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Posts Tagged ‘plastic surgery case study’

Case Study – Temporal Artery Ligation

Monday, May 23rd, 2016

 

Background: The superficial temporal artery is a branch of the external carotid artery. It runs up along the back line of the lower jaw and curves anteriorly where it crosses teh back part of the zygomatic arch at its junction with the temporal bone. Once it crosses the  zygomatic arch, it splits into a Y into two divides in two terminal branches. The anterior branch, also called the frontal branch, ascend obliquely across the upper temporal region into the forehead. The posterior branch, also called the parietal branch, courses posteriorly above the ear.

The frontal branch of the superficial temporal artery is prone to develop extreme visibility in some people which they find bothersome. The reasons why it does so are not clear. I have only seen it in men and have never received a concern about its appearance from women. The typical symptoms are that it can not be present at all or slightly present at ‘rest’ but numerous activities make the pathway of the vessel dilate and become very prominent. Such activities includes exercise, heat, excitability, and drinking alcohol.

Treatment of the prominent anterior branch of the superficial temporal artery is by surgical ligation.While ligating the takeoff of the anterior branch would seem a logical approach, there is always the issue of backflow into it which would still leave it prominent. Thus at least a two point ligation should be done with the distal point on the forehead before it branches and goes into the frontal hairline.

Temporal Artery LIgation mapping Dr Barry Eppley IndianapolisCase Study: This middle-aged male had visible anterior branches of the superficial temporal artery at rest on both sides of his temples. These became more so with increased activity and heat. Their irregular course was clearly visible from the edge of the temporal hairline up into the forehead. Their wavy irregular course, which is common, was clearly seen and marked.

Right Temporal Artery LIgation immediate result Dr Barry Eppley IndianapolisLeft Temporal Artery LIgation immediate result Dr Barry Eppley IndianapolisUnder local anesthesia small incisions (6mms) were made just inside the temporal hairline and at the end of an upper forehead wrinkle just below the frontal hairline on both sides. Double ligations were performed in all four areas with 5-0 prolene suture. While the palpable inflow was immediately reduced (pulsations were no longer felt), the prominent of the vessels initially remained. With further observation they did reduce somewhat but an additional ligation was done along the temporal hairline area above the initial ligation point.

The success or temporal artery ligation depends on elimination of the inflow AND subsequent collapse of the vessels. Even with two ligation, which should theoretically work, the visibility of the arteries may not always be completely eliminated. Unseen feeder vessels between the two ligation points and strength of the vessel walls (they are arteries so their walls contain muscle) may cause the vessel prominence to persist although less so than before ligation.

The other issue about the success of temporal artery ligation is whether such flow can eventually return. Loss of the ligature points (which is why I double tie) and backflow dilation of any unseen takeoff branches could all be reasons for potential recurrence.

Highlights:

1) A prominent anterior branch of the superficial temporal artery can create an undesired aesthetic line along the sides of the forehead.

2) Two-point temporal artery ligation can reduce and, in some cases, eliminate the appearance of the temporal vessels.

3) The aesthetic success of temporal artery ligation depends on whether unseen feeders flow into the visible nerve branch and how much the artery will shrink after flow into it is eliminated.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Large Abdominal Panniculectomy

Monday, May 23rd, 2016

 

Background: The abdominal pannus is a well known medical condition of a large overhanging apron of skin and fat that extends well beyond the waistline. Technically the proper term is a panniculus but it is far more commonly referred to as a pannus. What defines a pannus is how large the actual overhang is.

There are five degrees of an abdominal pannus from a grade 1 that rests on the mons pubis to a grade 5 that hangs down to the knees. While no abdominal pannus is pleasant for the patient the grade 5 pannus is the most disabling. It not only obstructs the urinary stream and causes associated hygiene issues but its sheer weight makes mobility difficult. It causes tremendous strain on the back and knees and leads to early deterioration of both.

An abdominal panniculectomy procedure should not be confused with a more traditional tummy tuck. The scope of the problem being treated would indicate such but how the operation is performed and under what circumstance is also vastly different. This is no more manifest than in the massive type 5 abdominal panniculectomy operation.

Case Study: This 40 year-old male reached out from Canada because he could not find a surgeon to perform his abdominal panniculectomy procedure.  He had a prior gastric bypass which dropped his weight from over 500 lbs down to 325lbs.  This resulted in the creation of a massive type 5 pannus. Surprisingly he had no otherwise medical problems. Because of chronic skin infections and urinary obstruction he had been to the hospital numerous times. But despite his obvious need for a surgical solution, he stated that no one would take on his case because it was too dangerous or difficult.

