Archive for the 'dr barry eppley' Category
I often get asked by patients if I think they are ready to have plastic surgery. My initial reponse is always the same….if you think you want or need it…then you are ready. Something as elective and personal as plastic surgery can’t really be decided by the doctor, I simply decide what the best treatment options are for you and help educate you to a decision on how to deal with your concern.
While that is an initial response, a more in-depth answer would include the following three very relevant issues. 1) Do your homework on treatment options for your concern first. While the internet is full of inaccurate and misleading information, there is also a wealth of accurate information on any plastic surgery topic. Review it and bring in your questions. 2) Make sure you can afford it. That is something that I as a plastic surgeon can not help you with. Only you know your finances and whether your plastic surgery desires fit into your budget and were it sits on the priority scale of your life. 3) Be prepared for the risk of potential complications. Not all plastic surgery procedures turn out perfect. While most ‘complications’ are minor, they can and do occur with some frequency. Allot time in your schedule for this possibility…and have have the psychological mindset that it can happen and its occurrence will not be devastating for you.
If you have thought through these significant issues with your plastic surgery procedure, then you are indeed ready in my opinion.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Eyelid surgery, known as blepharoplasty, is one of the most common aging facial surgeries. This is not only because every person has four eyelids (4 surgeries per patient) but because it is often the first plastic surgery procedure (not an office-based procedure such as Botox) one may go through to deal with the effects of aging. Because the eyes are seen by everyone (every human conversation is based on heavy eye contact), we are all too aware of when we appear tired even if we aren’t. The eyes may be the window to the soul but they are also the shades to the eyeball whbich do weather with age.
Aging of the eyelids is a result of three things; 1) The constant muscle movement around the eye causes the skin to wrinkle and create folds (lower eyelid) and hooding (upper eyelid), 2) eyelid skin starts to sag due to gravity, and 3) fat starts to protrude out from under the eye (lower eyelid bags) much like a hernia. All three aging conditions cause the eyelids to look heavy, saggy and swollen creating a very tired appearance. The eyelids can be made to look worse if one’s brow also starts to sag, making the skin on the upper eyelid look even worse.
Surgical correction of these aging eyelid problems is to remove the ‘extra’ skin’, remove or push back the herniated fat (lower eyelid), and sometimes even tighten the corners of the eye. On the upper eyelid, a large amount of skin can be removed leaving a very fine scar along the natural upper eyelid crease. Sometimes fat is removed in the upper eyelid but it is not as big of a problem as it is in the lower eyelid. A surprising large amount of skin can be removed in the upper eyelid without causing any problems with eyelid closure. In the lower eyelid, however, the reverse is true. Managing the herniated fat is a very important part of lower eyelid surgery. Whether the fat that protrudes is removed or, in a newer technique, tucked back up under the eye like a hernia repair, getting rid of excess lower eyelid fat is key to a good result for most patients. Removal of skin in the lower eyelid, however, must be done very carefully and much less can be removed than one would think. If just a little too much is removed, the risk of the lower eyelid pulling down after surgery is a real possibility. For this reason, particularly in the older patient, the lower eyelid which is often loose anyway is tightened like a clothesline at the side of the eyelid where it attaches to the bone.
When all four eyelids are done at the same time (which is most common), the overall effect can be quite dramatic. And since everyone looks at our eyes in conversation, the more youthful and refreshed appearance is appreciated by all even though most do not know it is from plastic surgery.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
I was contacted earlier this week by one of our local magazines in regards to being the plastic surgeon in next year’s extreme makeover contest. In this annual contest (now in its 5th year), potential patients apply to the magazine (75 entries are taken), are screened down to 10 potential candidates, and then the final ten are examined by the sponsoring plastic surgeon. Once selected, the winner gets a full plastic surgery makeover (for free) as determined by the patient’s desires and the recommendations of the plastic surgeon. Such an annual contest was undoubtably inspired by the TV show, Extreme Makeover.
