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Archive for the ‘forehead recontouring’ Category

Case Study – Forehead Ridge Reduction

Wednesday, May 10th, 2017

Background: There are a wide variety of shape deformations that can occur in the forehead. Most of these are caused or influenced by some congenital or developmental influence on the frontal bone forms. Bump, lumps, prominences, flatness and asymmetries are how they present which are readily apparent give the very visible and broad surface of the forehead.

One unique type of aesthetic forehead deformity is that of the midline ridge. Always seen at the upper part of the forehead, it is a raised ridge that comes down below the front edge of the hairline. It ends down the middle of the forehead and usually stops about the middle between the hairline and the glabellar region. it always has a ridge extension that goes back behind the hairline to some degree.

This midline forehead ridge is known as microform metopic craniosynostosis or a metopic ridge. It is a very minor expression of a limited premature closure of the metopic or frontal suture. The frontal suture is the fibrous joint that exists in utero and shortly after birth between the two halfs of the frontal bone. It nornally closes by 9 to 12 months after birth if not sooner. But if the suture is not present at birth the frontal bone halfs unite prematurely and a keel-shaped deformity known as trigonocephaly occurs. In minor metopic ridges just a very small portion of the suture closes too soon creating a much more minor expression of a frontal keel.

Case Study: This 35 year male presented with a visible ridge extending down from his hairline in the center of his forehead. It had bothered him his whole life.

Under general anesthesia an irregular frontal hairline incision was made of 3.5 cms. The bone was exposed and burred down to the level of the surrounding bone down into the forehead as well as back behind the the hairline to reduce the prominent ridge or small keel.

Because the metopic ridge is always thicker than the surrounding frontal bone, which is part of its natural pathology, it can be safely eliminated to create a smoother upper forehead contour. A frontal hairline incision provides direct access so ‘line of sight’ bone reduction can be most effectively done.

Highlights:

  1. The metopic ridge is an aesthetic forehead deformity that is the result of a minor frontal suture abnormality.
  2. Open burring reduction of the metopic ridge is the most effective reduction method.
  3. Surgical access is best done through a hairline incision.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Forehead Asymmetry Surgery

Friday, March 24th, 2017

 

Background: The forehead occupies a full third of the human face and sometimes than that based on the location of the frontal hairline. While the forehead does not draw one’s attention, like the lower two-thirds of the face due to the sphincteric motion of the eyes and mouth, its broad surface can not be overlooked.

Forehead asymmetries are not that uncommon and can result from a variety of causes. One of the most common is that from plagiocephaly where the twisting of the entire skull creates well known front and back of the head asymmetries.  It is also seen in varying degrees of isolated frontal facial asymmetries with the smaller facial side having less forehead projection and a lower brow bone position.

Another less common cause of forehead asymmetry is iatrogenic from prior surgery. In performing brow bone reduction or more superior frontal bone reshaping, slight bony shaoe differences may exist or be created between the two sides. While not apparent during the actual operation, these slight differences may become revealed after surgery as the tissues contract down around the expanse of the broad forehead.

Forehead AsymmetryCase Study: This young middle-aged male had a prior history of brow bone and forehead reduction surgery. While it took months after surgery to see the final shape of his forehead, it eventually showed a forehead/brow bone asymmetry that was confirmed by a 3D CT scan. The left brow bone, in particular, and the upper forehead were flatter than that of the right side.

Intraoperative Custom Forehead Implant 2 Dr Barry Eppley IndianapolisIntraoperative Custom Forehead Implant for Asymmetry Dr Barry Eppley IndianapolisBecause he already had a full coronal scalp incision, a full open approach was done for wide open access to the forehead. Using PMMA bone cement a thinly design implant was fashioned to visually match that of the right side. The edges were burred down to be very thin at their perimeters. It was secured into place with two small microscrews.

Left Foreheasd Augmentation Dr Barry Eppley IndianapolisHis after surgery results show improvement in his forehead shape between the two sides. Careful inspection shows just a hint of the outline of the bone cement application which is surprising given its paper thin edges and the thickness of his scalp tissues. Whether he may eventually undergo a revision for this aesthetic tradeoff remains to be determined.