Large Abdominal Panniculectomy flaps intraop Dr Barry Eppley IndianapolisLarge Abdominal Panniculectomy tissue removals initraop Dr Barry Eppley IndianapolisUnder general anesthesia a large portion of his abdominal pannus was removed in two sections.  Its total weight was 40 lbs.  It was determined before surgery not to reconstruct his umbilicus. The long umbilical stalk and the umbilical hernia created by its removal were repaired. Closure was done over a large single drain.

Large Abdominal Panniculectomy result intraop Dr Barry Eppley IndianapolisLarge Abdominal Panniculectomy result intraop right oblique view Dr Barry Eppley IndianapolisLarge Abdominal Panniculectomy intraop result left oblique view Dr Barry Eppley IndianapolisHe stayed overnight in the facility and was released to a hotel the morning after. He remained in town for one week for monitoring and flew back to Canada thereafter. His drain will be removed at home after two weeks.

Large abdominal panniculectomies are challenging for a variety of reasons. Their sheer size makes intraoperative positioning and maneuvering difficult. There are many large blood vessels that supply the abdominal pannus and intra- as well as postoperative bleeding is always a risk. The operation needs to be performed as expeditiously as possible to get the patient off the operating room table as soon as possible. When performing the operation as just an overnight stay, the patient must have few other medical problems and be motivated to get up and moving as soon as possible after surgery. Drains are always needed and should stay in at least several weeks. For the out of town patient this means that they will have to get some medical care at home to get it removed.

Highlights:

1) Large abdominal panniculectomies can be safely done in an outpatient surgery center if the patient is otherwise healthy.

2) Enough abdominal pannus is removed to relief the obstruction on the pubic area and eliminate any overhang on the groin creases.

3) The most likely complication from any abdominal panniculectomy is a seroma or fluid collection.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Silicone Testicle Implant Surgery

Sunday, May 22nd, 2016

 

Background: While many body parts can be partially replaced or augmented, few can be completely replaced in their totality by a single prosthesis. Such is the case with the testes undoubtably due to its small size and location in the hollows of the scrotal sac. While a testicular implant will not resume the functions of the natural testicle, it can create the external appearance that a pair is present.

The physical and aesthetic requirements of a testicular implant are fairly simple. It should replicate in size and shape that of the opposite testicle. It should also feel soft and supple, not only to match the feel of the opposite testicle, but be easily compressible given its near continuous exposure to external forces.

Testicular Replacement Implant Dr Barry Eppley IndianapolisThe solid but very soft silicone material fulfills all requirements needed for a testicle implant. It is extremely compressible with a very low durometer silicone composition. It is available in sizes up to 5 x 4 cms which will work for most men. A custom testicle implant can be made for even larger sizes.

Case Study: This 55 year-old male lost his right testicle at fourteen years of age due to an unknown pathology. He had a long scar on his right scrotal sac that went its full vertical length. He had always felt inadequate and embarrassed his entire life with a missing testicle and was often referred to as ‘single shot’ throughout his life. He was completely unaware that a testicle implant even existed until very recently.

Right Scrotal ScarTesticular Implant intraoperative sizing Dr Barry Eppley IndianapolisUnder general anesthesia the upper portion of his scrotal scar was reopen and a pocket made into the right scrotal sac. The skin was very elastic and a pocket of adequate size was easily made. The largest size silicone testicle implant was used which matched well to his opposite left normal testicle. The scrotal sac was closed in layers and dissolveable sutures used for the skin.

Right Testicular Implant Reconstruction result Dr Barry Eppley IndianapolisHis immediate intraoperative result showed a good match between the implant and the normal testicle. They had a very similar feel externally.

The use of a silicone testicle implant provides a natural feeling and looking testicle that creates good scrotal sac symmetry. It is a procedure that has minimal discomfort afterward with a rapid recovery. One can return to all normal activities within a few weeks after the procedure.

Highlights:

1) Testicular implants can be done at any age no matter how long ago the natural testicle  was lost.

2) A soft silicone testicular implant provides the most natural feeling replacement prosthesis.

3) Recovery from testicular implant surgery is rapid with a return to all normal activities in a few weeks.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Rib Removals for Waistline Narrowing

Saturday, May 21st, 2016

 

Background: Rib removal surgery has been done so infrequently that it is a highly misunderstood cosmetic body contouring procedure. While it sounds extreme, and it is certainly for the most motivated, it is neither a dangerous or a radical operation. It is a procedure that is based on an understanding of the lower shape of the ribcage.

Rib Removal Surgery Dr Barry Eppley IndianapolisThe concept behind most rib removal surgeries is to create a more narrow waistline that has an hourglass shape. This is possible when one looks at the anatomy of the lower ribcage. The lower two ribs, known as free floating 11and 12 ribs, are not attached to any ribs above them. In fact careful inspection of their shape shows that they actually point downward more than the ribs above which assume a more horizontal orientation as they wrap around the side of the body. These more vertically oriented ribs point down toward the hip and cross the horizontal level of the anatomic waistline at the level of the umbilicus.

