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Posts Tagged ‘lip lift’

Case Study – Female Subnasal Lip Lift

Tuesday, December 8th, 2015

 

Background: There are a variety of upper lip enhancement procedures from injectable fillers to lifts. By far lip lifts represent just a minority of cosmetic lip procedures done and, as a result, is a frequently misunderstood operation. A subnasal lip lift can be confused with a lower lip advancement because they are both excisional procedures. But a lip lift truly does lift the lip up while a lip advancement pushed up the vermilion from below.

The appeal of a subnasal lip lift is that the scar rests in a relatively concealed area along the base of the nose. When performing the procedure it is important to recognize that the interface between the base of the nose and the lip is not a straight line. It is a multiply curved interface hence the urban name for a subnasal lip lift…the bullhorn lip lift. But despite the appeal of the scar location, a lip lift has its limitations and it is important that patients understand what they are before undergoing to the operation.

By removing skin from under the nose, the vertical distance of the upper lip is effectively shortened. That is its primary effect and by so doing there will be an increase in the fullness of the cupid’s bow vermilion. But beyond the centrally located cupid’s bow the vermilion along the sides of the lip will not change. Draw a vertical line down from the sides of the nostrils and any part of the lip lateral to it will be unaffected by a lip lift. Also, contrary to popular perception, a lip lift will not increase upper tooth show. That area is simply too far away from the point of pull to be affected. To improve tooth show at the time of a subnasal lip lift, a lower horizontal vermilion excision is needed at the same time.

Case Study: This 44 year female felt she had a long upper lip and wanted it shortened. She also wanted the lip lift to look natural and not be overdone. The length of the upper lip along the philtral columns was 18mms.

Cali Lip Lift results front view Dr Barry Eppley IndianapolisCali Lip Lift results oblique view Dr Barry Eppley IndianapolisUnder local anesthesia, a bullhorn pattern of skin excision was marked under the base of the nose and removed. An excisional width of 4.5mms was made along the philtral columns, making it 25% of the total upper lip length. At three months after the procedure the subnasal scar redness is fading nicely and the stability of the lip lift maintained at 14mms of philtral column length.

Cali Lip Lift results side view Dr Barry Eppley IndianapolisA subnasal lip lift has a central upper lip effect that is limited to the skin component area of the prolabium. The skin distance of the upper lip is reduced and the cupid’s bow is more pronounced. But the sides and bottom area of the central upper lip remained unchanged.

Highlights:

  1. A lip lift is a lip shortening procedure that affects the central part of the upper lip only.
  2. A well placed subnasal lip lift scar curves in and around the nostrils and columella and is not a straight line.

3) A subnasal lip lift will usually not increase upper tooth show and will not increase the fullness of the sides of the lip.

Dr. Barry Eppley

Indianapolis, Indiana

Nips and Tucks for the Aging Mouth

Thursday, May 6th, 2010

The mouth area is not spared as the rest of the face ages. Most women focus on changes in the neck and jowls as well as around the eyes. And while there are some well known procedures that make great improvements in these facial areas (facelift, blepharoplasty), how to improve the mouth area is not so standard and well known.

The mouth looks older as a result of  numerous anatomic changes. The upper lip will get longer and thinner. The corners of the mouth start to turn downward. From the downturned corners, grooves extend towards the jaw line creating marionette lines. The nasolabial folds or lip-cheek grooves which ‘parenthesize’ the mouth become more pronounced and deeper. Vertical wrinkles develop on both the upper and lower lip running into the pink (vermilion) of the lip, often resulting in lipstick which bleeds into them.

While wrinkle reduction around the mouth can be done with various laser methods and injectable fillers, improvement in that alone is often not enough to make an overall youthful change. Like the rest of the face, the mouth area can benefit from various ‘nips and tucks.’

There are some small but very effective perioral (mouth) procedures that can create some subtle but significant lifting and upturning of the lips. Youthful changes come from having more exposed vermilion and a more even or horizontal smile line. (mouth corner to corner line) These perioral rejuvenation procedures include lifts of the lip, corner of the mouth, and smile lines.

