Explore Plastic Surgery

Elective plastic surgery procedures, such as tummy tucks (abdominoplasty), extensive liposuction, breast reductions, and full facelifts, place great stress on the body in an effort to heal the extensively traumatized tissues. Such operations are prone to ‘wound complications’ such as small open areas and delayed healing as the body is stressed to meet the nutritional needs of the recovering tissues. Many patients are not optimally prepared from a nutritional standpoint for such procedures and may be more prone to such postoperative problems.
I like to think of preparing for surgery as an athletic event. Being at a good weight, if possible, in reasonable physical shape, and in good nutritional balance will help improve the surgical outcome, lessen the risks of certain complications, and have a faster physical recovery. Any edge that a patient can gain is fair game when it comes to your own surgical experience. For this reason, I advise my ‘big surgery’ patients to begin nutritional supplements 3 weeks before surgery including high doses of Vitamin C (2 grams per day) and Maxitropin supplements.
Maxitropin is targeted nutrition therapy that contains a patented blend of amino acids that function as ‘secretagogues’, which are designed to stimulate growth hormone release and support wound healing through collagen and protein synthesis. Such targeted nutrition therapy can help improve surgical outcomes through enhanced wound healing. One packet (two scoops per day) provides the following:

Glutamine 6g. : Its most important function is to strengthen the immune system and prevent muscle loss.
Arginine 1g. : Helps build muscle, enhances fat metabolism and mobility and fights off infection.
Lysine 1g. :The human body cannot produce it on its own, and it is critical for the growth and production of hormones, enzymes and antibodies.
Glycine 1g.: Essential for the formation of DNA, collagen, phospholipids and the release of energy.
Ornithine 1g. : Reduces fat and increases muscle mass, stimulates the immune system and enhances wound healing.

Suggested Use: Dissolve 2 scoops in your favorite juice or beverage 1-2 times daily on an empty stomach for optimal absorption. (half hour before a meal or 1-2 hours after a meal)

Nutritional intervention that increases collagen and protein synthesis, supports immune function, and rebuilds lean body mass is a fundamental part of promoting wound healing.

In addition to the responsibilities of your plastic surgeon, anesthesiologist, and the nursing staff of a hospital or surgery center, surgery involves certain obligations on the part of the patient to ensure a safe and uncomplicated experience. The following is a list of the four most common issues that I have encountered over the years in plastic surgery practice that have resulted in the need for someone’s surgery being cancelled on their scheduled day of surgery.

SHOWING UP LATE

While it can happen that someone gets lost on the way to their surgery or gets up late on the morning of their surgery, the usual cause of surgical lateness is a misunderstanding of their surgery time and the needed time of arrival. Surgery time is when your operation is scheduled to begin but a sufficient amount of time is needed to get you ready for your operation beforehand. Generally, one to one and half hours is needed to get you ready so you should arrive at the facility with that much time beforehand. Arriving 15 minutes before your surgery is scheduled will likely get your actual surgery time pushed back (so the next operation can be done before you) or you may have to re-schedule for another day.

NOTHING TO EAT OR DRINK EIGHT (8) HOURS PRIOR TO SURGERY

This is an inviolate preoperative rule of surgery that, if misunderstood, may have life-threatening consequences. Food or liquids in the stomach may be vomited while being put to sleep, entering the lungs and causing a potential life-threatening pneumonia. For this reason, surgery is never performed without an empty stomach even if it is only a conscious sedation.

YOU WILL NEED TO BE TAKEN HOME BY SOMEONE AFTER SURGERY

Unless you are having a procedure under local anesthetic injections, the use of IV medication for sedation or general anesthesia requires that someone be available to take you home after surgery. It is simply not safe for you to drive home after an anesthetic. Taking a taxi home is also not permitted. The medical knowledge of most taxi drivers is probably very limited.

IF YOU ARE FROM OUT OF TOWN AND STAYING IN A HOTEL, SOMEONE WILL NEED TO STAY WITH YOU THE NIGHT AFTER SURGERY

It is not medically advisable to have you alone in a hotel room after any surgical procedure that required a general anesthetic. If you do not have someone, arrangements will need to be done to have you stay overnite in the surgery center or for a caretaker to stay with you in the hotel. These arrangements will need to be made in advance.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Here is a list of several important issues to be aware of and to do before your plastic surgery procedure.

Restrain from eating and drinking 8 hours prior to surgery
This is a rule of any surgery that, if misunderstood, may have life-threatening consequences. Food or liquids in the stomach may be vomited while being put to sleep, entering the lungs and causing a potential life-threatening pneumonia. For this reason, anesthesia is never performed without an empty stomach even if it is only a conscious sedation.

Unless you are having a procedure under local anesthetic injections, the use of IV medication for sedation or general anesthesia requires that someone be available to take you home after surgery. It is simply not safe for you to drive home after an anesthetic or most surgical procedures. Taking a taxi home is also not permitted.

Expectations
Studies and my experience have shown that informed patients feel less anxiety before and after surgery. Make sure you understand the procedure you are having, and don’t be afraid to ask questions such as: what type of anesthesia will be used? How long will the procedure take? What medications will I take? When can I start doing normal activities? When can I shower and apply makeup? There are no silly questions and it is in your best interest to have as much information as possible about your recovery.

Elective surgery should not be a mystery. The procedures you are having are commonly done and what will occur both during and after surgery can generally be predicted. Being fully informed should make you more comfortable about what you are to experience and what the outcome of surgery will be. Share this information with the person who will be taking care of you for the first few days after surgery. It can be very frightening for a spouse or your family to see bandages, bruising or swelling if they do not understand that this is normal after surgery. A good suggestion is to leave a copy of your Post-Op instructions out for your ‘nurse’ to read.

Post-surgical planning
Plan for the hours immediately after your surgery ahead of time: make trips to the pharmacy and grocery store; and arrange for child care. Plan your wardrobe for the day of surgery and a few days after. Loose-fitting clothing that can be unbuttoned or unzipped down the front is best. Designate an area in your home for yourself- such as a quiet bedroom or sofa away from busy family activities. Even if you are having a minor procedure, you will still need a minimum of 24 hours to fully recover from anesthesia, and will not be up to handling responsibilities by yourself. If you do not have a friend or family member to care for you the night of surgery, see if arrangements can be made for you to spend the night after surgery at the surgery center with nursing care for a fee. This option is routinuely available in my practice.

Rest and sleep, combined with a small meal and plenty of fluids are key to a quicker and more comfortable recovery. Hydration is much more important than ‘packing in the calories’.

Allow yourself adequate time for recovery. The biggest mistake most patients make after surgery is shortchanging time for recovery. The number one cause of postoperative pain and complications is ‘over-doing it’ on your arrival home. Plan to take it easy for a few days, and be patient.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

In the most recent July 2008 issue of Plastic Surgery News, the top five most expensive cosmetic surgical procedures for 2007 were reported. These figures are based on the national average per plastic surgeon and represent the physician’s fee only, excluding the cost of the operating room, anesthesia, and any other related expenses.

Circumferential Body Lift $ 8,073
Tummy Tuck $ 5,264
Facelift $ 5,031
Buttock Implants $ 4,722
Buttock Lift $ 4,711

These plastic surgeon’s fees vary per region across the United States and represent an averaging of different geographic regions into a single typical fee. These numbers do not necessarily reflect a typical fee here in Indianapolis and will vary somewhat between different plastic surgeons. Operating room and anesthesia charges, which are additional, can vary dramatically based on what facility the plastic surgeon uses. As an average, you can add 30 - 35% of the plastic surgeon’s fee as the additional costs of surgery to get an estimate of the total cost of the procedure.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Plastic surgeon Dr. Barry Eppley is on Blog Talk Radio today discussing his plastic surgery practice, experience, and the Ology Spa concept which he has developed in Indianapolis.

Barry L. Eppley, MD, DMD, one of Indianapolis premier plastic surgeons is giving patients from Indianapolis and across Indiana a glimpse of his professional background and a better understanding of the wide array of surgical and non-surgical treatments that he performs at his state-of-the-art Ology Spa facilities. Ology is a full-service medical spa located in Clarian North and West Centers that provides spa, plastic surgery, and anti-aging medicine services.
Dr. Eppley has an extensive educational background and years of experience helping his patients with their cosmetic surgery needs. He received a Doctor of Medicine degree from Washington University in St. Louis, a Doctor of Dental Medicine degree from the University of Pennsylvania in Philadelphia as well as full training in Plastic and Reconstructive Surgery at Indiana University. As a result of his education, Dr. Eppley is both a licensed physician and dentist and certified by the American Board of Plastic and Reconstructive Surgery.
His background goes on to include being a former member of University Plastic Surgeons at the Indiana University in Indianapolis, prominent international experience in the investigation and development of numerous technologic advances in plastic surgery and he has an extensive history of research experience in various aspects of bone and soft tissue healing. He has been the recipient of numerous National Institute of Health and private corporate research grants for the evaluation of promising surgical technologies and his contributions to the surgical literature includes 2 books, over 250 journal articles and 35 book chapters.
Specializing in procedures for the face, breast and body, patients can choose from many different procedures such as breast augmentation, facelift, rhinoplasty, tummy tuck and liposuction. Dr. Eppley takes pride in helping his patients achieve beautiful, natural-looking results as is noted by many of his patients who have resoundingly express their many thanks and various comments of praise including; “you are the best”, “ I will never forget all you have done for me” and ‘Thank you for the opportunity to change my life”.
Dr. Eppley’s radio interview is available to be heard on Blog Talk Radio at http://www.blogtalkradio.com. More information on Dr. Eppley and his plastic surgery practice is available at http://www.eppleyplasticsurgery.com or the Ology Spas at http://www.ologyspa.com.

EMMI Solutions based in Chicago provides online medical education programs in 16 different specialities for patients on various medical conditions and surgical procedures. Through physician enrollment in the program, they can offer their patients online education which helps them prepare for and recover from medical procedures, manage their expectations, and engages them in quality and safety initiatives. EMMI Solutions helps provide another layer of procedure information beyond what the physician’s office normally does. In Plastic Surgery, programs are currently available for saline breast augmentation, silicone breast augmentation, facelift, liposuction, breast reduction, breast reconstruction, rhinoplasty and abdominoplasty. New programs soon to be available include blepharoplasty and brow lift surgery.
Dr. Barry Eppley, plastic surgeon of Indianapolis, has participated in this program both as a practice tool and a medical advisor over the past year. The program enjoys high patient satisfaction with 96% of patients surveyed saying that EMMI improved their understanding of what to expect before their procedure. Over 90% of patients say they were more comfortable about their upcoming procedure after viewing the EMMI program.
In looking at my EMMI practice statistics in 2008 so far, 59 cosmetic surgery patients have been issed access codes to review programs prior to their specific procedure(s). Of these 59 patients, 50 (85%) actually took advantage and started viewing the program. Of those that started the program, 40 (80%) patients actually viewed the programs in their entirety. There was no obvious trend or biass towards any particular procedure that was viewed more or less than others.
I find the EMMI program to be extremely valuable to my practice. While I have lengthy discussions with patients concerning their procedures and expectations and provide a lot of written information prior to their surgery, the selective hearing of some patients and low retention rates of a lot of information means that my patients are often not as informed or educated as I may think. EMMI Solutions provides an additional source of information and reinforcement that patients can view on their own time and leisure. Whether they take advantage of the programs or not, they have been provided with the opportunity which I consider much better than any brochure or pamphlet of information. Plus, EMMI Solutions provides documentation of not only if they viewed the programs but for how long and what specific section(s) were or were not viewed.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Cosmetic plastic surgery is both elective and very individualized. The decision to have plastic surgery is obviously very personal and every patient has their unique reasons for wanting a specific plastic surgery procedure, although most of the reasons are quite similar for most patients. Much thought should go into the before surgery aspect, including what plastic surgeon(s) to consult with, what procedures do you need and want, and what are the risks and complications. As a plastic surgeon, it is my privilege to take each new patient that I see and educate them about their surgical options. I do not personally care wheher any patient chooses surgery or not…I only care about whether I have given them a good education so they can make the right decision for themselves.

After surgery care is just as important to me as the before surgery discussions. Once I have taken a patient into my ‘family’, I am obligated to care of you as if you were my family. (and in the short term you might be just as wanting and demanding!) The best way I accomplish this is through what I call a ‘concierge’ approach. Other than my office staff, I leave no interface between you the patient and myself. I am available by cell phone to all of my patients 24 hours a day…every day. If a patient has a problem or concern, I want to know about it. It does me no good, and it is not good service, if you have to weed through two or three people in hopes your message gets through or you eventually get an answer. Since I will have to know about it eventfully, I might as well know about it right up front. And besides, I am the most knowledgeable to deal with whatever problem or concern you may be having. After 20 years in plastic surgery, I basically have seen and heard it all. So whatever problem you may be having, rest assured I have seen it before.

This is what I call concierge plastic surgery. I am available to my patients anytime and no question or problem is insignificant or irrelevant. This is simply good service and I am happy to do it….and besides….this is the way I would want it if I were a patient. Why would I treat you any different than what I would do for myself?

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

While the economy partly has been in a recent downturn, partly driven by higher gas prices (amongst many issues), there is no certainty as to how far south it may go. Where it stays as it is today or gets worse in the next 6 months is impossible to predict. What is possible to predict is that plastic surgery business is down and will continue to be so for awhile. Since cosmetic plastic surgery is completely elective, it is a luxury item that can wait for another day.
But my observation has been that the demand will not change, just the timing and amount of service. People still want change in their face and bodies and most people still want to look their best and fight father time and mother nature. So bigger more expensive surgeries will be put off, but not forever cancelled. I have a few patients every week that talk about ‘doing it later in the year’, probably after the national election, but they are definitely going to do it at some point. For those patients who have saved for the procedure or have a good amount of disposable income, they will go ahead and schedule now. Others choose financing their procedure and the concept of low monthly payments may make them more recession-proof.
One aspect of plastic surgery that is likely not to be affected are the office-based procedures. Botox, injectable fillers, and medical skin treatments have not changed in numbers in my practice nor do I expect them to be. In fact, we may see a temporary increase in demand as the economy is down as patients will do smaller, less costly procedures in lieu of 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

