Explore Plastic Surgery

As plastic surgery has worked its way into the mainstream of American society, it is no surprise that procedures are being done today that were not imaginable a mere ten years ago. And I am not referring here to surgery wonders of technology and scientific advancement (although that exists also), I am talking about what patients desire to have done. This is a reflection and commentary on contemporary American culture, not necessarily how far the science of plastic surgery has come.
As I talk with friends and colleagues about some of the plastic surgery procedures that I do today, I have come to realize that some of them may be considered ‘unusual’ . Certainly, some of them are different than traditional perceptions of plastic surgery. Many are relatively minor procedures that can be performed in the office and probably reflect the trend toward treating smaller concerns. They are the opposite of bariatric plastic surgery, for example, where a new subspecialty of plastic surgery has developed to treat the sequelae of gastric bypass and massive weight loss patients. The emergence of larger plastic surgeries and big procedures doesn’t occur very often but every few decades. But the emergence of more minor plastic surgery procedures occurs much more frequently. Here is a list of my unusual plastic surgery procedures that have emerged and become popular in the past decade.
Buttock Implants/Fat Injections - The appeal of a larger, more rounded buttocks is certainly a body image of recent note. Whether done by transferring fat from one body part to another or by an implant placed through an incision near the tailbone, the desire for buttock enhancement could not have been envisioned ten or twenty years ago. There is actually a great number of patients who would like buttock reduction but no single good procedure exists for that problem.
Labial Reduction - Whether due to discomfort from rubbing on clothes or during inetrcourse or simply to ‘look better’, reducing the size of a woman’s labia is now a common procedure. One would never have thought that such a concealed part of the anatomy would create a demand for treatment. A very simple and effective procedure, labial reduction restores the outer appearance of the vagina to a more youthful appearance.
Earlobe Reduction/Enhancement - As woman age and with the lifelong use of ear rings, the ear lobes will frequently get longer. The size of the ar lobe can easily8 be reduced in the office and it is a procedure that I often do at the same time of a facelift. Aging may also make one’s earlobes get quite thin and almost shriveled in appearance in very thin females. Injectable fillers, such as Juvaderm or Radiesse, can give an immediate rejuvenation effect to the earlobes that may last as long as a year.
Eyebrow/Eyelash Transplants - The science of hair transplantation has evolved to the point that single hair (follicle) transplants are now routinuely done in scalp hair restoration. It is quite logical that single follicular transplantation be applied to very small areas such as the eyebrow and even the eye lashes. The alternatives of permanent makeup, colored pencils, and false eyelashes made opting for actual hair tranplants a difficult decision. But some few patients do.
Umbilioplasty - While every full tummy tuck patient gets a new bellybutton (umbilicus), some non-tummy tuck patients want one also. Most commonly, it is to change an outie to an inne belly button.
Nipple Reduction/Nipple Enlargement - I have seen it both ways. The concern of large nipples is that they can be very visible through clothes…and at all times. Reducing the size of the nipple is a simple procedure and some women may lose a little sensation. Most recently, I have started to some men that want their nipples reduced also! Conversely, nipple enlargement or enhancement is about changing an inverted nippled (which is turned inward) to one that has some outward projection. While not quite as predictable (long-term result) as nipple reduction, the nipple can be released and brought more outward.
Corner of Mouth Lift - The downturning of the corners of one’s mouth with age gives a sad or angry appearance. A simple procedure in which a small amount of skin is removed and the corners lifted up and the mouth line leveled gives a nice and subtle improvement. Such a procedure is a simple office operation or is often done as part of a facelift. This is actually an old procedure that has now been ‘reinvented’ or rediscovered.

One wonders what this list will be in another ten years!

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Many female patients today seek rejuvenation procedures whici involve making the mouth area look better or less aged. As women age, some will lose lip volume, develope upper and lower lip wrinkles, and have the corners of the mouth draw down. This often creates a sad, mad, or unhappy appearance to the lip area. Most commonly, lip injections with hyaluronic fillers such as Juvaderm, Restylane, or Perlane are done to enhance the size of the lips, help fill out some of the fine wrinkles which are around the pink part of the lips, and raise up the mouth corners to some degree. While these forms of injectable treatments are effective and non-invasive, they are not permanent.
The corner of the mouth lift is a surgical option that has lasting effects. It is an old procedure that has been around for many decades. The corner of the mouth lift should be more popular than it is given that it is a minor procedure that can be performed alone in the office or as part of many other facial rejuvenation procedures. By taking a small triangle of skin from just above the drooping mouth corner, the downhanging mouth corner can be turned up quickly and easily. It is a very powerful procedure for such a small removal of skin and one must be careful not to overdo it by raising the corner of the mouth too far up and having too long of a scar. It does create a very small scar at the corner of the mouth but it is nearly indetectable if done right.
The key to a good corner of the mouth lift result is making the mouth corner level, and not more, and keeping the scar small that does not wander far from the corner of the mouth. Many facelift patients mistakenly think that the facelift will pull up the corner which is a misunderstanding. That is why some facelift patients with ‘frowns’ needs a concurrent corner of the mouth lift procedure.
I have found this procedure to be well accepted and most patients are surprised when I mention it as they have never heard of it. As an in-office procedure, it works well with lip injections and lip lifts and advancements. The frown that runs down into the ‘marionette lines’ will usually need filling of the deeper marionette line with injectable synthetic fillers, fat grafts, or a soft gore-tex implant, depending upon whether the procedure is done in the office or the oeprating room. For those patients with chronic irritation due to salivary overflow (a condition known as angular cheilitis), a corner of the mouth may even be curative as it rearranges the angulation of the ’spout’ and creating a more competent lip dam effect.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Mouth Lifts – Turn Up That Smile Line!

While lip concerns can range from lips that are too thin to those with too many wrinkles, the ‘frowning smile’ is a different issue. In this lip problem, it is the corners of the mouth that are downturned, creating a sad or unhappy expression when one is not smiling. Some patients have this naturally, others develop it from aging to the weight of the falling cheek tissues onto the corner of the mouth. Eiher way, it is not an infrequent concern that I hear expressed from many patients.

The good news is….there are two simple methods for improvement of this problem…and both can be done in the office. The easiest treatment is to simply place any of the injectable fillers into the mouth corners, (e.g., Restylane, Juvaderm, or Radiesse) , making less deep the natural crease that exists there as well as creating a subtle lifting effect. While easy and instantaneous, the result is not permanent and will last only as long as the filler persists. (months) I prefer in some cases a corner of the mouth lift, it can be more effective than fillers and is more permanent. In this office procedure under local anesthesia, a very small triangle of skin is removed from just above the corner of the mouth and the corner lifted into a new position. While it does create a very small scar, I have not found it to be a problem in any of my patients. The key is a subtle lift and not to overdo it. The creation of a permanent smile or the ‘Joker’ look is not natural. I have found this procedure, combined with the use of injectable fillers in other areas of the lip, provides a nice more youthful look to the mouth area.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical center, Avon, Indiana
Indianapolis