedure and the feasibility for my goals. Thanks

A:Thank you for your inquiry and sending your picture. I can certainly see your aesthetic concern in which the brow bones is less well developed  area than that out of your very strong facial features beneath it. That’s the consideration of a brow bone implant seems appropriate. To further evaluate that potential change I would need a side and three-quarter view pictures to do imaging which is far more useful then a front view picture in assessing this type of upper facial augmentation.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley,I have sliding genioplasty & abdominal liposuction booked tomorrow at a separate place.

HOWEVER—I just discovered infraorbital implants are a thing.

I’m guessing the ideal sequence for the loss of midface volume is:

1. Infraorbital/midface implant

2. Face-lift if needed

3. Fat grafts to face if needed

My questions are:

1. Should I skip the liposuction to preserve my native fat stores in case they’re needed for far grafts later?

2. Can I get a facelift before infraorbital/midface implants wothout compromising the end result?

3. If I get a lower face SMAS lift (chin area), can an upper face-lift still be done subsequently.

Thank you.

A:In looking at your pictures there are three things in which I am absolutely certain:

1) You do not need or would benefit by any form of fat grafting to your face.

2) The chin augmentation procedure, which you described as a sliding genioplasty is going to improve or resolve any submental concerns that you have. At best you might combine submental liposucton with the sliding genioplasty but you absolutely do not need any form of open necklift/tightening procedure.

3) You also do not need any form of a facelift either above the jawline or in the midface area. Face lifting in a young person like yourself has no value and does not have the ability to create improved facial definition or shape which is your real objective. This requires augmentation of the bony structure.

Here is what you need to remember when it comes to a young person seeking improved official definition… You can’t fat graft or lift your way into achieving that objective. These are flawed concepts but are commonly employed by plastic surgeons because it is what they know how to do. But such techniques are more applicable in the older facial rejuvenation patient who actually have lost volume and have tissue laxity and descent.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I am a young man looking to get just one (1) custom cheek implant for my right side. I would like to replicate the structure of my left cheekbone, which is larger and more projected than my right, to correct my severe facial asymmetry. Is this possible? Thank you

A:With natural cheekbone asymmetry hey right custom cheek implants can be designed by mirroring the bone structure on the left side with the discrepancy being the actual implant design. This is a common technique used in the management of any form of facial bone asymmetry. This requires a 3-D CT scan of your face which can be obtained where you live and sent to me.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I’ve attached front and side view photos for Dr. Eppley’s assessment, along with an edited version I created to provide a loose visual of the aesthetic I’m hoping to achieve.

My primary concerns are facial asymmetry and improving overall facial harmony. I’m specifically interested in an evaluation of whether I would be a good candidate for a brow lift and chin augmentation to improve my eyebrow and chin symmetry.

My goal is to raise my left brow so it sits at the same level as my right, while also creating a slightly more upturned, lifted appearance for both brows. I’d also like to lengthen my chin slightly and improve its symmetry.

At the moment, I’m leaning toward filler for the chin, but I’m open to Dr. Eppley’s recommendations if he feels another approach would be more appropriate.

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

1)  There is not usually an explanation for most facial asymmetries and the most minor ones, such as yours, is not uncommon. Perfect facial asymmetry is actually very rare.

2) A differential endoscopic browlift is needed. Whether perfect brow symmetry can be achieved may not always be possible.

3) The vertical chin lengthening shows a V-shaped chin which can only be achieved reliably by a custom chin implant design.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I’m reaching out to inquire about scheduling a consultation in the future with Dr. Eppley.

I’m interested in the following procedures, ideally bundled in a single surgery:

– Custom jaw angle implants

– Chin implant

– Buccal fat removal

– Submental liposuction

My main goals are a more defined and structured lower face, improved symmetry, and a sharper side profile. I’m based in New York and would be traveling specifically for this, so I’d also appreciate knowing whether an initial virtual consultation is available before committing to the trip. Could you let me know if Dr. Eppley performs all four of these procedures together.

A: All four (technically three since the chin/jaw are treated with a single wrap around jaw implant) are done together. These are a very common combination as they are synergistic aesthetic facial procedures.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Hello. Ive seen contradicting information regarding the choosing of either PEEk or Medpor for Jawline implants especially jaw angle implants by Dr. Eppley,

Does Dr. Eppley favor one material and why? And after clarifying this, can I become a patient as a EU-Citizen?

A: In answer to your questions:

1) PEEK is the superior material because of its ease of reversibility and/or secondary modification/replacement.

