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 ‘palstic surgery’

Plastic Surgery’s Did You Know? Attitudes Towards Having Plastic Surgery

Sunday, December 23rd, 2012


With over 9 million cosmetic surgery procedures performed last year in the U.S. it is fair to say that considering a physical improvement today is as common as choosing a hair color or a brand of toothpaste. Twenty-five years ago cosmetic plastic surgery was considered extreme and reserved for a privileged few. What a difference a few decades of social change have made in the attitude towards the whole concept of plastic surgery. Everybody is aware of its existence and most certainly has an opinion about it. While celebrities and untoward events in cosmetic surgery make the news, everyday decisions are made by the average person to change a facial or body feature that is significant for them even though it does not end up as a YouTube video. A past survery conducted in the U.S. indicates that one-third of responders were in favor of having plastic surgery on themselves. When asked if the procedure was done for free, those favoring plastic surgery doubled to nearly two-thirds of responders. A more recent survey in the U.K. showed that nearly 50% of those surveyed would opt for surgery if it was offered for free of charge. These surveys show that the attitude towards plastic surgery is highly influenced by the economics of it. Those who can afford it have more favorable attitudes than those who can’t. Although I would question if this holds true for the youngest generation of teenagers and young adults who have grown up as plastic surgery has rapidly expanded and see it as a more normal experience than older generations.

Case Study: Reduction of the Prominent Nipples in Men

Saturday, August 28th, 2010

Background:  The nipple, technically known as the nipple-areolar complex, is present in both men and women. While it has a functional role in women, it is a non-functional vestigial structur in men. While a man’s chest would look strange without it, it aesthetically should blend in and be relatively non-prominent. Changes in the size and shape of the nipple are undesireable.

One of the undesireable topographies of the nipple is when the nipple is too long or enlarged.  Rather than having a fairly smooth chest contour across the nipple’s surface, a prominent nipple creates an obvious two-tiered structure. This not only sticks out and is obvious when one is bare-chested but protrudes through shirts. ‘High beams’ in men is particularly bothersome to most men and is a source of embarrassment. Concerns about a prominent nipple can affect what type of clothes to wear.

Case: This is a 24 year-old male who was concerned about his prominent nipples. He said they were not always so and had appeared just a few years ago. They stuck out all the time and he was not comfortable wearing any type of form fitting shirt. Exposure to cold made them stick out even further.

In discussion about their reduction, he was not concerned about whether any feeling remained in them. He was most concerned that they were as flat as possible and did not have any noticeable scarring. Two techniques for nipple reduction were reviewed, wedge excision and circular or donut reduction. Wedge excision nipple reduction is essentially an amputation method where it is completely removed. It will make the nipple completely flat (because it is gone) but there will be no tiny mound or slight raised area where the nipple would normally be. The invisible scar will have the same tissue characteristics and scar as the surrounding areola. The circular method removes a ring of nipple tissue at its base and shortens it. This will not make it flat and will leave a smaller raised nipple mound. Feeling in the nipple may be maintained after.

Under local anesthesia in the office, the nipples were removed by wedge excision that were vertically oriented. The excised area was closed with small dissolveable sutures. The only dressings applied were glued on tapes that only covered the diameter of the areolas. The entire procedure was completed in 30 minutes.

The results are immediate without swelling or bruising. There are no restrictions from any activity after surgery. One can shower, swim and workout the very next day. The results will be permanent as the nipple can never grow back.

For those men, young or old, that are bothered by a long or prominent nipple can quickly solve this problem without pain, recovery, or prominent scarring.

Case Highlights:

1)      Nipple protrusion in the male is a source of embarrassment and usually develops after puberty in most cases.


2)      The wedge excision (amputation) technique of nipple reduction is usually preferred as it assures that the nipple will be completely flat.


3)      Nipple reduction surgery is a simple office procedure done under local anesthesia. There is no recovery or physical restrictions after the procedure.


Dr. Barry Eppley

Indianapolis Indiana

The Myth of Facial Liposuction

Saturday, November 28th, 2009

Liposuction is a very effective method of fat removal. While it can be used in almost any location of the body where there is fat, it does have limitations. And when applied to certain fat areas, it may even have the opposite effect of an undesired result.

The face is one such area where the concept of liposuction is largely more theoretical than practical. While the face does have fat below the skin, it is not easily removed like that in the trunk or extremities. Facial fat is more fibrous and has branches of the facial nerve lying deep to it. There are few very discrete collections which can easily be removed with the exception of the buccal fat pad and some of its numerous extensions.

Plastic surgeons frequently advertise and perform neck liposuction. And while the neck is part of the face, most patients do not think of the neck when they envision the concept of facial liposuction.