In essence, patients are competing for a prize of free plastic surgery. Their ‘price’ is one of media exposure, the plastic surgeon’s ‘price’ is the cost of the giveaway plastic surgery and he/she has to agree to purchase 6 full-page ads in the magazine over the next year.
When asked if I would be this year’s sponsoring plastic surgeon, I respectfully declined. Participating in such a contest is in direct violation of the ethical standards established by the American Society of Plastic Surgeons. Giving away free surgery in any contest, charity raffle, or promotion violates the high ethical guidelines established by the premier plastic surgery organization in the world. By doing so, one is shamelessly using patients for individual self-promotion. Many people would have plastic surgery if it were free. While such a concept is entertaining on television, it is not a reputable method on which to build a plastic surgeon’s experience or promote their practice.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
I was contacted by a patient’s husband today by e-mail and asked, even though his wife was sick, if she could still have a breast augmentation. His wife suffered from a serious brain disease but had always wanted larger breasts for much of her adult life. Is doing the requested procedure responsible plastic surgery? Is it a humanitarian act….or the fulfillment of a frivolous selfish desire that may jeopardize her medically
?
In theory, as long as both patients and husband consent to the procedure and are appraised of the risks involved, this would not be reckless plastic surgery. But what if she developed a complication during the procedure or as a result thereof and died? Would this have been a responsible thing to do? Is this risk, or any risk in an already ill patient, worth it for a non-medically necessary cosmetic procedure?
I don’t have a clear cut answer. I can make an argument on either side of the issue. I would be intrigued to hear from others. But there is a simple answer and is an old surgical axiom…if you have to think about whether doing the surgery is the right thing, then you shouldn’t.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medcal Center, Avon, Indiana
Indianapolis
I saw a book on the internet today entitled ‘My Beautiful Mommy’, co-authored by a female patient and a plastic surgeon from Florida. It is beautifully done and a very clever idea. Besides being cute, it is also reflective of our culture and the tremendous popularity of plastic surgery. Had someone told anyone ten years ago that a children’s book would be written so that they could ‘understand’ what plastic surgery their mommy was going to go through, they would have been told they were crazy. Not only would someone not write it but there is no market for it. Such prognostications are about as accurate as someone in 1985 saying who would spent a dollar for a bottle of water, $4.00 for coffee, or be able to call you in the middle of the night from Mt. Ararat…..complete with a live picture. Who knows what may be next…..monogrammed dressings with your plastic surgeon’s scrolled initials?
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Indianapolis
Only three years ago, the number of patients who used financing for elective cosmetic plastic surgery procedures in my practice was around 10% or less. As we proceed forward into 2008, that number has jumped to over 30% and appears to be going even higher. There are many reasons for this trend from a general reflection of our society, the economic times, the emphasis on plastic surgery marketing, and the aging of our society, to name a few.
On the positive note, however, it indicates how many people want the benefits that plastic surgery offers…..which is basically the opportunity to feel better about one’s self. It also indicates that people can ‘afford’ what they want, not necessarily want they need. Is this a good trend? Most would say not but I would disagree. Plastic surgery, from a cosmetic standpoint, is a reflection of some of our societies deeper values. Valuing one’s appearance in an effort to improve social or work status has been around since the beginning of time. It has risen to its current level due to economic progress and information dissemination through the internet, both of which are unparalleled advancements that have heretofore not existed. It is no worse a reflection on society than any other advancement that we have seen in the past 20 years.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
As I was sitting here early this morning at 5:30AM preparing for a day of plastic surgery sorting out implants and patient records, there was a peculiar slience and then a noise which caught my attention. It made me sit right up and listen…and then a subtle vibration began. And then the whole building shook for about what seemed six to eight seconds….followed by what must have a small aftershock which slowly faded away over the next 20 seconds or so. A rare earthquale indeed here in Indianapolis.
The aslt earthquake appreciably felt here in Indianapolis was back in 1987 if I remember correctly. It may have been about the same magnitude. (5.0 or so on the Recihter scale) Infrequent as they are, erthquakes do occur here in Indiana….go down to the Indiana State Museum and check out the eathquakes that have occurred from 1955 - 2000 here in the Midwest on one of their computer displays. The epicenter of this one was over in southern Illinois but epicenters have certainly occurred in Indiana as well.