2) Many of our patients are international from all over the world.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, can doctor partially remove/debulk facial silicone injections in cheek and jawline, and  also restore contour?

A: The removal of silicone granulomas is very challenging of which the foundational procedure is excision. While most would think of making an incision directly over them to do so, I wouldn’t as such scarring just creates another potential aesthetic concern. I would rather approach them from a more remote facelift approach and do as much debulking as possible.

The facelift approach also allows the application of Alloderm sheeting which would be the best method for creating additional volume over a large facial surface area.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, is there also a way of being able to by some means attach a calf implant inside the leg to avoid the postoperative movement?

A: Soft tissue muscle implants can not be securely fixed to a stable structure like bone as it done in facial implants. However there are numerous design strategies that I have used to help establish some form of soft tissue fixation including:

1) application of ePTFE strips on the implant’s undersurface, a material that encourages soft tissue adhesion

2) Irregular implant edging/notching

3) Intraoperative creation of perfusion holes cut into the implant prior to insertion

Custom implant designing allows for material alterations that do not exist in off-the-shelf implants

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Hi, I had a bad surgery experience with a surgeon abroad who advanced my lower jaw by around 10-15mm I believe, he also did a 7 degree Ccw rotation and then on top of that exploited me and made me pay for a genio too. I don’t know the measurements of the genio but I have consulted with a surgeon near me for a revision, he has proposed a 3mm setback and 2.5mm upward movement will this shorten and soften my chin enough. I really cannot stand my current chin length and prominence, I’ve attached an image

A: While I haven’t seen any x-rays to make a more accurate estimate, but I do not think that these small movements will make a big difference in the size of your chin. You are more likely going to need at least 7 mm of vertical reduction and 5 mm of setback. This may create some soft tissue chin pad excess, but to make a real difference, you are going to have to make a more significant bony chin reduction.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I got a surgery last year in South Korea that I greatly regret. It was a cheekbone reduction. My face now looks very narrow, I have visible malar lines in certain lighting, and my under eye lines are more obvious. I’m wondering what’s the best course of action for me to take now because I’m also scared of premature sagging. I wanted the width in my face to increase a bit and for my fine lines to be smoothed out. I’m not sure if cheek implants or fillers are the best course of action. I would like your professional opinion and suggestions

A: Thank you for your inquiry and sending your pictures. Unfortunately, it is not rare that some patients develop regret after cheekbone reduction surgery because of its adverse effects. The correct long-term approach to bring back some of your width is a custom cheek implant made to fit exactly where the bone is most reduced based on the 3-D CT scan as well as to make sure that the actual thickness is but a few millimeters which is all you really need. You can certainly do injectable fillers as a test, but that is not a long-term solution.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, In a previous response you gave to someone else, you mentioned that custom PEEK implants could be used to correct an inwardly tilted ramus. Is it also possible to correct this using procedures such as osteotomies or bone grafts?

A: There is no osteotomy that can change the angle of the mandibular ramus. Onlay bone grafts will largely melt away and lose significant volume.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Hello, I’m interested in scheduling a consultation for a permanent correction of a localized indentation in the center of my forehead. The depression is mainly due to a previous frontal-bone fracture rather than a soft-tissue issue, and I am specifically interested in learning whether I may be a candidate for PMMA bone-cement frontal skull reshaping or another form of reconstructive forehead contouring. I can provide photos and obtain a thin-cut CT scan with 3D reconstruction if needed. Could you please let me know whether your surgeons have experience treating post-traumatic depressed frontal-bone fractures similar to mine, what procedure they would generally consider, and whether you can provide a rough price range—including surgeon, facility, anesthesia, and material fees—before I schedule a consultation? I understand an exact quote would require an examination, I am working with a limited budget and am trying to determine whether the procedure is financially doable for me. Thank you!

A: Thank you for your inquiry and sending all of your pictures. The key question is whether your left forehead indentation is due to a bone defect or a reflection of soft tissue atrophy from the obvious trauma that has occurred in that area as evidenced by the vertical scar. This is where the 3-D CT scan of your forehead would be invaluable to answer that question.

For the sake of this discussion, let us assume that it is a bony indentation. The ideal approach would be hydroxyapatite cement contouring going through the scar that already exists.