When you combine what is contained in the buccal space with the subcutaneous tissues in the neck, these are the only two facial areas where contouring can be done through fat removal. The neck can be liposuctioned while the buccal fat pad can be directly extracted through a small open incision. Removal of any other facial fat areas through liposuction  is not only ineffective but can cause a lot of tissue trauma and prolonged swelling.

When liposuction first became widely used in the 1980s and 90s, facial liposuction was both advocated and written about. It was used to try and reduce facial fullness in the lateral face and even reduce the prominent mound of tissue that develops above the nasolabial fold with aging. It was proven to be ineffective and has since become largely abandoned as a treatment for facial fullness.

For those seeking to reduce their ‘fat’ face or to deround their facial appearance, liposuction is not the answer. It simply can not do what can be done for the circumference of the thigh or the waistline. One cannot deflate the face so to speak.

Improving the shape of a very full and round face does include some fat removal which is accessible, the buccal and neck fat. But fat removal alone is inadequate as it can only change some of the contour. If a full neck is all that bothers someone, then liposuction alone is a good treatment. But for more total facial sculpting and definition creation,  it must be combined with other procedures that bring out or highlight facial prominences such as the chin, cheeks, or jaw angles. Using implants in these facial convexity areas can help bring shape to an otherwise amorphous face.         

Dr. Barry Eppley

Indianapolis, Indiana


Injectable Facial Rejuvenation Treatments on Indianapolis Doc Chat Radio Show

Sunday, November 8th, 2009

On this week’s Doc Chat Radio show on WXNT 1430AM in Indianapolis from 12:00 to 1:00PM on Saturday afternoon, hosted by Dr. Barry Eppley Indianapolis plastic surgeon,  the very popular topic of injectable anti-aging and facial rejuvenation treatments was presented. With a guest facial plastic surgeon, the numerous injectable treatments of Botox and Injectable Fillers and their role in facial rejuvenation and enhancement was discussed.

In the past, cosmetic plastic surgery was all about having surgery to reverse the effects of aging on the face.  Time was, once you were scared enough by what you saw staring back at you in from the mirror every morning, facelifts, eye tucks and the like were routine procedures with all of the associated bandages, expense and gossiping tongues.

Since 2002, non-surgical injectable alternatives have burst onto the anti-aging scene in ways that never could have been predicted. The concepts of muscle paralysis, plumping fillers, and fat dissolving agents have made it possible to have smooth foreheads, fuller lips and softer laugh lines, and maybe some subtle tightening of the jowls and neck in a few simple visits to the doctor’s office.  Unlike surgery, injectable facial treatments are as much about the prevention of the effects of aging as they are about reversing what has already taken place.

Along  with this explosion of available injectable treatments have come the inevitable, unbelievable marketing claims, and so-called ‘expert’ injectors. But, like much of what you may read on the internet, in popular magazines, and hear in commercials , what can you really believe? How do you separate reality from marketing hype? How can you decide where-or if-injectable treatments fit into your needs and desires?

Today’s programs discussed all of these issues to help the listener discern whether and which of the injectable beauty treatments is right for them.

Plastic Surgery and Injectable Botox and Filler consultations with Dr. Eppley can be arranged by calling his Indianapolis suburban area facilities at IU Health North or IU Health West Hospitals at 317-706-4444 or sending an email inquiry to: info@eppleyplasticsurgery.com.

The Top Ten Instructions After Your Rhinoplasty Surgery

Monday, August 18th, 2008

Rhinoplasty (nosejob) surgery can make a dramatic difference in the appearance of one’s face and an overall improvement in self-image. What to expect and how to take of your new nose right after surgery is an important part of the recovery process. Here are my top ten instructions that I provide to my rhinoplasty patients.
1. After the operation, you nose will be covered by tapes and a splint for both
protection and to keep down the amount of swelling.dressings. These will stay
in place for one week and be removed in the office. It is ok to get it wet in the
shower as it will not easily come off.
2. Nasal packing is rarely used and is not a routinue part of the nasal dressing.
A gauze pad (drip pad) will be secured on the upper lip to catch any oozing
from the nose. Change this as needed. It does not need to be used after the
first few days.
3. The use of an ice pack to your nose and eyes for the first 48 hours will help
limit the amount of swelling and bruising that may develop. (if your bones were
broken as part of the rhinoplasty operation) If not, then ice packs will not be
4. Keeping your head elevated for the first week after surgery is also helpful in
reducing swelling and making your breathing easier. This can be done by
sleeping in a recliner or on 2 to 3 pillows. Do not bend over as this may cause
5. Difficulty breathing through the nose can be expected immediately after
surgery due to swelling of the internal nasal linings. Saline (salt water) nasal
sprays may be started after the first postoperative week to moisturize the
lining and loosen any crusts. This is only important if you have had simultaneous
surgery on the inside of the nose to improve breathing.
6. In certain types of rhinoplasties (open), small skin sutures will be placed in
the columella. (skin between the nostrils)These are dissolvable and do not need to be
7. Avoiding blowing your nose for 3 weeks after surgery so as not to loosen any
clots and cause bleeding.
8. Eyeglasses may be worn across the bridge of the nose when it feels
9. Avoid strenuous exercise such as jogging and other sporting activities for
3 weeks after surgery so as not to disturb nasal healing.
10. Once the obvious swelling and bruising are gone within the first few weeks, the
nose will still continue to change shape over the next several months. Be
patient with the results until the final shape is obtained.
Dr. Barry Eppley