Highlights:

  1. Forehead asymmetry can be created by brow bone and forehead reduction surgery.
  2. One method of bone augmentation for forehead asymmetry surgery is that of the use of bone cements which requires a wide surgical access for application.
  3. Any method of forehead augmentation requires the smoothest transition between the material and the natural tissues to avoid any visible lines of transition.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Forehead Reconstruction with Hydroxyapatite Cement

Sunday, February 5th, 2017

 

Background: Many well known congenital skull deformities (craniosynostoses) are treated by early surgery, usually under one year of age. While this allows the developing brain more space to grow and have it help shape the overlying skull, the final shape of the skull is rarely ideally normal. Scar, growth potential and genetics all play a role in preventing a consistent and reliably formed convex skull shape.

Such secondary skull deformities are most manifest in the forehead. Between its visible large contribution to the face and the frequent bone irregularities and temporal hollowing that develops from prior surgeries, the forehead can lack a smooth and pleasing shape. Forehead recession and narrowing along with temporal depressions makes for a commonly seen disproportionate forehead contour. Many of these patients will also have small metal plates and screws across the forehead and brow bones as well as some full-thickness bone defects.

Case Study: This 22 year-old female was originally born with a bilateral coronal craniosynostosis. She has previously undergone both early and several subsequent fronto-orbital reconstructive procedures. Her forehead had a recessed and inverted shape and the temporal areas at the side of the forehead had marked hollowing. There were also several areas of tenderness over the forehead underneath which were palpable metal hardware.

Hydroxyapatite Cement Forehead Augmentation Dr. Barry Eppley IndianapolisUnder general anesthesia and using the full extent of her existing coronal scalp incision, the forehead and temples were fully exposed. Over a dozen plates and thirty small screws were removed. Numerous full thickness bone defects were encountered with intact dura. Using over 150 grams of hydroxyapatite cement,  the forehead, brows and temporal region were built up to more normal contour. All full thickness skull defects were also covered at the same time.

NN Forehead Augmentation with Hydroxyapatite Cement result oblique view Dr Barry Eppley IndianapolisNN Forehead Augmentation withj Hydroxyapatite Cement result front view Dr Barry Eppley IndianapolisHer forehead and temporal areas showed much improved contours once all the swelling had resolved. This fronto-temporal augmentation improved what looked like a constriction band around the forehead just above the brow bones.

The use of hydroxyapatite cement is largely restricted to such procedures as forehead reconstruction due to its high cost. ($100/gram) Its working properties also make it most easily and consistently used with wide open exposure of the bone site. These two reasons keep hydroxyapatite cement from more frequent use in aesthetic skull reshaping surgery.

Highlights:

1) Forehead reconstruction of large contour defects from congenital skull deformities is best treated by hydroxyapatite cement.

2) Hydroxyapatite cement offers a smooth and highly biocompatible contouring material for long-term persistence.

3) The high cost of hydroxyapatite cements makes their use more common in reconstructive forehead reconstruction and not aesthetic forehead augmentations.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Forehead Osteoma Removal

Saturday, December 3rd, 2016

 

Background: Osteomas are the most common bony tumor of the craniofacial skeleton. They are benign bone growth that is typically seen growing on another piece of bone. They appear as an outcropping or ‘mushroom’ of slowly growing bone and are easily disinguishable by appearing as a hard bump on an otherwise smooth bone surface. This makes them very identifiable on the skull where such bumps appear evident even when they are small.

Their are various causes of osteomas but the most common one is a history of prior trauma. Low impact blunt trauma to the skull is common since the head is a large object that frequently is inadvertently hit. If the head is struck in just the right location with enough force a perforating blood vessel may bleed and create an external bruise.When blood gets under the periosteum it can serve as a trigger for bone growth.

large-forehead-osteomaCase Study: This 56 year-old female had a large bump of the left brow bone that began over 17 years when she was accidentally struck by an attic door on her forehead. She developed a large bruise from which a small bump eventually grow to the big bump now seen. It has finally gotten big enough that she could no longer hide it. A CT scan showed that it was an outcropping of bone emanating from the outer cortex of the brow bone.

