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Posts Tagged ‘gynecomastia reduction’

Case Study – Gynecomastia Reduction with Power-Assisted Liposuction

Thursday, December 31st, 2015

 

Background: Gynecomastia reduction is a well known surgical procedure that can be used in males of almost all ages. Male breast tissue enlargement can occur for a variety of endocrine reasons from pubertal hormonal surges to the older male with declining testosterone levels. In every case the mass of breast tissue increases starting centrally under the nipple and radiating outward, creating differently sized breast/chest mounds.

While the size of the breast tissue in gynecomastia varies amongst each individual male, one very important element that factors into its treatment is the quality of the overlying chest skin. How much chest skin exists (is there any sag), its natural elasticity and the position of the nipple determines whether any skin excision is needed. (lift) This becomes more of an issue in very large gynecomastias of any age and in older gynecomastias even of smaller sizes. A low nipple position may necessitate some type of nipple lift.

Power Assisted Liposuction Indianapolis Dr Barry EppleyLiposuction can be done by a variety of energy-driven methods. One of these devices is power-assisted liposuction. (PAL) This is mechanically driven and moves the tip of the cannula back and forth several thousand times a minute. Such an oscillating is particularly good in tough or high fibrous bearing fat tissue such as most gynecomastias. This is particularly effective for the firmest of breast tissue which is always located right under the nipple.

Case Study: This 50 year-old male had a saggy chest with small breast mounds that became more pronounced after weight loss. Despite intense exercise and weight lifting, he could not improve or exercise off his gyneomastia.

Mark Gynecomastia Reduction result front viewUnder general anesthesia, he initially had power-assisted liposuction performed on both sides of his chest from a singe small 4mm incision at the lateral chest wall. A total of 1,000 of aspirate was obtained with 500cc removed per side. At the completion of the liposuction, an eccentric periareolar nipple lift was done to move the level of the top position of the areola up by 1cm.

Mark Gynecomastia Reduction result oblique viewIn the older male, particularly after weight loss, residual breast tissue will remain and the nipples will hang lower often near the level of the inframammary fold. Gynecomastia reduction by lipoaspiration will flatten the chest but will not lift the nipples. The skin retraction in the older male’s chest skin is limited and often requires some help to better reposition the nipples.

Highlights:

  1. Gynecomastia reduction can be successfully done in some cases by liposuction alone.
  2. The use of power-assisted liposuction and basket cannulas can be effective for the stubborn fibrous breast tissue right under the nipple.
  3. The success of gynecomastia reduction by liposuction depends on how well the skin retracts and the original position of the nipple.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Power-Assisted Liposuction for Male Gynecomastia Reduction

Sunday, May 24th, 2015

 

Background: Gynecomastia, or male breast enlargement, occurs in a wide variety of forms and ages. While typically perceived as a condition that occurs in teens and young men as a reaction to elevated hormonal levels from puberty, gynecomastia occurs equally in older men as well. ‘Man boobs’ as they are often called can be an aesthetic affliction to any man at any age.

older male gynecomastiaOlder men can develop gynecomastia for a variety of reasons from weight gain, dropping testosterone levels (and elevated estrogen levels) and various medications. (e.g., propecia or testosterone supplements) Often the cause is multifactorial and weight gain is a common denominator. Many older men as their abdomens become bigger and rounder will develop a similar but smaller enlargement of their breasts as well.

The surgical treatment of gynecomastia consists of only two basic approaches, liposuction or open excision. In many gynecomastia reductions surgeries of all ages, a combination of open excision and liposuction is usually needed. But softer gynecomastias and those thayt have little evidence of any lumps or masses under the nipple will do well with liposuction alone. Many different types of liposuction can be used for gynecomastia surgery and will work equally well based on the practitioner’s skill and experience.

Case Study: This 54 year-old male came for liposuction of the chest, abdomen and flanks…the three classic liposuction areas for men. He had lost as much weight as he could through diet and exercise and had ‘hit the wall’. He needed a surgical boost to make a more significant change than we he could accomplish. His chest had a softer type of breast enlargement that had no hard lu

Power-Assisted Liposuction Indianapolis Dr Barry EppleyUnder general anesthesia, liposuction was performed on his abdomen and flanks as well as both sides of his chest using a 3mm cannula on a power-assisted device. (PAL, power assisted liposuction) A total of 700ccs was removed from both sides of his chest. After surgery he wore a circumferential chest compression garment for three weeks.