From a cost standpoint, we will start with this being the ideal approach. There are other more economic alternatives in terms of materials, but we won’t pursue that until we know where you stand with the hydroxyapatite cement approach.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley,  what area of the face is this and what happened? Lost over 100 lbs. went to a doctor for “excess skin removal “ on my face. He recommended a lower facelift. We did not talk much about it but I do know it was not a “deep plane” lift. I am left with this 10 months after surgery. Bulges. I did not have these bulges prior. Loose skin? Sure, but not “bulges”. What can be done? Feel free to be candid. Your reply is for my understanding exclusively. I am very surprised with this happening. Was medically discharged from the practice and am now independently seeking answers. Found you via an excellent online article. Am open to your feedback. What part of the face is this? What happened. Can you help.. Please reply by email if possible. I am sorry but I do not use the text portion of phone. Thank you.

A: The simple answer is that, while a lower facelift helps the neck and jawline which clearly has been useful in your case. it will have  effect for any facial areas that lie above the jawline. Thus what you see is essentially untreated areas from the nasal folds and cheeks that were beyond the scope of the facelift procedure you had performed.

To achieve a midface effect, the incisions would have to run up higher than the ear and along your temporal hairline. They would likely be needed a lower eyelid incision as well. Innocence you needed a more extended type of facelift to deal with your tremendous amount of facial skin laxity from the weight loss.

There was nothing wrong with the procedure you had performed other than your expectations of what you thought it would do and the type of facelift chosen for your concerns was a bit of a mismatch. How that happened I cannot say since I obviously was not involved in those preoperative discussions. There may have been good reasons for a more limited facelift approach to your problem, such as the duration of the surgery and your general health. But in essence the solution was not adequate for the problem.

The question now is how far do you want to pursue this improvement. You can certainly go on and have a mid face lift secondarily after a lower facelift. While everyone is an enamored  today with the deep plane facelift this is not the source of your problem. The location of the incisions controls skin movement and what you need is not going to be accomplished by a traditional lower facelift procedure. As I often say, traditional problems require traditional procedures. But when you have an exceptional problem, which is what happens with a 100 pound weight loss, you need an exceptional procedure to treat it.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I am interested in getting silicone deltoid implants, as despite putting in years of work at the gym my shoulder width remains small. Basically I’d like as much extra width as you can give me – I’ve heard around 1-2cm per shoulder is ‘normal’ which would be great.

A: Thank you for your inquiry about deltoid implants. Of all body implants in my extensive experience, deltoid implants are the most challenging. There are numerous options to consider, including pocket location(submuscular or subfascial),  the specific type of implant to be used, and the incisional approaches to place them. The only thing we probably knew at this point for certain is that standard style implants may be adequate, particularly if they are to be placed sub muscular.

The first place to start is to see some pictures of your shoulders to make an assessment. But you are correct in that 1 to 2 cm of increased shoulder width is what is reasonable to accomplish.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I has a bullhorn lip lift and have downward turned corners that make me look sad now. Did not look like that before the lip lift.

A: A subnasal lip lift is essentially a central lip procedure that largely affects the underlying Cupid’s bow area. While it is commonly believed by some surgeons and patients that it affects the whole way to the mouth corners that is not an anatomically correct perception. While some people can have an isolated subnasal lip lift that is only effective when the size of the lips are naturally fuller all the way out to the mouth corner. In your case, you never had much vermilion show laterally, so it would be expected that you would get more of an A-frame deformity by performing a subnasal lip lift alone. The more effective approach would’ve been a combined subnasal lip lift with lateral vermilion advancements to have a complete mouth corner to mouth corner lip augmentation effect.

But just because it was not done initially you can still have it done secondarily to create a more complete upper lip, augmentation result.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I am writing to you because I am currently facing a very distressing situation with my facial structure, and I deeply hope that your expertise can help me find a solution. Right now, I have a custom wrap-around jawline implant in place. Unfortunately, it leaves my lower face looking far too wide and poorly shaped, which has become a significant emotional burden for me. Additionally, during the implant surgery, a buccal fat removal (bichectomy) was also performed. Since then, I have been dealing with a severe aesthetic issue when I smile or laugh: my “apple cheeks” bunch up aggressively and project forward in a very unnatural, isolated way. The tissue simply does not distribute smoothly or laterally anymore. My goal is to achieve a much narrower, leaner, and more naturally chiseled facial shape. I would love to schedule a virtual consultation with you to discuss how we can correct the implant’s shape and restore a harmonious, flat transition to my cheeks during animation. I would be incredibly grateful if you could help me.Thank you so much for your time and compassion.

A: Thank you for your inquiry and sending your pictures. While I have not seen your custom jawline implant design file it is obvious is that the jaw angles were vertically lengthened and extended posteriorly which is well known to have adverse aesthetic effects. For whatever reason, many surgeons and designers believe that creating a more distinct jaw angle appearance requires this type of structural change, which is rarely successful unless that is exactly the look the patient is seeking. That type of jawline change is a far cry from what I assume to be in the last picture you sent at your ideal goal. I can also see externally that there is a symmetry of the jaw angle implant placements. This is correctable by new jawline implant design that is more appropriately done for your objectives. Hopefully in creating this type of abnormal jaw angle change the masseter muscles have not been dehisced in so doing.

From a facial defining standpoint, you were never a good candidate for buccal lipectomies as this was not the source for creating a more defined face in you . You simply weren’t full in these areas. You would’ve been better off had you had perioral/lateral facial liposuction which treats the area beneath the buccal region and is more consistent with your aesthetic objectives although that degree of indentation seen in your ideal imaged picture would never be achievable to that degree.

The contour complication that you now have from the buccal lipectomy can only be treated by fan injections in an effort to restore some contour and support to the skin.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, Hello, I had gynecomastia surgery done about five years ago and I’ve had a hard time building a to find chest and I am looking into getting large custom implants and I’m curious on pricing and what the best method is if it’s a mixture of implants and fat transfer or what but will attach a photo of current body and what I’m wanting to achieve.

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

1) Besides the fact that fat transfer is never a good method for male chest enhancement, you do not have enough fat to even consider that as an option.

2) The imaged results that you were showing can only be achieved by pectoral implants of which the size and shape would likely have to be custom given the images that you have shown. The size of the implants you are showing do not really require a custom design as that is not a particularly large petrol implant augmentation effect in my experience. But it is the shape that makes custom necessary as the width versus height, and the thickness from the sternum out to the lateral pectoral border is not what any standard implant is designed to do.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, About nine months ago, I underwent a standard lip repositioning surgery for my gummy smile.  The procedure appears to have relapsed — I suspect due to the strength and hypermobility of my smile muscles.  I’m hoping to schedule a consultation with you to discuss treatment options along the lines of what’s discussed on your web page: intraoral levator myotomy combined with a V-Y mucosal advancement/vestibuloplasty.  This approach seems like it would address the root issue of overactive muscles.

A: In my experience with gummy smile surgery, we usually see very little if any relapse. Since I don’t know the exact technique you previously had done it is hard to say whether a second gummy smile surgery would be more effective. Usually when you shorten the vestibule that is a permanent change, which is the primary technique in gummy smile surgery. Release of some of the levator muscles is an adjunct procedure that I incorporate into the technique based on what I’ve learned by doing Botox injections into these muscles.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I had an otoplasty surgery in my mid twenties to pin my ears back. I regret having the surgery, as i do not like the shape of me ears. I did have one reverse otoplasty surgery to try and reverse the ears from being pinned. It did help, but i really want my ears out farther from my head like they were before the original surgery. I would like to know if it is possible to move the middle of my ear on both sides of my head out away from my head about 1/4″ or 6.35 mm. My right ear looks to need a little more correction than the left ear. If this is possible.

A: Thank you for your inquiry and sending your pictures. In performing a total or subtotal reverse otoplasty The key technique is to place a wedge of material or graft into the released concha or the middle part of the year. Using ePTFE postauricular wedge of 12 mm in thickness this material as well within the range of achieving an increase of approximately 6 mm of increased projection in the middle part of the ear. The wedge can be reduced to any thickness intraoperatively and thus can be adjusted to fit the amount of millimeters the patient feels they need.

Dr. Barry Eppley

Plastic Surgeon

Q: Dr. Eppley, I’d like to ask about the general cost range for a cranium height reduction procedure, the usual wait time between a successful consultation and the surgery date, and how soon after the surgery a patient can typically fly back to their home country (Denmark in my case).

A: I believe you are referring to a top of the skull bone reduction procedure. The wait time between the consultation and the time for surgery will largely depend on your schedule. We try to make it work to our patient’s best time frame given their international location and having to travel. In all skull reductions, the greatest wait time is based on getting a 3-D CT scan of the skull and performing bone thickness color mapping so we can determine how much of the skull can be effectively and safelyreduced. Getting the scan and having it mapped does take some time.

After the surgery, you should be able to go home within 48 hours.

Dr. Barry Eppley

Plastic Surgeon