Explore Plastic Surgery - Dr. Barry Eppley

Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?

Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.

While teenagers (under 18 years of age) make up just a small fraction of all plastic surgery patients, that percent has decreased over the past decade. According to statistics from the American Society of Aesthetic Plastic Surgery, teenagers represented about 3.5% of all procedures performed in 2001 and decreased to about 1.5% by 2009. This is interesting in light of all the plastic surgery reality shows and press that cosmetic surgery garners. It is the public’s perception that such exposure from the TV and internet promotes teens to want and subsequently undergo plastic surgery The statistics, however, shows that it simply isn’t so. The reason is economics. Teens simply can’t afford plastic surgery, or even get it, without parental consent and financial assistance.

For those teens that do get plastic surgery, the most common procedures are skin-related being laser hair removal and chemical peels. These are relatively low cost procedures compared to surgery and treated disturbing skin conditions related to puberty such as acne and excessive facial and body hair. When it comes to surgery, however, otoplasty or ear pinning is the most common teen plastic surgery procedure. Because of the very obvious presence of ears that stick out and the ridicule that can result from them, parents support such ear surgery. Otoplasty often is recommended for children as they near total ear development at age five or six. Correction of the ears prior to the child entering school helps eliminate potential psychological trauma from the teasing of classmates. If not done as a child, the pressure of the teenage years will usually bring it to the table, so to speak. (the operative table)

Beyond otoplasty, the nose and breast represent the majority of other teen cosmetic surgeries. Rhinoplasty or nose reshaping has always been a highly requested aesthetic surgical procedure by teens. It can be performed when the nose has completed 90 percent of its growth, which can occur as early as age 13 or 14 in girls and 15 or 16 in boys. Because of internal breathing problems from septal deviation and broken noses, this also serves as an opportune time to change how it looks as well.

Teen breast surgery is just as common in boys as it is girls. In some teenage boys, excessive breast development (gynecomastia) can become a significant psychosocial problem. It has kept many teen boys from participating in sports and becoming a recluse at the swimming pool. Gynecomastia reduction helps make the chest flatter and more masculine. Breast reduction is frequently performed on girls also with overly large breasts that may cause back and shoulder pain, as well as restrict physical activity. Breast reduction usually is delayed until the breasts have reached full development closer to age 15 or 16.

Why does breast augmentation not appear as a teen procedure? With the exception of significant breast asymmetry or congenital or traumatic deformities, federal regulations prohibit breast implants for those under the age of 18. But it is done for medical reasons and represents about 1% of all breast implants placed in the U.S.. Severe breast asymmetry, Poland’s Syndrome (congenital absent breast), tubular breast deformity and congenital micromastia (severe underdevelopment) are the medical reasons breast reconstruction with implants is done in teen girls.

Interestingly, liposuction is very uncommonly performed on teenagers. There are but a few thousand procedures that are done per year. This reflects the general cautious approach to liposuction by most plastic surgeons and the belief that weight and body contour at this age requires non-surgical management.

The past decade has shown that the expansion in plastic surgery has not, and probably should not, translate to teenagers. But the reshaping and reconstruction of prominent ears and noses and large and abnormally developed breasts provides great benefit to the still developing psyche of the teenage boy and girl.

Dr. Barry Eppley

www.eppleyplasticsurgery.com

Indianapolis, Indiana

The ear is a peculiar facial feature. While not existing on the face per se, it has a convoluted shape of hills and valleys that surround the ear canal. Like the nose, it is incredibly unique in its size and shape and each person has their own particular ‘ear print’.  Despite its complexity, it is not paid much attention to unless it stands out in some particular way.

One of the ways the ear stands out, literally, is when it protrudes too far from the side of the head. While the angle of the ear to the side of the head should not be much greater than about 30 degrees, how it looks is more important than some measurement. When someone’s ear sticks out too far, it is a social judgment that one knows well…usually having been told (ridiculed) about it since when they started school.  While some corrective ear surgeries (setback otoplasty) are done either before and after one starts their primary schooling, many are not done or considered until they are in their teenage years.

Whether a teen should undergo otoplasty or not is a personal decision. There is no medical reason whether one should be done or not or at any particular age. I have done otoplasties from age 2 to 78. The timing of corrective otoplasty is when one decides that it is a problem and they are tired of having their ears being a focus of attention or concern. Many teens are not prone to mention that their ears are a concern. Rather they will wear their hair long or pull it forward to cover them. Or even wear hats and other head attire that will hide them. Parents may often have a clue because they never see their teen’s ears. With today’s longer hairstyles and different head wear, it is easy for them to be camouflaged without  being out of style.

Otoplasty in the teenage years is just as common as when they are done at single digit ages. The primary problem behind most protruding ears, regardless of age, is that one of the ear folds is missing or only very weak. (antihelical fold) This allows the outer rim of the ear (helix) to stick out too far. One can easily tell if this is the problem if the ear looks better when the helix is pushed back. (the ‘fold test’) In some cases, the bowl of the ear (concha) may also be a contributing cause if it is too big. But the concha is very rarely the sole cause of the protruding ear. Corrective otoplasty will often change the ear shape by manipulation of both the antihelical fold and the concha through internal suture techniques.

Otoplasty is a fairly simple outpatient procedure. In one hour of  surgery, the ears can be dramatically reshaped. It can be done through a fineline incision on the back of the ear. No sutures need to be removed after surgery. There are no visible scars on the front of the ears. In teens, a head dressing is placed at the end of the operation but it is removed the very next day. Showering and washing one’s hair can be done after dressing removal. I like for my patients to wear a head or sweatband at night for several weeks so that they do not inadvertently fold or crimp newly shaped on the ears while sleeping. Some swelling and soreness can be expected but there rarely is any bruising. A teen can go back to school within several days, but should not need any longer than a week out at most. Contact sports should be avoided for at least 6 weeks.

Otoplasty in the teenage years can make a big difference at a time when conformity in appearance is exquisitely important. A simple one hour operation can provide a lifetime of relief. Few physical problems can be solved so simply and effectively in plastic surgery. It is one of those teenage physical concerns for which a ‘cure’does exist.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Indianapolis Indiana

Parents are understandably concerned about the potential influence of the media on their children’s perception of their self-image and sense of fashion. With so much coverage of plastic surgery on every type of media, young minds are definitely exposed and easily swayed. This has led to a perception that many teenagers and college students are having plastic surgery. Some have even called it an epidemic. I am frequently asked about this perceived trend from older adults.
In reality, there is no such deluge of young patients undergoing plastic surgery. In my practice, I see no more than 3 or 4 patients a year under the age of 22 who are having some form of cosmetic enhancement. That makes up less than 2% of my practice patients. According to the American Society of Plastic Surgeons, only 5% of college-age women have had plastic surgery although many more see it as an acceptable thing to do. Their study of over 500 women from 6 universities showed that the most common procedures were chemical peels, breast augmentation, breast reduction, and rhinoplasty.

 
While many more young women may want some form of plastic surgery, there is a simple reason as to why this percentage will not ever significantly increase…..affordability. While many young people may want plastic surgery, there are also the less likely of any age group to have the disposable cash for it. Nor are they likely to be able to get financing which now accounts for a significant percent of patients having cosmetic surgery today.

 
This exposure at such young ages, while not accounting for a current epidemic, will likely have an impact decades later. I suspect that this generation will be more likely to have plastic surgery later on as a result of their media exposure and the acceptance of face and body alterations.

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