dl-forehead-osteoma-removal-specimen-dr-barry-eppley-indianapolisdl-forehead-osteoma-removal-intraop-top-vew-dr-barry-eppley-indianapolisUnder general anesthesia the brow bone osteoma was approach through a hairline (pretrichial) incision directly above it. Through a subperiosteal tunnel of the forehead skin the osteoma was exposed and dissected off of the overlying scalp tissues and the supraorbital nerve. An osteotome was used to separate it from the normal surrounding bone. The osteoma was composed of poorly calcified bone that was softer than normal skull bone.

dl-forehead-osteoma-removal-intraop-side-view-dr-barry-eppley-indianapolisThe removal of forehead osteomas are often dramatic as the removal of a large bump on the upper face resumes a normal appearance. The removal of a benign bony tumor should be done, if possible, through a discrete incision to avoid creating any adverse aesthetic trade-offs. Incisional approaches include a direct incision (right over it) and the remote approaches of a pretrichial or scalp incision.

Highlights:

1) Osteomas are benign bony tumors that are common in the craniofacial region.

2) Forehead osteomas are often the result of prior trauma and are slow growing over many years.

3) Forehead osteomas can be removed through either a hairline incision or an endoscopic approach further back in the scalp.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Forehead Horn Reduction

Monday, September 19th, 2016

 

Background: The shape of the frontal skull bone known as forehead is an important aesthetic facial feature. Since the forehead occupies one-third of the visible face it is not surprising that it has significant aesthetic value even though it seems like it is just a flat a amorphous structure. In reality there are very distinct gender differences in the shape of the forehead as well as having a good proportion in size to the rest of the face.

The forehead can have a variety of aesthetic deformities or disharmonies. One such aesthetic problem is the forehead that is too big or protrusive. This is most manifest as an upper forehead bulge or protrusion. Known as frontal bossing the upper forehead sticks out and can even protrude further out than the eyebrows. This is almost always due to an overgrowth of skull bone.

A unique form of a forehead protrusion is that of the forehead horns. While the term horns usually implies a pathology due to a keratinized growth from the skin, forehead horns in frontal skull surgery refers to an overgrowth of bone. This is not to be confused with an osteoma which would never present in a paired or bilateral presentation and is an outcropping of new bone growth not just part of the normal development of the skull.. These paired upper forehead bony mounds may appear like two very distinct paired protrusion or may also have a ‘dumbbell’ appearance if a ridge of bone connects between the two of them.

Case Study: This 25 year-old male presented with concerns about the appearance of his upper forehead. He had two distinct bony protrusions of his upper forehead that were particularly obvious in certain lighting due to the shadowing that it caused. There was also a small horizontal ridge of bone that connected the two more prominent outcroppings of bone.

forehead-horn-reduction-dr-barry-eppley-indianapolisforehead-reduction-incision-dr-barry-eppley-indianapolisforehead-reduction-surgery-technique-burr-guarding-dr-barry-eppley-indianapolisUnder general anesthesia a 5 cm scalp incision was made about 1.5 cms behind his frontal hairline. With the edges of the hairline protected by sponges and using a guarded rotary instrument and burr, the forehead horns were reduced as well as the connection of bone between them. The incision was closed in two layers with no loss of any external hair shafts.

forehead-horn-reduction-surgery-intraop-results-top-view-dr-barry-eppley-indianapolisforehead-horn-reduction-surgery-intraop-results-side-view-dr-barry-eppley-indianapolisForehead horn reduction is accomplished by removing the outer cortex of the frontal bone. The only preoperative question is what incisional approach is to be used. There are three incision options; 1) a direct approach using a horizontal forehead wrinkle line, 2) a superior pretrichial incision or 3) a more posterior incision back behind the hairline. the first two incision options are the ‘easiest’ since the rotary instrument is on the same linear problem as the bony protrusions. The scalp incision adds a level of difficulty because it is ‘over the top of the hill’ so to speak and one has to change the angle of the drill to reach the bony forehead protrusions. Protection of the hair shaft and follicle also adds a difficult factor as well. But all three incisions can produce equally good forehead horn reduction results.

Highlights:

1) Forehead horns are a pair of congenital upper forehead bony skull protrusions that may or may not be connected.

2) They can be satisfactorily reduced through three different incisional approaches, all work equally well.