A long upper lip can be shortened with an upper lip lift, often known as a subnasal or bullhorn lip lift. It is done to primarily shorten the aged long lip, but a small amount of increased upper teeth may result when the lips are slightly open. By using a wavy or bullhorn-shaped ellipse of skin under the nose, the central part of the lip is upturned. The key to this procedure is to remove skin only. If one removes any of the deeper muscle, the upper lip will get tight and look unnatural when smiling. There will be a few millimeters or relapse over the first six months after the lift.

 Rather than done under the nose, lip advancements are done lower at the actual border of the upper lip. It creates a different and more complete upper lip lift because it effects the entire horizontal width of the upper lip. Lip advancement achieves improved exposure of the vermilion and eliminates the bottom end of the vertical lip lines. A small strip of skin abobe the lip line is removed to make the whole upper lip look bigger as well as shortens upper lip length.

The corner of the mouth lift is the ‘cutest’ of the perioral procedures because it removes such a small amount of skin to achieve its effect. Its intent is to elevate the down turned corners of the mouth so that the smile line (lips at rest) becomes more horizontal. This makes one’s mouth appearance more perky. This is done by removing a small triangle or heart-shaped piece of skin above each corner which changes the location and angulation of the sides of the mouth.

Beyond the corners of the mouth, folds of skin may drape downward. This loose skin can be improved somewhat by a facelift but some patients may not want to invest that much effort for improvement. These “parachute” folds of skin can be removed, placing a fine line scar in the lower end of the cheek-lip groove. It also creates a small amount of  lifting of the corners of the mouth as well.

One of the great benefits to these procedures is that they can be done in an office setting under local anesthesia. This keeps the cost down compared to more extensive surgery. They can be combined with injectable procedures such as Botox and fillers as well as laser and light skin treatments. They are a great compliment to be done with a facelift, either before or after.

Nips and tucks of the mouth area will result  in some small scars as a trade-off for their rejuvenating effects. Minor scar revision and touch-ups may occasionally be needed as the margin of error or forgiveness of any scar abnormality is quite small in the very visible mouth area.

Dr. Barry Eppley

Indianapolis, Indiana

Common Questions about Mouth Rejuvenation

Sunday, February 14th, 2010
  1. What happens to the mouth area with aging?

Like the rest of the face, aging affects the mouth by atrophy and sagging. This is manifest by lips that get thinner, the development of vertical lip wrinkles, corners of the mouth that turn down, and the appearance of marionette lines or folds. These changes collectively can give the mouth an invert U-shape or frowning look, making one look sad or even angry.

Rejuvenation of the mouth area is based on a variety of techniques including volume restoration (injectable fillers), lifting techniques (skin excision and rearrangement) and wrinkle reduction. (skin resurfacing)  

2. How do you improve thinning lips?

The most common and simple method for lip augmentation is through the use of synthetically-created injectable fillers. While over a dozen such fillers exist, not all are appropriate for injection into the lips. Those fillers based on hyaluronic-acid (hyaluron, a sugar molecule) produce a natural and soft fuller lip that is very well accepted. Based on their concentration, they may last anywhere from four to eight months between injection treatments.

Fat is another option for lip injection. It is generally done in the operating room when other plastic surgery procedures are being done. While it is the most natural lip filling material, it’s downside is that its survival is not predictable and some resorption does occur.

3. Are there any permanent lip augmentation procedures?

The appearance of a larger lip that is permanent is possible by changing the amount of visible vermilion. (pink part of the lip) This can be done by removing a strip of skin above (upper lip) or below (lower lip) where the vermilion meets the skin. The vermilion is then moved up or below to cover where the skin was removed. This produces a permanent enlargement of the lip…at the price of a fine line scar along the lip line. This procedure is known as a lip or vermilion advancement and can be used on either the upper or the lower lip.

The upper lip vermilion can also be lifted without removing skin directly above the lip line. By removing a strip of skin from beneath the nose, rather than lower at the lip line, the central part of the upper lip can be lifted to show more vermilion. Known as a lip lift, it can only be used on the upper lip (there is no nose on your chin!) and it does not lift the sides of the upper lip which are outside of the nose.

4. Can a facelift help get rid of my mouth frown?

Downturning of the corners of the mouth is a common perioral sign of aging. Although there are some people who have it naturally even when they are young. Contrary to what many people believe, it is not possible to lift the corner of the mouth (commissure) with a pull that comes from the side. (lateral) In addition, the point of pull is far away (by the ear) from the commissure so it would have little effect on it even if it was from the right direction.

