Your Questions

Q: Dr. Eppley, I’m interested in a beard transplant and would want to get that done before doing a jaw implant. However, I’m still very much interested in getting the jaw implant done with Dr. Eppley in the near future. I do have one question for Dr. Eppley regarding the beard transplant however, if you would be so kind as to relay it to him: “Given that I currently have a chin implant, and infection is a possibility, I’m wondering what sort of risk having hair transplanted to the chin area would pose for the implant? You have spoken about needles penetrating facial implants when people undergo filler injections, and that being a cause of infection in certain cases. I’m sure you’re aware of the process of extraction and implantation for hair transplants (the same process applies to beard transplants). A small needle (much smaller than a filler needle) would be poked into the chin area to create the holes needed for graft implantation. What are your thoughts on this? Could this process potentially cause an infection to the implant? Or is there no cause for concern in your opinion? Any time you could take to answer that question would be greatly appreciated.

A: I see no concerns doing a beard transplant over an existing chin implant. The soft tissue chin pad is very thick so it is a long way from the depth of the hair follicles to the implant capsule.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, At this point I don’t know where to turn too. I removed four healthy wisdom teeth. Ever since then I’ve developed a range of health issues. However, I noticed a lot of facial changes such as a loss of forward growth, loss of cheekbones, less defined angle of jaw, less defined jaw, narrow midface and jaw. I’m wondering if I could potentially show you an image of my face before removal and you try your best to recreate that image. No surgery or implant is too invasive nor too expensive. The phone of me in the red is before extraction. Please let me know. Thanks

A:Removal of wisdom (3rd molar) teeth would certainly be a rare predicate for developing any health issues including facial shape changes. Regardless of the origin the pertinent question is what could be done for your facial restoration. This is a dimensional question of which you have already  provided that answer by you description of  ‘ loss of forward growth, loss of cheekbones, less defined angle of jaw, less defined jaw, narrow midface and jaw.’  This speaks to augmentation of the cheeks/midface and jawline to some degree. The discussion then turns to whether it should be done by standard or custom implants and what surface areas need to be covered. Ironically I just did a young male patient yesterday with similar subtle augmentation needs where no augmented area was larger than 2 to 3mms in thickness. (see attached) I am not saying this is exactly what you need but it is just a concept of subtle larger surface area midface and jawline augmentation effects. What you are describing is more of a global effect a rather than an isolated ‘spot’ issue.

Dr. Barry Eppley

World-Renowned Plastic Surge

Q: Dr. Eppley, I found your page when searching for testicle enlargement. I’ve been on testosterone for about a year and have noted a significant decrease in the size of both of my testicles during that time.

I have heard of two possible procedures and would like to get information on both.

First is an implant that wraps around the testicle and is filled with silicone.

The second is testicle removal and replacement with an artificial testicle. I realize that this will eliminate my body’s production of T but my level was nearly at the bottom of the scale before I started T replacement therapy. Since I’m doing that already I don’t have any problems with this option.

At this point I’m leaning more toward the second option since the end result is similar and it just seems more reliable over the long term to me.

Just some background information. I’m 67 years old in good health. I have HBP and high cholesterol and take amlodipine, metoprolol tartrate, and simvastatin which control both well.

A:At age 67 there is no question that a solid testicle implant is what you would best suit your situation. The only question is whether testicle removal is really necessary with the placement of the implants. That would be driven by what size testicle implants you desire. In most acses of older men with testicla atrophy the testicles are left in place and larger implants are placed which naturally pushes the testicle out of visibility. (displacement effect) If there is not a big difference between the size of the implant and the testicles then testicle removal would be needed.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q:Dr. Eppley,as I recall, he mentioned that it’s possible to contour the body further through liposuction. In this context, I have a question: Is it possible to define the midline of the abdomen more prominently using liposuction? Or to make the abdomen appear more contoured overall through liposuction? Please find three reference images attached, including a recent photo of myself.