For those women who seek a much more narrow anatomic waistline, these lower two ribs can serve as a vertical physical block for that effect to occur. This can be demonstrated by pushing it at the side of the waistline and feeling the bony obstruction.

Case Study: This young transgender male to female patient wanted a more feminine waistline rather than the torso of a male which is more straight up and down at the sides. She also wanted to improve the hip indentations by fat injections at the same time.

Lateral Waistline Rib Removal Dr Barry Eppley IndianapolisUnder general anesthesia and initially in the supine position the full abdomen and waistline areas in the back were harvested of fat. Then in the prone position, the flanks and upper intergluteal area were also harvested of fat. After concentration of the fat, a total of 200cc was injected into the hip indents. Then through a 4 cm incision oriented over rib #11 that did not come further to the side that the posterior axillary line, the ends of ribs 10, 11 and 12 were removed.

Lateral Wasitline Narrowing result intraop Dr Barry Eppley IndianapolisWhen viewed from behind the combination of rib removals, liposuction and fat injections to the hips made for a more hourglass torso shape. This effect will become greater over time as the waistline reduces as the swelling subsides and the tissues shrink inward.

Rib removal surgery for waistline narrowing is a bit of a misnomer. It should be called ribcage modification by removing of smaller portions of the obstructing ribs. While the pleura of the lung can be found at the level of ribs 10 and 11, careful technique can avoid its violation.

Highlights:

1) Posterior rib removals are for helping create a more narrow anatomic waistline.

2) The removal of the outer or distal portions of ribs 10, 11 and 12 removes the anatomic obstruction to the outer waistline profile

3) Rib removal is best thought of as ribcage modification as complete rib removal is never actually done.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Chin Implant Revision

Saturday, May 21st, 2016

 

Background: Chin augmentation is one of the original facial reshaping surgeries and has been performed for decades. Whether done through the mouth or done from an incision below the chin, the fundamental concept is that an implant is placed over the central aspect of the lower chin bone. (pogonion)

While the basic technique for chin augmentation has not changed over the years, the styles of chin implants has. Chin implant shapes have evolved to be large with long lateral wings. Known as anatomic chin implants, these lateral wings are added to the implant to allow it to transition more smoothly into the lower border of the jaw behind the chin.

While this lateral wing concept has its merits, it is also prone to creating chin implant asymmetry. Even slight amounts of chin implant rotation can cause the end of the wings to be asymmetric. The higher wing can even be felt inside the mouth as it encroaches into  the vestibule and may even put pressure on the mental nerve.

Chin Implant MalpositionCase Study: This 67 year-old female had two previous chin implants. An initial larger implant was placed two years ago and subsequently downsized due to dissatisfaction with its size. Once the swelling subsided the patient noticed an asymmetry of the chin with a higher wing on the right side.  The implant asymmetry was seen externally across her chin. She could feel it inside her mouth at the gumline on the right side which caused intermittent tingling and numbness sensations on the right side of her lip.

Chin Implant Malposition surgery Dr Barry Eppley IndianapolisChin Implant Repositioning surgery Dr Barry Epley IndianapolisUnder general anesthesia, her chin implant was approached through her existing submental incision. The chin implant was found to be located about 1 cm above the lower border of the chin bone and the midline shifted to the right with obvious canting of the implant. The implant was removed, the lateral wings reduced and the implant pocket adjusted. The chin implant was out back in a central position lower on the bone and secured with a single 1.5mm screw.

Chin implant malposition is especially prone when a large implant is replaced with a smaller one. The smooth surface of silicone implant makes it especially prone to sliding around on the smooth underlying capsular layer. This is where the value of placing a single screw ca be invaluable in its prevention and/or correction.

Highlights:

1) Chin implant malposition is not an uncommon complication of chin augmentation surgery.

2) With today’s winged chin implants, asymmetry of the lateral wings of the implants can easily occur.

3) Chin implant revision surgery creates a new pocket for the implant and secures it centrally with a screw placed in the midline.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Buttock Reconstruction after Implant Removal

Monday, May 16th, 2016

 

Background: Buttock implants are the alternative option in gluteal augmentation to injectable fat grafting. (aka Brazilian Butt Lift) They are used when the patient has inadequate fat donor harvest sites due to a thin body frame. They are also used in rare cases where a BBL procedure has not produced adequate buttock augmentation and fat donor sites are exhausted.

The placement of buttock implants is either in the subfascial or intramuscular location. There are advantages and disadvantages to either implant location. The subfascial location offers larger implant placements but with a thinner soft tissue cover and a higher risk of infection and implant contracture/malposition/asymmetry. The intramuscular location by virtue of its thicker and better vascularized implant coverage has a much lower risk of infectious and malposition issues but only permits smaller implant sizes to be placed.