5. What is the best way to get my corners of mouth lifted back up?

Changing the orientation of the corner of the mouth to any significant degree requires a procedure that is done directly on it. Known as a corner of the mouth lift (COML), a triangle of skin is removed just above the commissure. Some plastic surgeons remove a triangle, others remove a heart-shape piece of skin. Either way, the corner is moved up to where the skin was removed. This little procedure can make a big difference in where the corner of the mouth is located. The COML is a small but powerful procedure that,if not done carefully, can actually turn the mouth corners up too far creating what is known as a  joker’s smile deformity.

If the corner’s of the mouth is not turned down too severely, the use of injectable fillers can have a mild lifting effect. 

6. What can improve the lines that run down from the corners of my mouth?

Vertical grooves or folds develop from the corners of the mouth down to the jawline because of the development of jowling. Loose and sagging skin falls forward toward the mouth and chin where it bunchs up against the more fixed skin of the chin. This creates a mound or fold which gives the appearance that there is a groove or line in front of it. This also makes any downturning of the corner of the mouth look worse.

Injectable fillers can certainly soften the appearance of the marionette lines, although they are only temporary. They can also be improved from the pull of a facelift and such tissue repositioning directly treats the cause of the problem.

In older patients who do not want a facelift or who have had one and have developed recurrent marionette lines due to inelastic skin, one can undergo a direct fold excision. A lenticular-shaped segment of skin is removed directly along the fold. While it does create a fine line scar, it is very effective at reducing its appearance.

7. How do you treat lip wrinkles?

Lip wrinkles develop as a direct result of the underlying action of the orbicularis muscle. When combined with thin skin, the appearance of vertical lip lines is inevitable. Small amounts of Botox can be used to soften the muscle action but too much will affect the way one smiles. Therefore, it is more effective to either try and fill the larger wrinkles directly and/or resurface the lip skin. The best results come from the simultaneous use of both methods. Laser resurfacing is a commonly used method that will soften the depth of most lip wrinkles. Whether fractional laser resurfacing is better than traditional laser methods is a matter of current discussion. Old-style dermabrasion is a time-proven technique for very deep wrinkles that is more effective than laser resurfacing in these more severely wrinkled lips. 

Dr. Barry Eppley

Indianapolis, Indiana

Common Questions about Lip Augmentation and Lip Lifts

Tuesday, January 19th, 2010

1.      What is the difference between lip enhancement and lip augmentation?


Most people, including plastic surgeons, often use these lip terms interchangeably. While one could argue no matter what you call it, the idea is to make the lip look better… which usually means fuller. However, there are some subtle differences between lip augmentation and enhancement. Lip augmentation adds or restores fullness to the lips. This can be done with either temporary injectable fillers or permanent materials. Enhancement procedures do not really add fullness, although they do make the lip look bigger. These are  skin removal procedures that change the position and shape of the vermilion, thus enhancing the appearance of the lip.

 

2.      What is the best injectable filler for lip augmentation?

 
There are nearly a dozen injectable filler materials but not all are appropriate for the lips. The lips are unique in that they are not covered with skin but a thinner and more sensitive tissue. (vermilion) In addition, the lips must remain very flexible and soft. For this reason, the best injectable filler for the lips is either collagen-based or composed of hyaluronic acid derivatives. (e.g., Restylane, Juvaderm) Fillers that contain particles, resorbable or permanent, are more likely to cause reactivity and delayed reaction problems.

 

 

3.      Are there any permanent options for making my lips bigger?


The desire for a permanent lip ‘filler’ is a common one and there are some options. There is no easy injectable method, however, for lip augmentation that is absolutely permanent. None off-the-shelf injectables are permanent. At best, some may last as long as nine to twelve months.

 

Fat is often injected into the lips because it is your own tissue and particularly if one is in the operating room for other procedures anyway. The downside to fat injections into the lips is that its survival is unpredictable. I have seen some patients in my Indianapolis plastic surgery practice who have done really well with it while many others have gone on to near complete resorption. It’s worth a try if you are already in the operating room but any long-term retention should be thought of as a bonus, not an absolute. It is not a procedure that can be done in the office.