Male GYnecomastia Liposuction Reduction result front viewMale Gynecomastia Liposuction Reduction side view 2His six month postoperative results showed a much improved chest contour with no residual signs of his ‘man boobs’. He also had no nipple protrusion or residual puffy nipples.

For many older men with gradual onset gynecomastia, liposuction alone can be a very effective treatment. It is often combined with other body areas such as the abdomen and flanks which many men have problems with as well. Power-assisted liposuction aids in fat and/or breast tissue removal through its oscillating tip, lessening the workload on the surgeon.

Case Highlights:

1) Liposuction is the most common surgical method used for gynecomastia reduction.

2) Men that develop gynecomastia as they age or gain weight are more likely to have a softer less fibrous type of breast tissue.

3) Power-assisted liposuction is an effective method to treat older softer male gynecomastias.

Dr. Barry Eppley

Indianapolis, Indiana

Gynecomastia Reduction in Male Body Builders

Friday, February 6th, 2015

 

Gynecomastia is a well known condition of breast enlargement in men. It can occur in any male body shape from a thin teenager to an older male. The size of the gynecomastia  and the extent of chest deformity can vary considerably. But the one feature that all gynecomastia patients have is the very firm lump of breast tissue that lies under and around the nipples.

Gynecomastia Reduction in Male Body Builders Dr Barry Eppley IndianapolisOne very unique form of gynecomastia is that seen in male body builders. Even though they have little body fat and are long past puberty, gynecomastia can occur most often due to the use of anabolic steroids or other high dose supplements. While their gynecomastias are small in size compared to many other forms, it is disturbing to them due to their high aesthetic standards and its easy visibility as a stand out feature on their chest which is highly scrutinized if they participate in competitions.

In the February 2015 issue of the journal Plastic and Reconstructive Surgery, a paper was published entitled ‘Correction of Gynecomastia in Body Builders and Patients with good Physique’. Over a 33 year period, over 1500 body builders underwent gynecomastia reduction. Subtotal excision of most of the firm breast tissue was removed through an open approach using an inferior areolar incision in all cases. Liposuction was minimally used in 2% of the cases. Good aesthetic results was obtained in 98% of the cases. Hematoma rates averaged 6% over the study period. The authors has no infections, contour deformities or redevelopment of breast tissue.

This paper highlights that successful gynecomastia reduction in male body builders requires essentially a near complete subcutaneous mastectomy. The tissue needs to be thinned out under the nipple-areolar complex to just a few millimeters so that it will lay flat on top of the pectoralis fascial/muscle layer. This will also prevent recurrence of the breast tissue since these patients may likely continue taking steroids and supplements that caused the problem initially. Attention to the smallest chest contour detail is important since these patients are by nature of their body types perfectionists.

One very important element of this type of gynecomastia reduction is the postoperative activity level. Male body builders are very religious about their workout routinues and it can be hard to keep the out of the gym for any extended period of time. Exercises of the chest need to be restricted for at least two weeks after surgery with three weeks preferred. Noncompliance is associated with higher rates of hematoma and seroma formation.

Dr. Barry Eppley

Indianapolis, Indiana

The Use of Drains in Gynecomastia Reduction Surgery

Thursday, March 20th, 2014

 

Gynecomastia  Reduction Dr Barry Eppley IndianapolisGynecomastia reduction surgery is very common for either young or middle-aged males who have various amounts of breast tissue development. While some forms of gynecomastia are treated by liposuction alone, more than half of them require an open approach through an inferior areolar incision. When doing an open gynecomastia reduction, it is common practice to insert a drain to prevent an after surgery fluid collection.

While the use of a drain out the side of the chest is not usually in place for very long after surgery (a few days up to a week), it is still an annoyance to the patient. Like the use of drains in other procedures like breast reduction and facelifts, the question is often raised as to their true need. It may be tradition to use them but are they really necessary

In the March 2014 issue of the Aesthetic Surgery Journal, an article was published entitled ‘Necessity of Suction Drains in Gynecomastia’. In this paper, the authors looked at their complication rates in gynecomastia reduction surgery when no closed suction drains were used. In 138 consecutive men who had gynecomastia reduction by ultrasonic-assisted liposuction both with and without the pull-through technique. The average of the patients was around 30 years old. The amount of fat removed from each side of the chest was around 350ccs. The pull through was needed in 23 patients. (17%) They had only one hematoma and no seromas. These results lead the authors to conclude that the use of drains is not needed in gynecomastia reduction.

It is important to realize when looking at these study results that less than 20% of the patients treated had an open excision of the gynecomastia tissue, which is the main indication for the use of a drain. Drains are never used in chest liposuction. Thus, this study is not convincing that there is no value whatsoever for drains in gynecomastia surgery. I would be a lot more convinced if all 138 patients in the study had an open pull through technique done.

What this study does demonstrate is that smaller amounts of breast tissue removed through an open areolar approach is probably not needed. But for larger amounts of breast tissue removed, particularly in combination with liposuction in the surrounding chest, a few days of a drain would not hurt.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Older Male Gynecomastia Reduction with Nipple Transposition

Monday, February 24th, 2014

 

Background: Gynecomastia, the development of breasts in men, is often thought of as a young man’s problem. While hormonal changes certainly set the stage for the emergence of breasts in some teenagers and young men, similar problems of a slightly different nature occur at the opposite end of the age spectrum.

When older men develop what used to be called ‘senile gynecomastia’ due to testosterone decline, it is not the ‘plump’ type of gynecomastia seen in youth. Rather it is a sagging mass of chest tissue in which the nipple and breast mound sags over the inframammary fold. There is a loss of skin elasticity and ligamentous laxity that allows the chest to fall off of the pectoralis muscle inferiorly.

While liposuction is a frequent treatment for gynecomastia reduction, it will not produce the desired result in many older gynecomastias. While some chest volume reduction will be achieved, the skin will not tighten up and the nipple will not be elevated higher on the chest wall afterwards. Some type of skin excisional chest wall tightening is needed.

When a breast lift is needed, men must be treated differently than women. Men can not have the same type of breast reduction scars since there is no mound to hide them when the lift is completed. It is the vertical scar between the nipple and the fold that would be objectionable in men.

Case Study: This 76 year-old man was bothered by the sagging shape of his chest. He did not like his appearance in shirts and felt he needed a ‘mansier’ to really hold his chest up. While he had some excessive breast tissue, his excessive skin was as much if not more of a problem.

Gynecomastia Reduction with Nipple Transposition markings Dr Barry Eppley IndianapolisPrior to surgery, his existing inframammary fold was marked as well as around his areolas. An elliptical excision pattern was then marked from one end of the inframammary fold to the other going above the nipple. Under general anesthesia, a tumescent solution was infiltrated into each side of the chest. Using power-assisted liposuction, 200cc of fat and breast tissue was aspirated from each side. The upper and lower ends of the horizontal excision pattern was incised as well as around the areolas. The intervening skin was de-epithelized. An upper chest skin flap was raised up near the collar bones on each side. The thinned out breast mound and nipple was then lifted as the skin edge of the raised chest flap was brought down over it. The new position of the nipples were marked and the overlying skin removed. The nipples were brought through and the circumareolar and inframammary skin edges were then closed to complete the reduction. The nipple transposition eliminated any need for a vertical scar.

Older Male Gynecomastia Reduction with Nipple Transposition front view Dr Barry Eppley IndianapolisOlder Male Gynecomastia Reduction with Nipple Lifts result Dr Barry Eppley IndianapolisHe had drains that were removed two days later  and the incisions remained taped for ten days as he wore a circumferential chest compression wrap. When seen at six weeks after surgery, his chest was flat and the nipples in a much more uplifted position. It would take another 3 to 6 months for the scars to completely mature and fade.

Gynecomastia Reduction and Nipple Transposition result side viewFor the man who has significant chest sagging and requires a breast lift, gynecomastia reduction with nipple transposition creates an acceptable location of the scars.

Case Highlights:

1) The older male patient often develops chest sagging that is difficult to hide and not cured by exercise.

2) With loose and inelastic skin due to age, liposuction does not produce a satisfactory gynecomastia reduction for many older men.

3) Gynecomastia reduction with nipple transposition is the most effective chest reshaping method for the older male with ‘man boobs’.

Dr. Barry Eppley

Indianapolis, Indiana

Contemporary Male Plastic Surgery Procedures

Sunday, May 5th, 2013

 

While plastic surgery always has and always will be dominated by female patients, more and more men are taking advantage of the changes that it has to offer. This is a reflection of a multitude of factors coming together including refined surgical techniques, new products and a fashion trend towards more masculinizing appearances of the face and body.

For the face, I have seen a strong trend towards the desire for more defined and strong jawlines. Men want not only a more pronounced chin but a jawline that goes with it. This includes more angular and defined jaw angles and a more straight jawline that connects it with the chin. To create this effect, more men are having a three-piece jaw implant approach of one chin and two jaw angle implants…as opposed to just an isolated chin augmentation procedure.

Men are also seeking stronger more ethnic noses as well. Men do not want smaller, dainty or upturned noses. They prefer noses that have a high, but straight, dorsal line. Even a small hump on the bridge may be acceptable if it is just a slight bump. They want a more narrow nasal tip but not an over rotated one. A straight and not too long of a nose is more important than a perfectly straight dorsal line for some men. I have done a few noses recently where the men prefered to leave just a little bump on the nasal bridge…to look better but still like their original nose somewhat.

While Botox and injectable fillers will always play a very small role in male facial rejuvenation, other slightly more invasive procedures are of more interest. A little liposuction under the chinj or along the neckline can help clean up the jawline in relatively short order. Fat reducing skin tightening devices, like Exilis, are also popular when a guy sees some neck or jowl line skin laxity developing. While the results are more subtle not the magnitude of surgery, the lack of downtime is very appealing.

Body procedures in men are becoming increasingly dominated by chest reshaping efforts. At the smallest level, the protruding nipple is a problem for men of all ages and nipple reductions are a simple and quick reduction procedure done in the office. Gynecomastia problems are often much smaller today than in the past. ‘Puffy nipples’ problems have become more common than the larger breast mound gynecomastia issues from years ago. Men simply don’t like any protrusions from their chest other than a well-shaped pectoralis chest muscle profile. Using either small cannula liposuction to reshape the pectoral outlines or creating increased muscle size by the placement of pectoral implants, men are making changes to their chest that diet and exercise can not create.

Men are becoming more familiar and comfortable with what plastic surgery has to offer. But their desires and needs are somewhat different than that of women and it is important that they seek improvements through plastic surgeons who are in tune with these more contemporary male aesthetic procedures.

Dr. Barry Eppley

Indianapolis, Indiana

Adolescent Gynecomastia and Its Negative Psychological Effects

Monday, April 8th, 2013

 

The number of gynecomastia surgeries has been steadily increasing over the past few years for a number of reasons. One of these is that more teens and older men are aware that there is a surgery for it and are not afraid to ask for it. Another reason is that smaller types of gynecomastia are being treated as the aesthetic desire for a completely flat chest, including the nipple, has become more prevalent.

The psychological embarrassment of having gynecomastia at any age is well known and begins as early as the teenage years. This is borne out by a recent published study in the April issue of the journal Plastic and Reconstructive Surgery. In this article, the researchers gave psychological tests to nearly 50 teenage boys with gynecomastia who averaged 16 years of age and compared them to teens without gynecomastia. Nearly two-thirds of them had mild to moderate gynecomastia and were also overweight. The study results showed that boys with gynecomastia had lower scores on a quality of life assessment. Even after adjustment for weight, their scores were lower for general health, mental heath and social functioning.

There are no surprises in this psychological study as I know full well how much breast enlargement of any size in a male is tremendously bothersome. And the concerns about having enlarged breasts is not just related to being overweight as many of the non-gynecomastia study patients with higher test scores were overweight as well.

Because teenage gynecomastia will often resolve as they mature, a wait and see approach is usually justified. But there is a point where its psychological impact exceeds the patience to justify waiting it out. I don’t have a magic age at which gynecomastia surgery should be done if it is particularly bothersome. Early puberty at age 12 or 13 would be too young but age 15 or 16 seems very justified in treating unremitting or only partial resolution of a problematic gynecomastia.