What do earthquakes and plastic surgery have in common? They are similar in at least one aspect…infrequent events do occur in plastic surgey as well. I am speaking specifically to untoward outcomes and complications from surgery. Just like you think an earthquale couldn’t happen here, most patients never feel that any complications for surgery can happen to them. Fortunately, major complications from plastic surgery are about as uncommon as earthquakes here in Indiana.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
One of the many things that you are never too old for is……..caring about a long-standing cosmetic concern. Several months ago, I did a facelift on a lady who was 82 years old. She was in perfect health and was bothered by her ‘neck waddle’. While obviously everyone her age probably had a lot of loose skin in the neck, her neck bothered here nonetheless. And while her family supported her decision for surgery, although they felt she didn’t need it, she had a facelift anyway.
This age concept as it applies to cosmetic surgery was seen again in a patient that I just saw yesterday. She was 73 years old and wanted her ears pinned back. (otoplasty) Why now you would ask? After living for 7 decades, why care now? The answer was not surprising to me…as I had heard it said many different ways. ‘Because it bothers me and I can!!’ She has been heavily teased as a child about her ears and that had remained with her all of her life. She had just buried her third husband and now she was free to do it. All her husbands had discouraged her or forbid her from doing it.
All this proves is…if something deeply bothers you, age will not make it go away. As long as one is healthy and the plastic surgery poses no significant risk to one’s health, then go ahead solve that long-standing cosmetic concern. It is never too late to feel better about yourself!
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
One of the most peculiar and now not uncommon request, thanks to the internet and patient referral sites, is the prospective patient who contacts you from afar. Due to the internet and e-mails, patients can easily contact just about any doctor with their requests. Sometimes these are patients who have never had plastic surgery, but more commonly, they have had procedures that they wish revised.
When I was younger, I would naively take this contact in a flattering manner as a compliment to my presumed skills and ‘expertise’. Now that I am older, and after a few poor experiences with such patients, I have come to realize that these far away patients are fraught with potential problems. First and foremost, why me? They are undoubtably hundreds of plastic surgeons between me and their geographic location. Seeing me is certainly inconvenient in terms of travel. And what I would have to offer is certainly not superior to the vast majority of plastic surgeons that are much closer. Secondly, if you operate on such a patient and they have postoperative issues and complications, such a geographic distance poses obvious logistical problems. An inability to easily manage a postoperative concern is fertile ground for an unhappy patient, even if they are well aware of this concern going into the surgery. Lastly, you have little control of a patient from states away. Just like how they contacted you, they are free to express any of their dissatisfaction on the internet. This is a phenomenon that is unique to far away patients, local patients do not usually engage in this cowardly form of self-expression.
In short, the far way patient has many red flags. I have painfully learned to heed these warning signs. The patient who seeks an ‘expert’ from far away may well have a good reason to do so but that does not always make them a good candidate for the ’sought after’ plastic surgeon.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Cosmetic Plastic Surgery offers a large array of procedures, many now non-surgical, to treat the entire gamut of aging and aesthetically imbalanced concerns.On the surface, it appears that we are providing physical change to make one more attractive or, at the least, less aged in appearance. But is that what we are really providing…or to ask it from a retail perspective…what is our product? What do we really sell in plastic surgery?
I have often observed that the outcome of a plastic surgery procedure (aka the result), is not always an accurate indicator of how a patient feels about it. Sometimes with very modest improvements, you see patients who are very happy. Sometimes, albeit much more rarely, you see very good results in which patients are not happy. These experiences have taught me that our product is much more than physical. Our product is about hope…and status. Each plastic surgery procedure is about hoping to look and feel better. And having the status to be able to do (afford) it. Satisfying these two basic human needs is what we really ’sell’. Just like Starbucks….are they really selling drinks that are ‘worth’ $3 and $4?….I think not, they are selling the experience and status to do so…..and the few minutes of comfort that it brings.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis