EXPLORE
Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Posts Tagged ‘browlift’

Case Study – Female Pretrichial Browlift

Sunday, December 27th, 2015

 

Background: Aging around the eyes is the earliest and most visible signs of facial aging. Periorbital aging affects both the upper and lower eyelids as well as the brows that sit above them. Unless the eyelids which develop excessive skin, the eyebrows age by ‘falling down’, changing their position on the brow bone and losing their arch shape. As the brows descend they close down the eye space making the eyes look smaller and more tired.

The most common form of periorbital rejuvenation is blepharoplasty surgery. Since every person has four eyelids, cleaning up loose eyelid skin and fat can make a dramatic difference in the appearance of the eyes. Provided blepharoplasties are not overdone, blepharoplasty creates a refreshened or rejuvenated look to the eyes. Lifting the brows above the eyelids may or may not be also beneficial at the time of blepharoplasties and requires a presurgical lift test to determine.

Browlift surgery can be done by a variety of superiorly based methods. One of these browlift methods is the pretrichial technique. Through an incision along the frontal hairline the brows can be directly lifted without increasing vertical forehead length. (and can be used to actually lower it if desired) Its disadvantage is the concern about visible scarring along the hairline.

Case Study: This 50 year-old female was undergoing a variety of facial rejuvenation procedures. While she had blepharoplasties done in the past, her periorbital aging issue could be discerned to be more in her brow position than that of her eyelids. Here brows were low on the brow bones with a flat arch shape. This contributed to an almost angry facial appearance.

Female Pretrichial Browlift result front view Dr Barry Eppley IndianapolisFemale Pretrichial Browlift result oblique view Dr Barry Eppley IndianapolisUnder general anesthesia, he had a pretrichial browlift done using an irregular zigzag hairline incision. After undermining down to the brow ridge and releasing the periosteal attachments, a 7mm strip of upper forehead tissue was removed centrally and 9mms out laterally. The upper edge of the forehead tissues were secured in an elevated position by suturing it to the bone through outer cortical interosseous holes.

Female Pretrichial Broiwlift results side view Dr Barry Eppley IndianapolisThe pretrichial browlift is an almost exclusively female periorbital rejuvenation procedure. The usually stable and more dense female hairline allows for good hairline scar results. The opening of the eyes from the browlift as this point in your age is far more important than what a blepharoplasty could create.

Highlights:

  1. Sagging of the brows is defined by the position of the eyebrows on the brow bones.
  2. In women brow ptosis is defined as eyebrows that have a flat arch shape and are positioned at or below the brow bones.

3) The pretrichial browlift is the most direct approach to elevating sagging brows.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Skull Implant Browlifting Effect

Monday, July 6th, 2015

 

Background: Skull implants are used today to treat a variety of aesthetic head shape concerns and deformities. While many think of skull implants of filling in craniotomy or other traumatic skull defects, aesthetic skull implants are placed in a subperiosteal onlay fashion to build out usually normal thickness skull bone areas. Skull implants placed in this manner are used for correcting skull asymmetries, flat spots, irregularities or just to create an overall larger circumference to the head.

Skull Cap Imnplant Design Dr Barry Eppley IndianapolisThe success of skull implants is partially dependent on the overlying scalp. The scalp has to stretch to accommodate what is placed beneath it. The skull implant can not be too large or too thick or the scalp will be too tight and the incision to place it will not be able to be closed. The bigger the skull implant or the larger the skull surface area that it covers the more that the scalp tissue is ‘recruited’ from elsewhere as the overall scalp stretches to accommodate the implant pressure underneath it.

Interestingly, some patients think that a skull implant will naturally have a bit of a facelifting effect. They envision that the upper pull of the scalp will translate into a distant effect low on the face. This is not what occurs, even in the largest of skull implants that I have placed. But there are certain circumstances with skull implants where a browlifting effect can be created.

Case Study: This 42 year-old female presented for a combination of forehead contouring and a near circumferential skull implant to build up the sides and the back of the head. A custom skull implant was designed with maximal thickness of 8mms in the back.

Skull Implant Browlift result front viewSkull Implant Browlift result oblique viewUnder general anesthesia, a pretrichial incision was made. Going anteriorly the slope of the forehead was reduced by bone burring. Going posteriorly the scalp was elevated over the temporal and occipital regions of the scalp. The custom made implant was inserted, trimmed where needed and secured with small titanium screws. Prior to placement multiple perfusion holes were placed through the implant.

Skull Implant Browlift result side viewHer postoperative results showed a larger circumference to the head but also that she had developed a significant browlifting effect. This was a desireable aesthetic side effect of the skull implant. It occurred most likely because the access point for the implant’s insertion was at the frontal hairline. (pretrichial incision) As the scalp behind the incision became elevated, closing the pretrichial incision (after elevation of the forehead flap and contouring) resulted in the brows moving upward.

Highlights:

1) Skull implants of substantial size can elevate the scalp through underlying volume addition.

2) If a skull implant is placed close enough to the frontal hairline and of sufficient size it can have a browlifting effect.

3) The pretrichial approach to skull implant placement can both contribute to a browlifting effect from skull implants or can be used to create a browlift if desired.

Dr. Barry Eppley

Indianapolis, Indiana

Technical Strategies – Direct Fixation Method for High Tail Browlifts

Wednesday, March 4th, 2015

 

Numerous browlift procedures exist to lift sagging brows and help rejuvenate an aging periorbital look. The success of most browlifts are based on a tissue release and a superior elevation of the sagging brows. Most techniques employ some form of fixation to the skull bone to hold the lifted forehead tissues as they heal. These have included a variety of metal and resorbable polymer devices that have taken the forms of pins, screws and platform style plates. They don’t have to hold the tissues very long as it has been shown that periosteal healing back to the bone in the new position takes about two weeks or less.

Male vs Female Eyebrow ShapeHow much to elevate sagging brows and how to shape them as they are lifted is as much an art form as it is a science. How the brow arch gets shaped as it is lifted is affected by numerous factors such as incision and tissue fixation location as well as the amount of upward pull. What is known is that the shape of the shape of the brows and the amount they can be aesthetically lifted does differ significantly between women and men. Women can tolerate higher amounts of browlifting with an arch shape that is often preferred to be higher at the outer aspect than the inner brow area. Conversely, men can tolerate only a modest amount of browlifting and the arch shape should stay relatively flat. (unarched)

A few women do prefer a  more dramatic browlift result which usually refers to a very high tail of the brow. This is often accompanied with a high outer corner of the eye lift as well. Such high tail of the brow positions can be difficult to achieve as they require a significant upward tissue lift and are almost always done best through a pretrichial or hairline incision to avoid backward displacement of the frontal hairline.

Direct Tail of the Brow Pexy technique Dr Barry Eppley IndianapolisDirect Tail of the Brow Pexy technique 2 Dr Barry Eppley IndianapolisOne simple method of brow fixation that I have found useful in these more extreme browlift procedutes is a direct browpexy method. Once the maximum amount of lift of the tail of the brow is achieved, a 3mm stab incision is made inside the hairline of the outer brow. Using a self-tapping 1.5mm screw, the deeper brow tissue are grasped lifted and secured to the underlying bone. The screw can be used to either hold the existing brow position or to even lift it up higher before placing the screw into the bone. If the tail of the brow is lifted up even higher, a skin bunching around the tail will occur. Thus will need to be released right under the skin with small sharp scissors. It is important to make sure the screw is turned down flush to the bone since it is not paplpable. A small resorbable sutures is then placed to close the tiny incision.

Tail of the Brow Lift intraop result Dr Barry Eppley IndianapolisThis direct brow fixation method is a useful adjunct to securing the outer tail of the brow in select cases. A direct browpexy may be necessary when a very high arch shape is desired amongst female patients.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Case Study: Visual Obstruction Treated By Browlift And Blepharoplasties

Monday, December 8th, 2014

 

Background: Changes around the eyes are the earliest signs of facial aging. As a result, the ongoing aging effects often creates severe changes around the eyes as one enters their sixties. Besides the excess skin of the upper eyelids and the lower eyelid bags, the eyebrows often sag downward magnifying the hooding effect on the upper eyelids.