An aggressive approach to treating adolecent gynecomastia is warranted given its documented psychological impact. In many cases, liposuction alone or combined with some limited open excision through the areola can produce a very satisfying flattening of the chest and nipple. Given the relatively quick recovery from gynecomastia reduction and a low risk of any serious complications, the benefits of the surgery can be obtainjed fairly quickly.

Despite the psychological evidence that gynecomastia is adolescent boys has a very negative psychological effect, parents should not expect insurance to pay for the surgery to reduce it. Insuracne companies are focused on the physical or functional alterations that occur from a medical problem and gynecomastia has none. They place little to no significant that the medical condition is psychologically bothersome and thus label gynecomastia surgery as a cosmetic procedure.

Dr. Barry Eppley

Indianapolis, Indiana

Postoperative Instructions for Gynecomastia Reduction

Sunday, January 27th, 2013

 

Gynecomastia reduction surgery is done to create a flatter male chest and near zero nipple-areolar projection. It can be done with liposuction alone, by breast tissue excision through an areolar incision or both procedures combined. In some larger gynecomastias, skin may need to be removed from around the entire areola as well.

The following postoperative instructions for excisional lip enhancement surgery are as follows:

1.  Gynecomnastia reduction surgery has a minimal to moderate amount of postoperative discomfort. Pain medications are prescribed and you should take them as directed on the label, usually 2 tablets every 3 to 4 hour as needed.

2.  There will be a circumferential chest binder applied at the end of the procedure. This is to be worn fairly continuously for the first week after surgery. You may take it off the next day to shower and then put it back on thereafter.

3. In some cases of gynecomastia reduction surgery, drains will be used for a few days after surgery. These are small tubes that come out of the side of the chest and are connected to a small bulb which collects any fluids. Empty the bulb as directed and there is NO need to measure the amount of fluid that comes out. You only need to apply antibiotic ointment where the drain comes out of the skin. No dressings are needed, You may shower and get the drain wet.

4. The areolar incisions at the nipples will be covered with glued-on tapes that you do not need to remove. They will be removed in the office at your first postoperative visit. You may get them wet when showering.

5. All sutures at the areola are under the skin and covered by the tapes. They will not need to be removed. Incisions at the side of the chest for liposuction will have one small stitch that will need to be removed at your first postoperative visit.

6. Your chest will be sore for several weeks after surgery. This is not the time to be working out or returning to any chest exercises or lifting weights. That should not be done for three to four weeks after surgery.

6. You may eat and drink whatever you like right after surgery.  Focus on liquids and soft foods for the first few days after surgery.

7. After sutures are removed and the incision lines healed (several weeks), massaging the lips and stretching them gently will help make them feel softer sooner and regain their normal suppleness again.

8.   You may return to work and any non-strenuous physical activity as soon as you would like based on your comfort level.

9.   You may drive when you feel comfortable and can react normally and are off pain medication.

10. If any chest or incisional redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Consent for Plastic Surgery: Gynecomastia Reduction

Sunday, January 27th, 2013

 

Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of the various lip enhancement procedures. The following is what Dr. Eppley discusses with his patients for these procedures. This list includes many, but not all,of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.

ALTERNATIVES 

There are no effective alternatives to surgical gynecomastia reduction. There are no exercises, drugs or weight loss strategies that will work. In very young male teenagers, further physical development may cause some lessening of the size of the breasts in some individuals.

GOALS

The goal of gynecomastia reduction surgery is to decrease the size of the breast tissue to make the chest as flat as possible. This includes the overall shape of the chest as well as the projection of the nipple-areolar complex.

LIMITATIONS

The limits to the amount of gynecomastia reduction is how much chest skin exists and the size of the nipple-areolar complex. The shape of the chest will ultimately be determined by how well the overlying skin shrinks down and adapts to the reduced breast tissue. Excess chest skin, chest skin with stretch marks and a large nipple-areolar complex may fail to produce a completely flat chest based on his elasticity and the amount of skin retraction.