3) Bone burring is the corrective technique for forehead horn reduction.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Total Forehead Reduction

Thursday, November 26th, 2015

 

Background: The shape of the forehead is affected by various hard and soft tissue components. The forehead is framed by the hairline superiorly, the brows inferiorly and the bony temporal lines to the sides. The projection of the forehead is controlled by the thickness of the frontal bone and its degree of convexity and smothness. The height of the forehead is judged by the vertical distance from the hairline to the brow.

Vertical forehead reduction can be of benefit when the hairline to brow distance is about 6.5 cm and longer. Numbers aside, one knows when the forehead is too long by their own aesthetic sense. Shortening the length of the forehead is done by moving the hairline forward or more inferior through extensive scalp undemining and mobilization. A powerful procedure, the hairline or scalp advancement can make a dramatic difference in the appearance of the upper third of the face.

Bony forehead reduction is done to either narrow the shape of the forehead or eliminate any obvious bony projections. This is a bone burring technique that is usually done to narrow the width of the forehead, reduce the amount of its forward projection (convexity) or smooth down so called forehead horns. This almost always need to be done through an open approach afforded by a hairline incision.

Case Study: This 40 year male had a long forehead due to receding frontal hairline and a wide and bulging forehead due to its bony shape. He had a prior hair transplant procedure with a linear strip scar on the back of his head. His desire was for a shorter forehead length and a less wide and bulging forehead.

Total Forehead Reduction result front view Dr Barry Eppley IndianapolisTotal Forehead Reduction result oblique view Dr Barry Eppley IndianapolisDue to his prior hair transplant harvests from the back of his head, it was elected to do a first stage scalp expansion to ensure enough scalp could be mobilized for the hairline advancement. This was done using 120cc of scalp expansion by fill volume. During the second stage through a hairline incision, the tissue expander was removed, the bony forehead reshaped by burring and the hairline advanced 2 cms. Small temporal rotational scalp flaps were also done to eliminate the temporal recession areas.

Total Forehead Reduction result side view Dr Barry Eppley IndianapolisTotal forehead reduction can be done through bony contouring and a hairline advancement. Using the ‘central’ pretrichial hairline incision positioned between the forehead and the scalp, both forehead reduction procedures can be successfully done. His history of strip occipital harvests for hair transplants did necessitate a first stage scalp tissue expander which would not normally be needed in most cases.

Many patients with high and long foreheads have a combination of a posteriorly recessed hairline and bony forehead bossing. Preoperative computer imaging will show whether the apparent forehead bossing is a function of just a high forehead and an exposed upper forehead bony contour or whether a true excessive forehead convexity exists. A very wide or broad forehead in the frontal view, however, is an excessive bony width problem for which a hairline advancement will not improve.

Highlights:

  1. Forehead bossing is treated by bony reduction of forehead width and projection. (forehead contouring)
  2. Vertical forehead reduction is a soft tissue procedure where hairline advancement is done. (scalp advancement)
  3. Total forehead reduction is when both bony and soft tissue procedures are done simultaneously.

Dr. Barry Eppley

Indianapolis, Indiana

Forehead Feminization Surgical Techniques

Tuesday, September 15th, 2015

 

Forehead feminization Surgery Dr Barry Eppley IndianapolisOne of the many important areas to change in facial feminization surgery (FFS) is that of the forehead. The typical male forehead has a prominent brow bone, a visible brow bone break into the upper forehead and a central forehead area that is often flat or even slopes backward to some degree. This is a major phenotypic difference from that of a female forehead who has or desires a rounder smoother and more vertically oriented forehead.

The cornerstone of a male to female forehead shape change begins at the brow bones. While the brow bones can have variable thicknesses before entering the underlying frontal sinus, simple burring down of the brow bones is minimally effective and inadequate for many patients. It may be useful when there is little brow bone protrusion or the outer table of the frontal sinus is very thick. (thus the importance of preoperative x-rays)

Transgender Brow Bone Reduction technique intraop 2 Dr Barry Eppley IndianapolisTransgender Brow Bone Reduction technique intraop 3 Dr Barry Eppley IndianapolisBut the most consistent and effective technique for brow bone reduction is that of the osteoplastic bone flap. Also known as the frontal sinus setback procedure the outer table of the frontal sinus (brow bone) is removed and reshaped. When the bone is replaced, which is necessary to cover the exposed frontal sinus cavity, it is put back so the brow bone contour is flatter. The much smaller segments of bone are usually best secured by small titanium microplates and screws. (1mm is thickness) The tail of the brow bones also needs to be reduced to create more of a lateral reduction and upward swoop. This can be done by bone burring since there is no underlying frontal sinus in this portion of the brow bone.