A:You are specifically referring to abdominal etching, a liposuction technique where lines are placed through linear fat removal. Since you mentioned the ‘midline of the abdomen’ this means midline vertical linear liposuction to make a vertical indentation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have been at a stable weight for years and I don’t smoke.  I lift weights 4 times a week. I had 5 children at 10 to 11 pounds each. I grew up not wearing sunscreen so age, pregnancy, weight loss, and sun damage caused me to have loose skin. I’ve been told I can’t have a BBL because there is not enough fat. 

Would you be able to help me? Not sure if I need a lower buttock lift only or if implants are necessary. I look okay in photos- which is why I sent them- but definitely not in a bikini or naked.  I was excited to find you online because you are exactly whom I was looking for- your skills fit what I’m wanting. 

I am willing to travel if you think I am a candidate for your expertise.  I look forward to hearing from you.

A:The key to understanding buttock reshaping procedures is what areas they affect. Per the diagram implants affect only the top ½ or 2/3s of the buttocks while lifts/tucks affect only the bottom third of the buttocks.

That being said when you look at your buttocks, while they are a bit flatter in projection,  there is significant ptosis or sag at their lower pole and I would view that as the bigger of the two issues. Thus lower buttock lifts are more indicated for you and you do that first and then see what you thinl about implant augmentation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have been experimenting with eye area aesthetics lately and have thought about what you said last time, that you do not need to have “true ptosis” to have ptosis correction surgery on the upper eyelids. I believe an optimal correction for my case would be to raise my upper eyelids to show 0.5-1 mm more of my iris. I would like to know the following:

1. Is the type of ptosis correction shown in the morphs below reasonable to expect for my case? This is slightly less than 1 mm.

2. What is the anatomic limit to how far the eyelids can be raised? If the Levator muscle is already tight, Can it still be tightened more?

3. Would I be a candidate for the Y-V lacrimal advancement you suggested to extend the lacrimal lake towards the nose?

A:In answer to your questions:

1) It is hard to appreciate in your morphs the upper eyelid change that a 1mm elevation would create. But suffice it to say that such modest upper eyelid lifting in a normal eyelid should be possible.

2) The anatomic limits of upper eyelid lifting in normal eyes is not known since it is rarely done. But modest amounts would certainly be within the anatomic limits.

3) Y-V inner eyelid lengthening can really be done in anyone.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I would you mind letting me know if it’s possible  To reduce height of the top of my head ? It’s high in height sort of cone shape and I want it reduced and more rounded. I have attached an edited photo to illustrate is this much seem doable? Left side is my current shape right is edit. 

A:Such an amount of head height reduction is possible provided the skull bone is thick enough to do so. It would take a preoperative 2D CT scan to make provide a definitive answer to that question.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am writing to inquire about a potential reconstructive surgery to reposition soft tissue and fat on my face, which has become displaced following cheek implant removal.

To provide some context, I previously had cheek implants, which involved creating pockets that required the dissection of the attachments to my soft tissue and fat from the bone. When the implants were removed six months later in 2016, the tissues were not sutured or reattached, leading to significant sliding, sagging and displacement of my facial soft tissue and fat. I went on to have a mid-face lift with another surgeon in 2019, who recommended remedying this. I loved the result (I no longer need or wish for implants). The procedure worked wonderfully to give me a side projection in my profile. It, however, did little to address the heavy nasio-labial folds or any of the soft tissue descent in the front of my face. I accepted these changes and moved on while secretly hoping one day I could put my soft tissue back where it slid from. I came across your blog and read about soft tissue resuspension, and I am very interested! I’m crossing my fingers that you can provide this. There is very little info or doctors who understand or offer this reconstructive need. I am grateful I came across your page and hopeful that you may be able to help me resolve this after so many years.

Thank you very much for your time, and I look forward to hearing from you

A:I think after having a midface lift you have maximized whatever amount of soft tissue reposiitioning that can be achieved. The change in the nasolabial folds is not really reversible  and, in theory, was also what a midface lift was designed to effect. (which it really can’t) There is no otehr procedure that can.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, For a little over a year now I’ve had what I believe to be enlarged temporal arteries on both sides. I’ve had no headaches, tenderness, or any vision problems.

They fluctuate in size, if the temperature is hot, if I’m being active, or anxious they become very noticeable. On the other hand if I’m at home in the AC they can become almost unnoticeable. So I’m reaching out to see if temporal artery ligation would be an option for me.

A:Your temporal artery presentation and history is classic. The only variation in temporal artery ligation in your case is the level or number of ligation points that may be needed because of your shaved head. How far they go up into the scalp is more apparent in your case.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, 13 years ago I got a chin implant made from mersilene mesh. I got an resorption (about 13 mm long). I do not have big symptons and it was an accidental discovery. I spoke with two maxillofacial surgeons but they do not have experience taking off mersilene implants and the plastic surgeon that put the implant in first place, I spoke with him and he does not know how to take that off. Is there any chance that the doctor will analyze my case?

A:Mersilene mesh chin implants can be removed, I have removed many, I would remove your mesh and fill in the bone defects with cadaveric bone chips for ‘reconstruction’.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, After my cheek implant removal I had a midface lift to help with the cheek sagging. While the mid-face lift did help reposition the deeper layers of my face, the more superficial soft tissue  and fat remains significantly lower than the deeper layers of muscle on my face. 

I’ve been using PDO thread lifts a couple of times a year to temporarily lift this tissue, and while I love the results and it perfectly addresses my concerns, it doesn’t last and isn’t cost effective long term. 

I’m wondering if an intraoral incision with the use of an Endotine or sutures could reposition and secure the soft tissue to the SMAS for a more lasting result. I believe it was this layer that was not addressed during my mid face lift and it was this layer that got disconnected when pockets for the implants were created in my face. 

A:The Temporal Endotine Midface Lifting technique is like any deep plane facelift approach…it elevates the deeper tissues as its effect are at the subperiosteal plane level. Your PDO threads have been effective because they are at a superficial tissue level which the Endotine device will not affect.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’ve been just super insecure about my lips for awhile  they’re just not wide and I feel like it just throws my face off. My questions are how much is pricing typically and is this a life long thing or will it go away after awhile. Thanks

A:You are undoubtably referring to mouth widening surgery. I would need to see a front view picture of your face to do imaging to see how much mouth width can be added. Mouth widening surgery creates permanent results but also some small permanent scars as a result. Thus the quetsion is not about the permanency of the increased mouth width but whether the permanent scars to do so are a good aesthetic tradeoff.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’m interested in a sliding genioplasty. My occlusion or bite is fine( as far as I know and have been told.My chin has never been operated on or i.e. a virgin chin that I think needs only minimal to moderate changes in order to harmonize and balance my face. 

Having said that;I think I have a mild to moderate short face syndrome as evidenced by these pics taken by max surgeon on Sep 2024. He claims I have no vertical deficiency at all based on his software but he agrees that I have about a 4 to 5 mm horizontal deficiency.

It’s confusing and frustrating because about 9 years ago another max surgeon did no cephalic study but just eyeballed me during the consultation and confidently proclaimed 4mm to 5mm horizontally but about 8mm to 10 mm on the vertical but he also said he would back the estimate it with a study.

What do you think? I’m just trying to be logical, prudent and practical here.

A:Like all aesthetic issues it is what the patient perceives,  not what numbers/measurements or a doctor says is so. From that perspective I like to dive into imaging and see how the patient responds to some changes. (see attached chin augmentation changes which includes vertical lengthening) One can debate about about how much vertical lengthening is desired and how to do it…but that is not initially relevant. The first step is to determine if any amount of vertical chin lengthening is desirable from your perspective.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello, I have a webbed neck and would like to learn more about the surgical procedure. I have not been diagnosed with Turner’s Syndrome, however I was also never tested. I am very self-conscious about it and would love to improve the look and functionality of my neck. 

A: First, webbed neck surgery is done to improve the appearance of the webs. It does not, however, improve the function of the neck. (e.g., range of motion)

Thank you for sending your pictures. Non-syndromic webbed necks, also known as mosiacs, usually have stiffer or non-flexible tissues. Thus, even though the smaller neck webs would seem to be the most improvable, they usually are the most resistant. That is my general experience based on your pictures alone. But the effectiveness of webbed neck surgery ultimately depends on how mobile the posterior neck tissues are which obviously can’t be assessed in pictures.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, My goal is to do this surgery. I hope you can help me to get red of rejection among people . Honestly I live hard live because of my skull shape. I wonder could you fix all this destruction on my skull. How much the possibility to have a good shape after surgery?

A: What you have is classic plagiocephaly with a left craniocoliosis rotation in which the left back side of the head is flatter and the left temporal and forehead is more protrusive/pushed forward. For the back of the head a custom skull implant it out is the standard approach. For the front of the head there are two options: 1) reduce the left forehead or 2) build up the right forehead. That choice is based on what the patient sees as the best aesthetic appearance.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi, I had maxillofacial surgery twice to increase size of chin. There is something that is missing on the jawline. I was thinking that an implant may help

A:I believe what you are saying is that you have had two bony genioplasties to increase your chin projection. In so doing what often happens is that a bony stepoff develops at the back end of the osteotomy cut from the advanced bone. Such a bony stepoff becomes more evident the larger the chin advancement becomes. You are correct in that the management of the bony stepoffs requires implant coverage. The only question is how best to make an implant for both to do so. A custom implant design is always the most accurate way to do it. But before any treatment option is considered a 3D CT scan of your chin should be done to have a complete visual understanding of the jawline defects.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q:Dr. Eppley, I would like wraparound testicle implant with the most size because it is my the trauma of the young man having small testicles.

A:Because of the numerous complications from the wrap around testicle concept (implant separation)  I only use large side by side implants today (6.0cm or greater) which have none of those issues. They work by displacing the appearance of the smaller testicles up and back up out of the way.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I had my brow bone shaved down four years ago and feel like it is not proportionate and throws off my eyebrow shape and doesn’t let them fully settle on the bone for a relaxed look. This is the before and after – while I am happy with my side profile I want to explore possible options to improve my front profile.

A: After such a brow bone reduction the question would be what can be done secondarily that only affects the front view and not the side view? As you have learned from this past procedure every facial bone reshaping procedure has multi dimensional effects that may have variaboe aesthetic benefits when seen from different facial angles. In other words if you restore some medial brow shape it will change the side profile.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I wanted to follow up if there are any planning images to be shared so far ? As you know I recently had my stage 1 scalp expander put in and I’m eager for the design process to unfold. Furthermore, when I spoke with Dr. Eppley in person, he mentioned the goal of us is about 5/8″ of protrusion, it seems really minor from a dimensional perspective. For previous patients such as the attached, it seemed more of a drastic change like closer to ~1″? Am I correct to make these assumptions?

A:These are partially incorrect assumptions. Skull augmentation is mainly about volume displacement rather than one specific linear measured point. Think of your head as a balloon and not a ruler. It is a large curved surfaces area rather than one flat surface. Thus skull implant designing is guided by implant volume which does come from its shape and various thicknesses. But in the end the volume that the scalp can contain (in your case the tissue expander) will determine the maxmum projection of the implant. To provide some insight in thar regard a one inch or 25mm thick implant would probable be an implant volume of 300 to 325ccs. 5/8s of an inch or 14-15mms would be in the range of 250ccs.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello I am interested in an operation before fall. I just don’t know which one because of my limited knowledge. I would like my side profile to be less “flat” and maybe my nose to be sharper as I think it is flat aswell. My cheekbone and under eye support is also very minimal. Please let me know which procedure I would benefit from so I can do my research before a full consultation.

A:With a flatter midface the discussion is whether infraorbital-malar augmentation would be sufficient or whether it should include the entire midface. (see attached image) Either approach requires a custom implant design to do so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have several issues. First, I want to define my jaw line .Throughout implant perhaps customized. Second issue is that I had chin implant before and I removed it afterwards. I noticed that the position of my chin changed and as if it was being pulled down. The previous doctor created a kind of pocket to fix the implant, but when I took it out, it pulled my chin down. There was a kind of fall. Can this be fixed?

A:The only way to have a more defined jawline is with a custom implant approach. While you do have thicker tissues, which does make getting more jawline definition harder, your lower face is also vertically short… where jawline lengthening works to help stretch out the tissues.

When chin implants are removed there will be loss of chin pad support, so ptosis is to be expected. A custom jawline implant will fill out that along with improving jawline shape/definition.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am planning to have a sliding genioplasty surgery in order to increase my chin projection 1 cm horizontally. I know that average mandible symphisis thickness is around 1 cm.I have seen some photos from surgeries on internet operated with plates more than 10 mm which puts the lingual cortex of the lower downfractured chin segment in front of the upper fixed chin segments buccal cortex with less than 1-2 mm of horizontal space separating the upper and lower bone segments.İs that kind of advancement stable without the plate ?Can you explain how this two segments fuse? Will only the lingual cortex of the lower segment and buccal cortex of the upper segment fuse and leave the marrow parts exposed? I am very confused.Thank you for answering.

A:Your confusion is understandable as you are only considering the cental part of the chin where the lower segment can be advanced in front of the upper segment. But you are not considering the sides or wings of the advanced lower chin segment which always maintains contact with the upper bony edges. This is what makes the chin segment stable with only central plate and screw fixation. The center part may go on to heal albeit often with incomplete bony consolidation. (harmless but may contribute to deepening of the labiomental fold) Hence the benefits of allogeneic bone grafting of the bony stepoff.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi. I have a very undeveloped mandible and recessed jawline. I had a chin implant surgery more than a year ago and I had no problem with it, but I still don’t get enough projection with it as I desire, especially from the profile. I want my chin to be more forward, but I also want more projection below my chin as well, to look thicker. So this time I would like to do the sliding genioplasty together with customized angular jaw implants. My questions are these:

1) Can a sliding genioplasty be done with the chin implant already in place without taking it out?

2) How much would all these cost?

3) There is currently a gap between my lower lip and chin. The skin there is pulled backward because I never really had a chin. So will that space be pulled forward after the surgery to fill that gap?

I will share the pictures of me before the implant, the current one and the expected one

A: You have correctly surmised that only a sliding genioplasty can provide any further significant horizontal or vertical lengthening.  The movement you have shown is more of a 30 to 45 degree movement (down and forward) which is good to lessen the impact of further chin augmentation on the deepening of the labiomental fold. What you have demonstrated in your chin augmentation goal imaging is exactly what will happen to the fold. (it will get deeper and this is unavoidable) Usually this is grafted with an allogeneic bone block to soften that adverse labiomental fold effect.

It would be ideal to keep the current chin implant in place and do the osteotomy cut above it so it carried forward with the bone movement, keeping the benefits of the prior surgery as well as not making the bone do all the chin augmentation effect. Whether that is possible depends on where the implant is sitting on the bone. Presuming you have a silicone implant in place this will be determined by a 3D CT scan of your face which is needed anyway for the custom jawline implant.

While the sliding genioplasty can make the movement you have desired you said something which is can not do…make the chin thicker. (wider) Thus what you are really looking at doing (need) is to have the jawline implant wrap around the chin to add width. This is needed anyway to cover the bony steps from the sliding genioplasty and well as create a smooth linear jawline effect.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi I am seriously considering going to your practice to have mandible implants but am undecided whether to go with conform mandible implants or lateral mandible implants. Can you briefly tell me the differences please. 

My goal is to have jawline accentuation and mainly widening. I have a very narrow face. But I don’t want something too conspicuous or off balance.

A:Pay no attention to the conform concept, thar relates to the internal surface of the implant which has no bearing on its external aesthetic effect.

Jaw angles come down to two different types, widening and vertical lengthening. By your own description the widening style seems appropriate for you. Like most patients your fear of having an implant too big is what being too conspicuous means, thus you want to stay under 10mms prjection for sure.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Quick question: on one response from the dr to the question around whether or not silicone testicular implants can be seen on a tsa screen says no , but the same question on another area of this same site says that silicone breast implants and testicular implants can be seen. Which is the correct answer?

A:All medical implants, metallic or not, can be seen on a TSA body scanner. Thus breast and testicle implants can be seen.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello, I live in Scotland and I want to have surgery because I am not happy with the shape of my skull. But I have a question, is the back of my skull high or the front low, what do you think is the problem exactly?

A:The interpretation of a head shape is very individualized so either approach (sagittal reduction or forehead augmentation) is an option. Looking at either potential change should help you determine of either skull reshaping approach is an improvement. (see attached imaging) There is no question in just looking at the magnitude of the ‘deformity’ the backward forehead slope/brow bone protrusion is the more significant of the two.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I found your page when searching for testicle enlargement. I’ve been on testosterone for about a year and have noted a significant decrease in the size of both of my testicles during that time.

I have heard of two possible procedures and would like to get information on both.

First is an implant that wraps around the testicle and is filled with silicone.

The second is testicle removal and replacement with an artificial testicle. I realize that this will eliminate my body’s production of T but my level was nearly at the bottom of the scale before I started T replacement therapy. Since I’m doing that already I don’t have any problems with this option.

At this point I’m leaning more toward the second option since the end result is similar and it just seems more reliable over the long term to me.

Just some background information. I’m 67 years old in good health. I have HBP and high cholesterol and take amlodipine, metoprolol tartrate, and simvastatin which control both well.

A:At age 67 there is no question that a solid testicle implant is what you would best suit your situation. The only question is whether testicle removal is really necessary with the placement of the implants. That would be driven by what size testicle implants you desire. In most acses of older men with testicla atrophy the testicles are left in place and larger implants are placed which naturally pushes the testicle out of visibility. (displacement effect) If there is not a big difference between the size of the implant and the testicles then testicle removal would be needed.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q:Dr. Eppley, Is itpossible to contour the body further through liposuction.

In this context, I have a question: Is it possible to define the midline of the abdomen more prominently using liposuction? Or to make the abdomen appear more contoured overall through liposuction?

Please find three reference images attached, including a recent photo of myself.

A:You are specifically referring to abdominal etching, a liposuction technique where lines are placed through linear fat removal. Since you mentioned the ‘midline of the abdomen’ this means midline vertical linear liposuction to make a vertical indentation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have been at a stable weight for years and I don’t smoke.  I lift weights 4 times a week. I had 5 children at 10 to 11 pounds each. I grew up not wearing sunscreen so age, pregnancy, weight loss, and sun damage caused me to have loose skin. I’ve been told I can’t have a BBL because there is not enough fat. 

Would you be able to help me? Not sure if I need a lower buttock lift only or if implants are necessary. I look okay in photos- which is why I sent them- but definitely not in a bikini or naked.  I was excited to find you online because you are exactly whom I was looking for- your skills fit what I’m wanting. 

I look forward to hearing from you.

A:The key to understanding buttock reshaping procedures is what areas they affect. Per the diagram implants affect only the top ½ or 2/3s of the buttocks while lifts/tucks affect only the bottom third of the buttocks.

That being said when you look at your buttocks, while they are a bit flatter in projection,  there is significant ptosis or sag at their lower pole and I would view that as the bigger of the two issues. Thus lower buttock lifts are more indicated for you and you do that first and then see what you thinl about implant augmentation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Will my surgery leave a scar?

A: The question is not whether surgery will leave a scar, as every incision does, by how significant will that scar be.

There are a wide number of factors that influence the appearance of an incisional scar from how the incision was made, what was done through that incision, the technique of wound closure and the skill of the surgeon doing it, skin type and pigment and where on the body was the incision located.

Scars shold never be considered invisible, just at well levek of inconspicuous will it be.

Dr. Barry Eppley

World-Renowned Plastic Surgeon