 

Implants have been tried over the years in the lips as a permanent filler, of which Gore-Tex (polytetrafluoroethylene) is the most commonly used. Different variations and designs of this material have been used over the years. The best one that I have used is Advanta, which is a very soft and spongy tube of various diameters. When well placed deep in the lip, it can be a very reliable and effective method for permanent lip enlargement.

 

4.      I have very thin lips that have no shape. I have tried injectable fillers but they didn’t work. Is there anything I can do?

 

Injectable fillers work when there is sufficient vermilion or lip tissue to expand. In very thin lips, fillers can often make for an unnatural ‘duckbill’ look because there is not enough vermilion to expand out naturally. Unless the filler is done in small amounts, the lips can assume an unusual bloated appearance.

 

One option for very thin lips is to treat the underlying problem, not enough vermilion exposure. This can be done through two types of skin excisional or removal procedures. The vermilion advancement is done by removing a strip of skin directly along and above the lip line and moving the vermilion upward (upper lip) or downward. (lower lip) For the upper lip, the cut out of skin can be done so that the cupid’s bow is more accentuated with a more defined shape. The vermilion advancement has the advantages of being able to affect the entire lip, from corner to corner, and being truly permanent. Its disadvantage is that it creates a fine line scar at the junction of the lip and skin.

 

The other vermilion changing procedure is the lip lift, also known as the ‘bullhorn’ lip procedure.In an effort to avoid a lip scar, the skin removal is done right under the nose placing the scar in the hidden crease between the lip and the nose. By removing skin in this area, the vermilion of the lip below is pulled up increasing its pout. The disadvantages of the lip lift is that it affects only the central part of the lip and it will lose some percent of the created lip fullness after surgery. (due to gravity)

 

5.      Can lip procedures be done in the office?

 

Any type of lip procedure, injection, implant, or surgery, can easily be done in the office. The lips can very effectively be numbed by the injection of local anesthetics, just like in the dental office. For patients who are anxious about those type of injections, oral sedation medications can be provided which will definitely alleviate any apprehension that one may have. If you take sedation, you will need someone to drive you home.

 

Injection procedures take about 15 minutes to perform. The placement of lip implants takes about 30 minutes. Lip lifts or lip advancements will take about 60 to 90 minutes to perform.

 

6.      Is there much pain and swelling after lip augmentation procedures?

Depending upon the technique used, the amount of swelling and discomfort afterwards changes. Injectable fillers result in no pain and very little swelling after. Lip implants cause considerable swelling for a week or so and have some mild discomfort from fullness and stiffness. Lip lifts and advancements cause much less swelling than implants and virtually no pain.

Recovery from lip procedures is essentially ‘social’, meaning how you look. There are no restrictions of any activities including eating and drinking.

Dr. Barry Eppley

Indianapolis, Indiana

 

 

The Concepts of Facial Feminization Surgery

Wednesday, July 15th, 2009

Facial feminization surgery (FFS) is an assortment of plastic surgery procedures that changes a genetically male face to bring its features closer in shape to that of a female. FFS is sought after largely by transsexual women and psychologically it is often more important than sex reassignment for social integration. FFS works on both the bone and the overlying soft tissues and, as a result, has much of its origins from craniomaxillofacial surgery as well as traditional cosmetic plastic surgery. For this reason, those few plastic surgeons who perform FFS usually have such backgrounds.

 I like to think of FFS as three potential zones of change… upper, middle, and lower face. Within these zones, the primary plastic surgery procedures include frontal hairline alteration/brow lift, forehead/brow recontouring, rhinoplasty, cheek/submalar augmentation, upper lip enhancement, jaw/chin modification, and thyroid cartilage reduction. To no surprise, many of these changes deal with facial prominences ….lessening the amount of bony and cartilage convexities. Each patient usually has one primary zone for change and two others for some modification. In essence, every patient has at least one dominant facial feature which must be changed onto which other procedures are complementary. While it is true that it takes many changes to create a  more convincing change of appearance, one or two of the procedures usually has a dominant effect.

FFS, philosophically, consists of a combination of reconstructive and cosmetic plastic surgery procedures. Changing the bony prominences, or changing the skeletal foundation of the face, is based more on the reconstructive heritage of the procedures. Modifying or lifting of soft tissues of the face encompasses more standard cosmetic procedures used for a primary anti-aging or more youthful effect.