Transgender Brow Bone Reduction Forehead Augmentation intraop 1 Dr Barry Eppley IndianapolisTransgender Brow Bone Reduction Forehead Augmentation intraop 2 Dr Barry Eppley IndianapolisBut reduction of the brow bones alone is often insufficient to create a more optimal female forehead shape. The central portion of the forehead also needs to be augmented to create a more vertical forehead inclination and a rounder shape from side to side between the temporal lines. Various bone cements can be used and both PMMA and hydroxyapatite compositions are effective. The optimal choice is, however, hydroxyapatite cement due to direct bonding to the bone without a scar interface due to its calcium phosphate composition.

Combining flattening of the inner half of the prominent brow bones, reduction of the outer or tail of the brow bones and increasing the convexity and vertical slop of the forehead are all important forehead feminization techniques. In some cases a hairline advancement to shorten a vertically long forehead can also be done at the same time tio provide the most complete forehead shape change.

Dr. Barry Eppley

Indianapolis, Indiana

Technical Strategies – Pretrichial Approach to Forehead Craniotomy Defect Reconstruction

Tuesday, January 6th, 2015

 

Craniotomies that involve the frontal and/or frontotemporal bones are commonly done for a variety of intracranial problems such as bleeding from trauma or for access to tumors. While the bone flap is put back into position using low profile plates and screws and the detached temporalis muscle resuspended, residual skull deformities are common.

Frontal skull deformities can occur if the bone flap settles to any degree as it heals or the craniotomy line does not heal by bony union. This can leave a palpable edge or visible ridge across the forehead along the original craniotomy line. A portion of the forehead may also be flatter or more recessed. The temporal region can also develop a visible concavity due to temporalis muscle atrophy from its initial detachment.

Forehead Hydreoxyapatite Cement Augmentation with Pretrichjal Incision Dr Barry Eppley IndianapolisThese after craniotomy contour defects of the forehead and temple region can be built back up by bone cement augmentation very successfully. But it is not always necessary to completely reopen part or all of the original scalp incision. This incision (now scar) is often way far back from the forehead region and may be well healed with regrowth of hair around it. A more direct and simpler approach to the forehead defects can be done through a pretrichial or hairline approach. Bone cement can be introduced through this closer and more limited incisional access.

The pretrichial incision is a standard approach for a cosmetic browlift so it usually heals in an inconspicuous manner. Using an irregular or zigzag incision pattern that parallels the frontal hairline ensures that it will heal with a scar that is hidden along its edge. The pretrichial approach to craniotomy defects of the forehead in selected patients can simplify the secondary correction of their residual contour problems.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Forehead Augmentation for Forehead Horns

Tuesday, October 21st, 2014

 

Background: The desirable features and shape of the male forehead is well known. It consists of a brow bone prominence, a superior brow bone break and a smooth slightly convex shape of the upper forehead to the hairline. A wider or more square forehead shape is often seen as an asset as well. Some put great stock in the appearance of the forehead in a man and it certainly can have a strong or weak appearance depending on the shape of the frontal and brow bones which make up its bone structure.

Regardless of gender, one of the desireable features of an attractive forehead is having a smooth contour. Irregularities or indentations are easily seen on the forehead given its broad surface area. This is particularly true in men who do not commonly have a hairstyle that can completely obscure the forehead.

Central indentations of the forehead are not rare in men and are the result of natural development. When present they often create the appearance of upper forehead prominences or horns. This is an artificial appearance that exists mainly because of the depression between them and the lower brow bones. Those who have these forehead horns often feel they make one look older and cast a shadow on the forehead which makes it look uneven even thought the forehead horns aren’t really that raised.

Case Study: This is a 17 year-old male teenager who was bothered by the appearance of his forehead. It had an irregular uneven appearance and he was teased about how it looked. His forehead had a central horizontal depression between the upper forehead and the brow bones that made it look like he had two forehead horns.