Visual Field testing Indianapolis Dr Barry EppleyHooding of upper eyelid skin and brow sagging do have functional effects. By weighing down the upper eyelids there is a loss of a portion of one’s visual fields. A portion or all of the upper visual field may be lost as the position of the upper eyelid acts like a blind over a window. Partial closure of the blind results in loss of one’s ability to see what lies above as one is looking straight forward. This is often confirmed by an historic test known as Goldman’s visual field examination which evaluates the entire range of peripheral vision. But automated perimetry testing today has replaced the traditional Goldman method in many ophthalmology/optometry practices.

To correct these severe eye aging effects and to improve one’s upper peripheral vision, multiple procedures need to be done. With brow sagging, an upper blepharoplasty alone (while helpful) may induce one to remove too much upper eyelid skin and severely shorten the distance between the eyebrow and the lashline. (in essence even pulling the eyebrow down further) A browlift combined with an upper blepharoplasty is needed to not only lift up the low brows but to also reduce the amount of upper eyelid skin that really needs to be removed. Together they create a periorbital effect that is better than a browlift or an upper blepharoplasty alone.

Case Study: This 62 year-old female was bothered by the way her eyes looked and how ‘old’ her appearance. She had such severe hooding that her upper eyelid skin hung below her lashlines. The weight of her upper eyelids, combined with some brow sagging, created a pseudo ptosis look as the level of her upper eyelids enchroached on the iros of the eye.

Visual Field Obstruction Blepharoplasties result front viewVisual Field Obstruction Browlift Blepharoplasties result oblique view Dr Barry Eppley IndianapolisUnder general anesthesia, an initial browlift was performed using a pretrichial incisional approach. An irregular zigzag incision was used along her frontal hairline. A total of 8mms of vertical upper forehead skin was removed for a moderate browlift effect. An upper blepharoplasty was then done using marks done before surgery based on pulling the brows upward. Lastly, lower blepharoplasties were performed with skin and fat removal, orbicularis muscle resuspension and lateral canthopexies.

Visual Field Obstruction Blepharoplasties result side viewHer results at six weeks after surgery showed a significant improvement in the appearance of her eyes but without an overdone look. Her lower eyelids had good contact with the globe and the position of the outer corner of her eyes was maintained. She did have some mild dry eye symptoms during the first month after surgery even though she had no ectropion or eyelid malpositioning problems. This is not rare when upper and lower blepharoplasties are combined with a browlift as this will slow the blink reflex for a period of time after surgery.

Case Highlights:

1) Severe aging around the eyes results in brow sagging and upper eyelid hooding which does impact one’s superior visual fields.

2) Optimal correction of visual field obstruction requires a combined brow lift and upper blepharoplasties.

3) Lower blepharoplasties are often done at the same time to enhance the overall periorbital aesthetic effect but do not provide an improvement in peripheral vision.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: The Pretrichial Browlift for Forehead Rejuvenation

Wednesday, June 11th, 2014

 

Browlift Surgery Indianapolis Dr Barry EppleyBackground: Aging of the face affects all structures but none are more noticeable, both early and late in the process, than that of what occurs around the eyes. One of those changes is a sag or lowering of the eyebrows. Due to frequent motion of the muscles which often pulls them down and the long-term effects of gravity, the eyebrows can lower from their original position on the brow bones. A lower than normal eyebrow position not only affects how we look but can make redundancy of upper eyelid worse.

The treatment of brow ptosis (brow sagging) can be done by a variety of techniques, most of which are based on some type of superior scalp incisional approach. The traditional full coronal incision of yesterday has been largely replaced by a much more limited endoscopic technique. With smaller incisions and a quicker recovery, the endoscopic browlift can be applied even to younger patients with smaller amounts of brow sagging.

But the endoscopic browlift is not perfect and the benefits of the smaller incisions are offset by the limits of what the procedure can do. Besides restrictions on how much of the forehead muscles can be manipulated, its lifting effect is based on an epicranial shift concept. Because no tissue is removed, the browlift effect is created because the scalp is moved backwards. As the scalp tissues a removed back, the forehead is pulled upward with the brows at the lower end being pulled with it. While the brows may be lifted, the forehead also lengthens. This may be aesthetically disadvantageous for the patient who already has a long forehead.

An intermediate browlift technique between a coronal and endoscopic method is the pretrichial or hairline method. This less frequently used browlifting method has many of the advantages of other browlift techniques with the only disadvantage of how well the hairline scar appears.