Indianapolis, Indiana

Different and Unusual Procedures in Plastic Surgery

Thursday, July 3rd, 2008

As plastic surgery has worked its way into the mainstream of American society, it is no surprise that procedures are being done today that were not imaginable a mere ten years ago. And I am not referring here to surgery wonders of technology and scientific advancement (although that exists also), I am talking about what patients desire to have done. This is a reflection and commentary on contemporary American culture, not necessarily how far the science of plastic surgery has come.
As I talk with friends and colleagues about some of the plastic surgery procedures that I do today, I have come to realize that some of them may be considered ‘unusual’ . Certainly, some of them are different than traditional perceptions of plastic surgery. Many are relatively minor procedures that can be performed in the office and probably reflect the trend toward treating smaller concerns. They are the opposite of bariatric plastic surgery, for example, where a new subspecialty of plastic surgery has developed to treat the sequelae of gastric bypass and massive weight loss patients. The emergence of larger plastic surgeries and big procedures doesn’t occur very often but every few decades. But the emergence of more minor plastic surgery procedures occurs much more frequently. Here is a list of my unusual plastic surgery procedures that have emerged and become popular in the past decade.
Buttock Implants/Fat Injections – The appeal of a larger, more rounded buttocks is certainly a body image of recent note. Whether done by transferring fat from one body part to another or by an implant placed through an incision near the tailbone, the desire for buttock enhancement could not have been envisioned ten or twenty years ago. There is actually a great number of patients who would like buttock reduction but no single good procedure exists for that problem.
Labial Reduction – Whether due to discomfort from rubbing on clothes or during inetrcourse or simply to ‘look better’, reducing the size of a woman’s labia is now a common procedure. One would never have thought that such a concealed part of the anatomy would create a demand for treatment. A very simple and effective procedure, labial reduction restores the outer appearance of the vagina to a more youthful appearance.
Earlobe Reduction/Enhancement – As woman age and with the lifelong use of ear rings, the ear lobes will frequently get longer. The size of the ear lobe can easily be reduced (earlobe reduction) in the office and it is a procedure that I often do at the same time of a facelift. Aging may also make one’s earlobes get quite thin and almost shriveled in appearance in very thin females. Injectable fillers, such as Juvaderm or Radiesse, can give an immediate rejuvenation effect to the earlobes that may last as long as a year.
Eyebrow/Eyelash Hair Transplants – The science of hair transplantation has evolved to the point that single hair (follicle) transplants are now routinuely done in scalp hair restoration. It is quite logical that single follicular transplantation be applied to very small areas such as the eyebrow and even the eye lashes. The alternatives of permanent makeup, colored pencils, and false eyelashes made opting for actual hair tranplants a difficult decision. But some few patients do.
Umbilicoplasty – While every full tummy tuck patient gets a new bellybutton (umbilicus), some non-tummy tuck patients want one also. Most commonly, it is to change an outie to an inne belly button.
Nipple Reduction/Nipple Enlargement – I have seen it both ways. The concern of large nipples is that they can be very visible through clothes…and at all times. Reducing the size of the nipple is a simple procedure and some women may lose a little sensation. Most recently, I have started to some men that want their nipples reduced also! Conversely, nipple enlargement or enhancement is about changing an inverted nippled (which is turned inward) to one that has some outward projection. While not quite as predictable (long-term result) as nipple reduction, the nipple can be released and brought more outward.
Corner of Mouth Lift – The downturning of the corners of one’s mouth with age gives a sad or angry appearance. A simple procedure in which a small amount of skin is removed and the corners lifted up and the mouth line leveled gives a nice and subtle improvement. Such a procedure is a simple office operation or is often done as part of a facelift. This is actually an old procedure that has now been ‘reinvented’ or rediscovered.

One wonders what this list will be in another ten years!

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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