Every FFS procedure has differing levels of difficulty and degrees of change. Some are easy to go through, while others are more extensive with prolonged swelling and social recovery. The procedures of tracheal shave, upper lip lift and cheek implants are very effective and relatively simple with little downside or complications. More difficult procedures are forehead contouring and brow reduction and the alteration of the chin and jawline. These have issues of surgical access and bone manipulation, of which makes for more swelling. Rhinoplasty and standard plastic surgery procedures such as facelift, blepharoplasty or browlift, falls between the two with a few weeks of relatively easy recovery.

The key to a successful FFS outcome is to plan a combination of facial procedures that can most effectively soften one’s appearance and make for a convincing change. There is no one standard set of procedures that will work for every patient. While some patients need just three or four, others may benefit by twice that many. Most patients have a good feel for what they think will be effective and a careful discussion and computer imaging is essential to create a reasonable working list of procedures. While some patients may want the most change possible by number of procedures, it is important to have a realistic outcome and work within one’s budget for maximal facial change.

Dr. Barry Eppley
Indianapolis, Indiana

 

Lip Advancements and Lip Lifts for Lip Enhancement

Wednesday, April 1st, 2009

Lip augmentation, making the lip bigger, is most commonly and successfully done with injectable fillers. Regardless of the injectable filler used, its instantaneous result is very satisfying in most cases. The use of injectable fillers in the lip, however, is predicated on one important concept…that there is enough vermilion (pink part of the lip ) to expand. For that is what fillers so, expand the soft tissue of the lip.

 There are some people, however, that do not have or show a lot of lip vermilion. Trying to expand these thin vermilions with filling agents can create a ‘duck lip’ appearance, which creates more horizontal projection rather than a vertical increase in exposed vermilion which creates a bigger lip.

 For these types of thin lips, the only way to really increase the size of the lips is to physically move the vermilion. These two surgical options for lip lifting are the vermilion advancement (lip advancement ) and the subnasal lip lift. (bullhorn or gullwing lift) Both are simple operations but they differ in location on the lip where they are performed and in what they can achieve. They are very similar in that both result in scars.

The vermilion advancement is the removal of a strip of skin to allow the vermilion to move up (in the upper lip) or move down. (in the lower lip) This simple but powerful procedure directly results in more vermilion exposure by the amount of skin removed. In the upper lip, the shape and accent of the cupid’s bow can be designed as part of the cut out. While this does leave a fine line scar at the junction of the vermilion and skin, this procedure affects the entire length of the lip from corner to corner. And its result is permanent.

The subnasal lip lift removes skin under the base of the nose in a gull wing or bullhorn fashion. This places the scar in a well hidden area. But it only creates more of a central upper lip pout as the skin excision is limited to the width of the base of the nose. Therefore, thin lips that taper down to the corner of the mouth will be unchanged. Plus, there will be some loss of the central pout over time as the upper lip relaxes somewhat. For this reason, the subnasal lip lift needs to be overcorrected to some degree.

Surgical lip enhancement is a most effective procedure that offers a permanent solution to small lips. Because of their scars, I do not perform them as the initial procedure for most thin lipped patients. One should undergo an initial injectable filler to ‘prove’ that this temporary procedure will not achieve the patient’s goals. This makes the decision to accept lip scars more acceptable.

In my Indianapolis plastic surgery practice both procedures can be done under local anesthesia, if desired, in an office setting. Other than some temporary swelling, there is very little discomfort and no restrictions after in regards to eating or the wearing of lipstick.

Dr. Barry Eppley

Indianapolis, Indiana

The Subnasal Lip Lift

Monday, November 19th, 2007

Lifting the Upper Lip from the Nose!

The most dramatic method of increasing the size of the upper lip is the lip advancement procedure. To expose more pink of the upper lip (which can dramatically increase its size), skin is removed from just above the pink portion of the upper lip. This cut out pattern is made like a ‘cupid’s bow’ (which is often necessary given that many small upper lips have little definition and are quite ‘flat’) which provides nice shape to the upper lip in the central most pouty area. This procedure, however, is not that commonly done as injectable fillers do very nicely for most people and do not leave a scar. They are, of course, not permanent. However, in those with a very thin upper lip particularly older patients who also have some upper lip lines and wrinkles, the lip scar may well be a reasonable trade-off ffor the permanency of the result.