Case Study: This 62 year-old female was undergoing a variety of facial rejuvenation procedures. One of them was her desire to give her eyes a less tired look. She already received Botox injections in the glabellar region and felt that if her brows were lifted, particularly the middle and outer areas (which Botox did not lift very much) then she would have a less tired and worn appearance.

JR Browlift results front viewUnder general anesthesia, a beveled frontal hairline incision was made which went behind the hairline as it was extended into the high temporal area. The forehead tissues were elevated off the bone and the brow ridge periosteum separated and lifted, exposing the supraorbital neurovascular bundles on each side. Portions of the corrugator and procerus muscles were removed centrally and around the nerves. Horizontal strips of frontalis muscle were also removed in two separate rows. The forehead skin was lifted to create the desired browlifting effect as well as temporal scalp skin out laterally. The overlapping forehead skin and scalp tissues were trimmed, the deeper tissues secured to the galea and deep temporal fascia and the incisions closed.

Pretrichial Browlift result side view Dr Barry Eppley IndianapolisRecovery from a pretrichial browlift is about whatever bruising and swelling occurs around the eyelids. That will be significantly influenced by whether any blepharoplasty surgery is done at the same time. When done without accompanying blepharoplasties, one can look pretty good in one week after surgery. When done with blepharoplasties, that recovery of acceptable appearance will be extended to 10 to 14 days.

Pretrichial Hairline Scar Dr Barry Eppley IndianapolisThe pretrichial browlift does carry two distinct disadvantages, one of which is obvious and the other not visibly apparent. There will be a fine line scar along the frontal hairline which usually heals very well. In patients with more pigment in their skin, a mild line of hypopigmentation may result. The unseen disadvantage is the transection of the sensory nerve branches as they cross into the scalp. This will cause some temporary numbness of the frontal scalp which patients often described as a ‘dead woody’ feeling in that area for  few months after surgery. That numbness feeling is usually more profound than the more traditional coronal incision because it cuts across the nerves closer to their origin.

Case Highlights:

1) Brow lifts can be done by a variety of techniques of which the hairline or pretrichial approach offers a balance between a relatively hidden scar and a powerful brow lifting effect.

2) The amount of skin removed along the frontal hairline correlates closely with the amount that the brows are actually elevated.

3) The scar along the frontal hairline can have some hair that grows through it with a small amount of hypopigmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Forehead Feminization with Combined Brow Bone Reduction, Browlift and Hairline Lowering

Sunday, April 21st, 2013

 

There are numerous surgical procedures to feminize a masculine facial appearance. They include jawline reshaping (chin and mandibular angle reduction), rhinoplasty, cheek reduction, tracheal shave and forehead reduction/reshaping. While every transgender patient’s face is different and may need just a few or all of these facial feminization procedures, the forehead is one of the top considerations for most patients. The female forehead has a very distinct shape with a rounded contour from the brows up to the hairline with no obvious bone break.

Forehead reshaping incorporates reduction of the prominence of the central glabellar region as well as the projection of the brow bones. The brow bones must not only be deprojected but should also have the tail of them near the lateral orbit reshaped to have more of a sweeping effect up and towards the temples. Since this procedure requires an open scalp approach, this creates the oportunity to lower the frontal hairline as well. Together this type of foreheadplasty has a significant impact on the gender identification of the face.

The prominent glabella and brow bones are always due to the pneumatization of the front sinus. In cases of minor protrusion, the outer table of the frontal sinus can be simply burred down. Unfortunately this rarely can be successfully done due to the thin bone thickness overlying the frontal sinus. A few millimeters of change is rarely enough to make a noticeable external change. Most patients require the anterior wall of the bone to be removed, reshaped and repositioned back into place with resorbable sutures or metal microplates and screws. This method sets back the bulging bony prominence while preserving sinus function. The outer brow bone areas that lie outside of the sinuses can be reshaped as desired by burring.

When significant brow bone reduction is done (flattening of the bone), there is the potential for an excess of overlying skin. Loose skin on the brows can result in sagging or overlying brow ptosis. This can be easily addressed at the time of the brow bone reduction by a comcomitant browlift using the transcoronal or hairline incision made for access to the brow bones. An alternative approach is a direct browpexy from the galea below the eyebrows to underlying bone holes or the fixation plates (if used) above the reshaped brow bones.