Forehead Augmentation with Hydroxyapatite Cement intraop Dr Barry Eppley IndianapolisUnder general anesthesia a coronal scalp incision was used to access the entire forehead. The forehead was built up with hydroxyapatite cement, filling in the depressed area in the center of the forehead. This created a smoother frontal bone shape which also eliminated his superior brow bone break.

Forehead Recontouring result front viewForehead Recontouring result oblique viewHis results showed a much improved forehead shape with complete elimination of his forehead horns and any shadowing effect. His scalp scar was essentially undetectable across the entire length of the incision.

Case Highlights:

1) In some men, a depressed upper forehead accentuates their brow bone prominence and can even create the appearance of forehead ‘horns’ or prominences.

2) Forehead augmentation through hydroxyapatite cement can effectively smooth out indented forehead contours.

3) Forehead augmentation with bone cement needs to be done through an open scalp approach and can have very acceptable scar outcomes.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Removal and Reconstruction of a Large Forehead Osteoma

Tuesday, September 30th, 2014

 

Background: Bony raised bumps on the forehead are not rare and are known as osteomas. They occur due to the development of normal bone under the periosteum of the non-hair bearing forehead. They are benign overgrowths of bone that are non-mobile. They are thought to usually be initially associated with a perforating vein through the bone which may serve as a nidus for their growth. They can occur from trauma due to bleeding, no obvious reason at all or as a hereditary trait.

The vast majority of forehead osteomas are small and benign and involve only the most outer aspect of the skull bone. They usually can be simply ‘popped off’ or easily separated from the outer forehead bone for removal. It is important, however, to initially obtain a skull film or CT scan beforehand to make sure the bone lesion does not extend down past the outer cortex of the skull bone.

Large frontal osteomas that are more than just a bump on the forehead are rare. But they present differently due to their size and their association with other symptoms such as pain. A CT scan will show that the osteoma is more aggressive as it extends deeper into the skull bone and is a truly expansile bone lesion. Simply removing the outer aspect of the osteoma will not be curative with these bone tumors.

Forehead Osteoma closeup Dr Barry Eppley IndianapolisForehead Osteoma Dr Barry Eppley IndianapolisCase Study: This 34 year-old female had developed a low growing bump on her left upper forehead over the past three years. As it had been larger she began to develop sensitivity when pressing on it and more recent onset headaches.  A CT scan showed an invasive osteoma that had penetrated beyond the outer cortex of the forehead bone but also down into the inner cortex with expansion on the intracranial surface.

Forehead Osteoma Excision Dr Barry Eppley IndianapolisForehead Osteoma Bone Reconstruction Dr Barry Eppley IndianapolisUnder general anesthesia a bicoronal scalp incision was made to expose the entire forehead. A large frontal bone flap was cut and removed that incorporated the entire osteoma. The osteoma portion was removed and the remainder of the normal bone saved. This cranial bone segment was split into two pieces and was used to reconstruct a portion of the outer cortex of the forehead with plates and screws. To ensure optimal smoothness, the remaining bone defect not covered by bone with hydroxyapatite cement.

Forehead Osteoma Reconstruction result front view Dr Barry Eppley IndianapolisForehead Osteoma Reconstruction result left oblique view Dr Barry Eppley IndianapolisThree months after surgery she maintained a smooth and symmetric forehead contour. Most of the numbness of the forehead had resolved and she no longer had any headaches.

The vast majority of forehead osteomas as small, benign and easily removed by separating them from the surrounding bone. Large and more infiltrating osteomas are rare  and can cause significant symptoms by their expansion of the persiosteum and even pressing on the dura. They require a full thickness bone flap to safely remove them from the underlying dura. Reconstruction can be done by a variety of skull restoration methods using bone grafts, alloplastic materials or a combination of both.

Case Highlights:

1) Large osteomas of the skull are uncommon but can be particularly deforming in the forehead and are often associated with pain. (headaches)

2) Full thickness resection of forehead osteomas requires a craniotomy flap for access.

3) Reconstruction of the resultant full-thickness forehead defect can be done by autologous bone grafts combined with contouring bone cement.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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