Another option to lift the upper lip is not to place the scar at the upper lip but to place it beneath the nose. This is called a subnasal lip lift. In this procedure, the cutout of skin is done right under the nose (resembling a bullhorn shape), so when it is closed, the scar lies in the natural groove at the base of the nose. This does hide the scar well. As the width of the cutout of skin is just the width of the nose, only the central portion of the upper lip (cupid’s bow area) actually gets lifted. The sides of the upper lip stay the same as they get no effect of the central upward pull from the skin cutout. This is the other difference that distinguishes the subnasal lip lift from the more traditional upper lip advancement. Which operation is best depends on what upper lip problem the patient has and where they can ‘deal’ with the scar placement.

Dr Barry Eppley

Indianapolis, Indiana

Lip Lifts – An Alternative to Injectable Fillers

Wednesday, November 7th, 2007

There are many injectable options for temporarily enhancing the lips and the areas around them. Hyaluronic acid-based fillers (e.g., Juvaderm, Restylane) are the most commonly sued currently and can last up to six months.  Even fat injections can be used but they have an unpredictable amount of volume survival in the lips and may even last than the injectable fillers if resorption is complete.

 For long-term results, there are lip lift procedures that produce a permanent solution. These are best used in either the patient whose teeth aren’t visible when they smile, whose lips have gotten longer with age, or those patients have such thin lips that lip fillers make them look more ‘duck-like’. A lip lift can reveal more of the pink part of the lip (vermilion) that is the hallmark of a youthful look. In the procedure, a small piece of skin is removed either under the nostrils or just above the upper lip to produce a three to four millimeter vertical lift of the lip. This is a very powerful technique that consistently works. A lip lift can be performed in the office under local anesthesia. Sutures are removed after a week and all bruising and swelling are gone in seven to ten days.

One cautionary note: scars are a trade-off associated with lip lifts. While they are very fine, they are present nonetheless. In those women who regularly wear lipstick out of the house, this is not usually a big concern. Usually I prefer to trial a patient on lip fillers first, before proceeding with a lip lift. This is reversible, lip lifts are not. This helps ‘qualify’ the patient for a lip lift and ensures that a filler may not be the best option for their lip concerns.

Dr Barry Eppley
Indianapolis, Indiana

Upper Lip Wrinkles – Difficult Problem, Multiple Treatments

Wednesday, October 31st, 2007

Upper Lip Lines – A Not So Simple Problem

One of the seemingly ‘simple’ but most difficult cosmetic facial problems that I see in my practice is the woman with upper lip lines. Like dark spots on the hands, these telltale signs of aging are very disturbing for the aging woman. Ironically, I have seen them even in some younger patients, so it is not always a sign of aging! While frequently thought of as being due to smoking or excessive sun exposure (and these certainly are important contributing factors), it is as much due to the native thickness of one’s skin (racial type) as well as how one moves their face with expressions than anything else. These can be easily shown by looking at African-Americans, Hispanics, and people of Middle Eastern or Pacific Rim descent who have much thicker skin (more dermis and elastin fibers), it is very rare to ever seen upper lip lines in these ethnicities. So, in many ways, this is a more significant problem in fair-skinned people of northern European descent, particularly in blondes and redheads.

The two basic treatment approaches are injectable fillers (JuvaDerm or Radiesse) placed directly into the vertical lip lines or laser skin resurfacing. Often I will do both together, at the same time, to get the best result. These are simple office procedures that are done under a local anesthetic to numb the whole upper lip through traditional dental block techniques. Neither of these approaches ‘cures’ the problem, but significant improvements can be obtained. To maintain the result, it is usually necessary to have the treatments twice a year.

An interesting ‘new’ treatment approach is that of medical needling. This is actually an old technique that may be coming back into popularity. Essentially, a roller with many fine needles is run over the upper lip (like aerating your lawn), creating fine tunnels into the deep part of the skin. Topical vitamin C preparations are then applied after so that they may ‘soak’ into the tunnels and stimulate the underside of the skin, causing it to thicken. So rather than burning the top layer of skin off (laser resurfacing) to soften the wrinkles, this approach focuses on stimulating the skin to thicken. It is being called Transdermal Collagen Stimulation therapy. Whether this is better than fillers or laser resurfacing remains to be seen, but I will be able to have a better idea in another year or so after treating and following some patients.

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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