A final component of the feminizing foreheadplasty procedure is the potential to simultaneously lower the frontal hairline. A long forehead (> than 6.5 to 7 cms between the brow and hairline) is unaesthetic for any gender but is particularly so in the male to female transgender patient. If a hairline approach (trichophytic) is used, a simultaneous scalp advancement can be done by securing the galea of the advanced scalp by sutures to bone holes in the outer table of the skull. By bringing the scalp forward, the lifted forehead skin will need to be trimmed creating a combined forehead skin reduction and browlift.

Ultimate feminization of the forehead can be done by simultaneous brow bone reduction, browlift and hairline lowering.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Combined Browlift and Eyelid Lifts in Severe Periorbital Aging

Wednesday, April 17th, 2013

 

Background: The aging process around the eyes is classic. The near continuous motion of the eyelids creates loose skin and, with enough time and motion, the eyebrows will fall over the supraorbital rims and sag downward.. For many patients today, they have eyelid surgery early in life and never progress to see the extreme aging changes that can occur around the eyes.

But in its most extreme form, eyelid aging will develop hooding where the loose and excessive skin will fall down and even over the eyelashes. The eyebrow can even lie completely under the brow bone further accentuating the hooding effect of the loose upper eyelid skin. While such severe changes are usually seen in the elderly, it can occur in younger patients due to their natural genetics.

When there is a large amount of loose upper eyelid skin, it is tempting to think that a dramatic change can occur with its excision alone. But this does not take into account the powerful negative effect of a low brow position and its influence on obscuring the vertical space between the lashline and the brow. Without such a space a supratarsal fold can not be created no matter how much eyelild skin is removed.

Case Study: This 57 year-old female wanted to improve the aging appearance of her eyes.  She has severe upper eyelid hooding, a low eyebrow position and significant obstruction of her upper visual field. While she initially resisted the idea of a browlift with her blepharoplasties, she eventually resigned herself to the fact that failing to deal with her eyebrow position would limit how much of a blepharoplasty result would be seen.

Under general anesthesia, a pretrichial (hairline) browlift was initially performed with a beveled incision along the frontal hairline. Eleven mms of forehead tissue was removed from the center of the hairline tapering out into the temporal area. The browlift was secured into position with suture fixation through outer cortical skull bone holes and sutures to the galea. An upper and lower blepharoplasty was then done, removing skin only in the upper eyelid and skin and fat from the lower eyelid.

Her postoperative course had the typical swelling and bruising around the eyes which ensues with some expected temporary foehead and frontal scalp skin numbness. She looked fairly normal at three weeks after surgery and completely normal by 6 weeks after surgery. She not only looked more refreshed by had a dramatic improvement in her field of vision.

With severe periorbital aging, oen has to consider a more comprehensive surgical approach around the eyes. This would include a browlift as well as the four eyelids. the choice of browlift is based on the existing length of the forehead and the degree of brow ptosis.

Case Highlights:

1) Severe upper eyelid hooding and brow ptosis produces an combined aesthetic and functional obliteration of the eyes.

2) When the brow is low, even aggressive upper eyelid skin removal will not produce an adequate result.

3) A combined browlift and 4-lid blepharoplasties is needed to open up the eyes in severe aging changes.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery’s Did You Know? Female Eyebrow Beauty

Friday, February 1st, 2013

 

The eyebrow is an important part of female facial beauty. Unlike men who pay little attention to the size and shape of their eyebrows (unless they meet in the middle), women shape and color their eyebrows with great care. Like all fashion trends, the concept of the ideal shape of the female eyebrow has changed over the years. Eyebrow beauty consists of whether the hair density is thick or thin and where the maximal arch point exists. For example, the 1980s were known for thick eyebrows. That changed to more thinner ones during the 1990s and 2000s and now thicker eyebrows are coming back in vogue again. The arch point of the eyebrow, an entity that can be affected by both Botox injections and browlift surgery, has also changed. According to a recent study published in the Clinics of Plastic Surgery in September 2012, the arch of the eyebrow has been gradually moving outward from the lateral limbus of the eye (outer area of iris) to the lateral canthal area. (eye corner) In addition, the height of the arch of the eyebrow has also been decreasing over time. The ideal female eyebrow today  is defined as starting near or below the orbital rim near the nose with the maximal arch of the brow (peak) at the lateral canthus in younger patients (can be closer to the middle of the brow in older women) and the tail of the brow located an inch or slightly less (20mm to 25mms) above the lateral canthus.