EXPECTED OUTCOME

Expected outcomes include the following: temporary bruising and swelling of the chest, temporary chest skin numbness, temporary vs permanent nipple numbness, permanent scars around the areola and at the side of the chest (if liposuction is used), undercorrection (residual gynecomastia), overcorrection (indentation of the nipple-areolar complex, chest skin irregularities and asymmetry if bilateral gynecomastia reduction is done. Healing of the scars and settling of any chest irregularities is a process that may take months (6 to 12) to see the very final result in many cases.

RISKS

Significant complications from gynecomastia reduction surgery are very rare but could include infection and bleeding. (hematoma) More likely complications could include aesthetic deformities such as asymmetry and irregularities of the chest skin, scar deformities of the areola and chest wall, too little breast tissue removed, too much breast tissue removed and nipple-areolar deformities.Any of these risks may require revisional surgery for improvement.

ADDITIONAL SURGERY     

Should additional surgery be required to adjust chest symmetry, remove further breast tissue, correct a nipple-areolar deformity or for scar revision will generate additional costs.

Case Study: Large Tumor Gynecomastia Reduction in Young Male

Sunday, December 23rd, 2012

 

Background: Gynecomastia is a well known condition of breast tissue enlargement that most commonly occurs in teenage and young males. Its incidence appears to be increasing in numbers based on surgeries performed for its correction although this may reflect increased awareness of surgical treatment and a fashion trend amongst young men with little tolerance for any areolar protrusion. While historically gynecomastia reduction was more frequently done for one-sided breast enlargement, it is more common today to do bilateral gynecomastia surgery. (perhaps due to the change in young male awareness of a pleasing chest appearance)

Gynecomastia reduction can be done using either liposuction removal or an open excisional approach. In some cases, both techniques are combined for optimal reduction. Which technique is needed can usually be determined before surgery by physical examination. Soft non-nodular gynecomastias can be removed by liposuction, firm masses which are almost right under the nipple-areolar complex which need to be cut out through an areolar incision. The patient’s description of their concerns is also helpful, it is just around the nipple or does it extend over a larger chest area?

The one thing that has become apparent in gynecomastia surgeries in my experience is that open excision is needed more times than not. Even in cases where the breast tissue appears soft there almost always is some nodular tissue right under the nipple. Failure to get this tissue will leave am areolar protrusion afterward that may result in the patient’s desire for revisional surgery for complete flattening. When the enlargement of the breast is mainly nodular, liposuction is not going to be effective at all.

Case Study: This 20 year-old college student had a unilateral left breast enlargement since he was an early teenager. Contrary to earlier medical opinions, it never resolved on its own. While the breast development was significant (a true B-cup), he never underwent surgery in high school due to his active participation in sports year round. While it always bothered him tremendously, he lived with it and covered it up as much as possible. Now that he was in college, he no longer did any organized athletic activities,m so he had the time to finally treat his gynecomastia.

Physical examination before surgery showed a remarkably-sized breast mound for a male that felt fairly firm but without any palpable nodules. Under general anesthesia, his gynecomastia was initially treated by liposuction with minimal fat extracted. It became apparent that much of the breast mound was a large fibrotic mass through which the liposuction cannula would not penetrate. Then through a lower areolar incision, the entire mass was excised using a facelift scissor technique. The large mass was able to be delivered in one large piece through this small 2 cm incision. This produced a complete and immediate resolution to his entire breast mound enlargement.

After surgery, a drain was kept in place for three days and then removed. When seen at three weeks after surgery, no fluid accumulation had occurred and the chest was completely flat and matched the opposite side. No areolar inversion was seen. Pathology of the removed specimen showed benign breast tissue.

This case represents an uncommon form of gynecomastia in which the entire breast mound was one large fibrous tumor. Removal of it produced a dramatic one-stage cure without fluid accumulation and good skin retraction back down onto the chest wall.

Case Highlights:

1)      Large unilateral breast development in young males may represent a single solid tumor rather than simple breast tissue hypertrophy that makes up most gynecomastias.

2)      Firm nodular gynecomastias will not respond to liposuction extraction and must be excised by an open technique

3)      Excision of even very large solid gynecomastias can be done through a small areolar incision without the need for visible scars on the chest skin.

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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