Scars from most plastic surgery procedures are an inevitable outcome. Most plastic surgery operations require an incision, and when this is necessary as it almost always is, a scar will result. While many incisions (and subsequent scars) can be relatively ‘hidden’ dependent upon the procedure (e.g., facelift, blepharoplasty), many plastic surgery procedures on the body can not. (e.g., breast reduction, arm lift) As a result, many procedures require the acceptance of a scar for the procedure’s other benefits. Or to put it another way….make sure the scars are a more acceptable ‘problem’ than the originial deformity.
For some procedures, the acceptance of a scar is relatively easy as it lays in a relatively non-visible location. Procedures such as facelifts, tummy tucks, or thigh lifts place scars in favorable locations that are very tolerable and patients do not usually have a problem with their presence. In other operations such as breast lifts and arm lifts, the scars are anything but hidden and the decision for that procedure can be a more delicate quandry. In the spirit of trading off one problem for another, I advise patients to be sure that the creation of a scar will be viewed as less of a problem than their original concern. In the end, cosmetic plastic surgery is about making the patient feel better about themselves and their areas for which they are self-conscious. It does the patient no good, for example, if the arm from an armlift is much smaller around but the patient hates the scar. In this example, the patient is still is not comfortable with their arm and nothing has been achieved but a surgical exercise.
There are certain plastic surgery procedures to which scarring is of an utmost concern. I find that the breast lift or mastopexy is the #1 plastic surgery procedure to which this scar concern applies. Which is better…a breast that sags with no scar or a better shaped breast with visible scars? That can be a tough call for some patients and obviously depends upon how severe the initial problem is. While a patient must make the final call about a scar vs. improvement trade-off, I have found a simple way to make this decision. If when talking about the scar, the patient quickly says and indicates that…..what do I care about that scar, who would want to live with this? (or some variation thereof) Then this is a safe scar bet. Conversely, if the patient slowly starts shaking their head, looks concerned, or says they are not sure or have to think about it, then I will not do the procedure. A scar is not something you should have to think very much about. If you have to talk yourself into thinking the scar will be fine, it will likely not be. Furthermore, once a scar is on the patient, I have no magic eraser to get it off. There will always be another day or sometime later in life in which the concept of a scar may be more appealing.
The other issue about a scar is that not all scars, no matter how visible or well placed, will always turn out well. Even in routinue procedures, a patient’s scar can turn out poorly no matter how well the operation is performed. Scar hypertrophy and the possible new for scar revision later is always a possibility. Patients have to be informed of this possibility and have to be willing to accept this poor outcome. Whiel scar revision is always possible, there is no guarantee that scar revision will always be successful.
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 read a recent article in People magazine this week entitled the same name as this blog. The fundamental premise of the article was that plastic surgery today is done on the ‘average person’, not necessarily the rich and famous. They go on to cite five people who had differing plastic surgery procedures and their stories.
This article was refreshing because they all had positive experiences, which is usually the norm, as opposed to many articles which talk about patient’s problems and complications which is not the norm. But the underlying theme of the article is what is most poignant for me. The large numbers of plastic surgery procedures done today could occur for only one reason….that the typical plastic surgery patient is just reflective of the average person in society. There is only a very small fraction of society that is famous or wealthy. The plastic surgery numbers of today, which total in the millions of procedures (surgical and non-surgical), could not come from that segment of society. In the past twenty years we have seen plastic surgery work its way into the mainstream of society and is much a part of American culture as Starbucks, cell phones, and My Space. The typical plastic surgery patient in my practice is just a normal person from the middle fabric of society, the range goes from the unemployed to a company CEO. Nearly 40% of my patients now use financing for major procedures, reinforcing the concept of the ‘average’ patient having plastic surgery. That number is starting to approach finance numbers for major appliances or other big ticket home items.
You may ask yourself why…..why do so many people undergo plastic surgery today? Is it the marketing hype from surgeons, is it the media convincing us that me must look better and younger through their projected images, or is our society just so vain? Probably all three of these have some responsibility, but there is one bigger reason. The main reason, in my practice experience, is that most plastic surgery procedures simply work and deliver what they purport to do. Breast implants make breast bigger and more shapely, tummy tucks really do flatten stomachs, facelifts do turn back the clock and tighten that jaw and neck line, and noses do get better shapes that look better on one’s face. Yes, plastic surgeons and plastic surgery procedures are not perfect. Every result is not ideal and some patients do experience complications. And yes sometimes plastic surgery procedures are overhyped. But, on average, most plastic surgery patients are very satisfied and would repeat the experience. A phenomenon that I call accompishment feedback. This explains why 30% of my plastic surgery operations in any given year is ‘repeat business’. Such positive experiences very directly promotes plastic surgery as a satisfied patient is very likely to consider another procedure or tell a friend, who may then go on to have plastic surgery themselves. Every business and profession recognizes the tremendous influence of such word of mouth referrals.
Plastic surgery today is and will continue to be for real people. Its benefits are wide reaching and the ability for all of society to benefit, from the child born with a cleft defect to the middle-aged sales representative who wants to look more refreshed, will continue to be more pervasive. The propagation of plastic surgery has as much to do with its overall effectiveness and high patient satisfaction as it does with marketing and media promotions.

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