Endoscopic vs. Transpalpebral Browlifts

Friday, January 18th, 2013

 

Repositioning of an aesthetically low eyebrow can be done by a variety of browlift procedures. Historically and most commonly, an approach from the scalp (coronal, hairline or endoscopic) is how many browlifts have and are done. This is the most logical approach because lifting up or pulling back seems the right direction for an eyebrow that is too low. A more recent and diametrically opposite approach to lifting the low brow is to push from below. This is known as the transpalpebral (through the upper eyelid) browlift technique that uses a device (endotine) to achieve its effect.

The origin of the transpalpebral browlift is based on three issues.  First, browlifting in men poses a unique challenge because of the dubious nature of their hairlines. Scalp approaches in men are usually unacceptable because of visible scar concerns. Coming from below through an eyelid incision is the only acceptable option for most men. Secondly, there are some women who may feel that the standard browlift approach is more than they want or need. They may desire a little browlifting but feel a scalp approach is too aggressive. Lastly, the sheer proximity of the upper eyelid to the brow bone makes the addition of a browlift through an upper blepharoplasty very convenient with very little additional risk and no extra incision.

An interesting question is  how similar are the results from these two very different approaches to browlifting. In the December 2012 issue of Plastic and Reconstructive Surgery, a paper entitled ‘Morphometric Long-Term Evaluation And Comparison Of Brow Position And Shape After Endoscopic Forehead Lift And Transpalpebral Browpexy’. Photographs of patients who had received either an endoscopic browlift or a transpalpebral browpexy were morphometrically evaluated for brow height and brow shape up to five years after surgery. Their results show a significant elevation of the brow done through the endoscopic approach is both higher and more sustained than the transpalpebral technique. The descent of the eyebrow after the transpalpebral browpexy is felt to be caused by a decrease of frontal hyperactivity after the simultaneously performed blepharoplasty.

It should be no surprise that an endoscopic browlift causes a greater change in the brow’s position and shape as it is a bigger and much more powerful procedure. By comparison, the transpalpebral technique is much more limited in subperiosteal elevation and forehead flap movement. In an endoscopic method the entire forehead is mobilized and moved in one large tissue flap. The transpalpebral approach only mobilizes the brow. This study merely confirms what is intuitively obvious that a bigger operation is more effective and sustained than a smaller one.

While the transpalpebral browlift is less effective than other browlift methods does not mean it has no periorbital rejuvenation value. Its very simplicity and more subtle effects makes it well suited for those who need just a little browlifting or want a less invasive method of doing it. This particularly applies to many male patients who desire a browlift result that does not look overdone with too much brow elevation change.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery’s Did You Know? The Shape of the Eyebrows

Sunday, July 1st, 2012

The one patch of hair that both male and female share are the eyebrows. With few exceptions, everyone is born with a pair of them. Their functional role in mammals is to protect the eye from water and debris from above. But humans go to great lengths to modify their natural hair pattern. Unlike the Egyptians who frequently shaved off all of their eyebrow hairs as a sign of beauty, keeping them is a more contemporary part of facial aesthetics. The desireable shape of the eyebrows has changed over the years in many subtle ways for women. Female eyebrows should have an arch which is peaked at the center of the browline and has a tail which tapers off as it descends out toward the temples. Thin and thick eyebrows have been in and out of vogue for women but the desire for an arched form has largely remained unchanged. The shape of the male eyebrow is less aesthetically important other than being more of a straight line, not having a unibrow, and keeping longer wild hairs in check. Non-surgical procedures like Botox and browlift surgery can change the shape and position of the eyebrows on the brow bone in both favorable and unfavorable ways.


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.

Read More


Free Plastic Surgery Consultation

*required fields


Military Discount

We offer discounts on plastic surgery to our United States Armed Forces.

Find Out Your Benefits


Categories