When buttock implant infection occurs, the sequelae of this complication has a much higher risk of secondary buttock shape distortions. The overlying soft tissue cover is much thinner and when it shrinks down after the implant(s) are removed, there will be an outward buttock contracture deformity.

Case Study: This 26 year-old female presented with bilateral buttock deformities consisting of scars and contracture deformities. She had a history of subfascial buttock implants placed in another country which became secondarily infected and needed to be removed. There were long scars that extended from the intergluteal crease outward. Ideally she needed first stage injection fat grafting followed by a second stage scar revision but her social and financial circumstances dictated that she have a singe stage reconstruction.

Buttock Reconstruction with Dermal Fat Grafts back view Dr Barry Eppley IndianapolisButtock Reconstruction with Dermal Fat Graft Dr Barry Eppley IndianapolisUnder general anesthesia, a large dermal fat graft was harvested from a c-section scar on her lower abdomen. Then in the prone position, her scars were excised, the buttock tissues widely undermined and released, and the dermal fat graft placed into the resulting soft tissue defect. (most of the graft was placed into the deeper left buttock contracture) The fat grafts were covered by advancing the residual fat layer on the underside of the skin over them.

Loss of buttock implants, particularly from the subfascial location, will result in overlying soft contracture. Whether it requires scar revision or not, soft tissue volume restoration is the cornerstone of its treatment. Injectable fat grafting is the preferred method of thickening the soft tissue and releasing scar contractures. But the very choice of buttock implants initially may mean that little fat is available. As a result, smaller dermal-fat grafts may need to be used.

Highlights:

1) Removal of subfascial buttock implants due to infection can be associated with secondary buttock deformities.

2) Buttock scar contracture ideally needs a combination of fat grafting and scar revision.

3) While injectable fat grafting offers a broader area and volume of soft tissue augmentation, dermal fat grafting can be done as a second grafting option.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Square Chin Implant

Saturday, May 14th, 2016

 

Background:  Chin augmentation is one of the most popular lower facial reshaping procedures and has been so for many decades. Its benefits are most commonly perceived in the side profile demonstrating increased horizontal projection of the chin. While changes in how far the chin projects forward is one of the most important benefits of a chin implant, that view alone is an inadequate perception of the overall chin augmentation  effect.

Chin augmentation should be seen as a 3D procedure and not just a 2D one. This takes into account the frontal view as well, assessing the vertical and transverse dimensions. The frontal view of the chin includes its width which is highly gender specific. The female chin ideally has a amore narrow and tapered shape. Conversely the male chin is wider, more angular  and can even have a square shape.

While there are numerous styles of chin implants, they have only two basic frontal shapes…convex and square. The square chin implant is unique in that it maintains a square shape when applied to the front edge of the chin bone which is usually convex. It does so because it is thicker on the sides of the chin so when pressed against the bone it maintains a square shape.

Case Study: This 45 year-old male had a chin implant placed several years previously through an intraoral approach. While it did improve his profile, he had been unhappy with how his chin looked straight on and he also felt it was sitting too high. He wanted more of a masculine square chin shape.

Chin Implant Removal Dr Barry Eppley IndianapolisChin Implant Replacement Dr Barry Eppley IndianapolisUnder general anesthesia, his existing chin implant was removed through a submental skin incision. The implant was positioned high and was asymmetric in position. It was a central style of chin implant that was curved with no lateral wings. It was replaced with a style 1 square chin implant of similar anterior projection thickness. (7mms) A centrally placed 2 x9mm screw was inserted to ensure its central position low on the chin bone.

Square Chin Implant replacement result Dr Barry Eppley IndianapolisA square chin implant is uniquely made for men who desire a wider and more angular chin shape. It comes in two widths known as a style 1 and style 2 chin. In the style 1 the square chin width is 45mms and in the style 2 the square chin width is 55mms. Which style of square chin width is best for each patient depends on the horizontal width of their mouth and how strong they want the square chin to appear.

Highlights:

1) Chin implants come in both different styles as well as sizes.

2) When considering chin augmentation how the chin will look in the frontal view is often overlooked.

3)  For men who seek a more angular and wider chin look, the square chin implant can help achieve this type of frontal chin shape.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Solid Silicone Testicular Implant Reconstruction

Saturday, May 14th, 2016

 

Background:  Lost of a testicle in a male can occur for a variety of reasons. Congenital absence, an undescended testicle, infection, traumatic injury, varicoeles and other pathologies can all cause an absent scrotal sac on one side. While a man can fully function in all capacities with one testicle, there is psychological benefit for some men to feel and be seen as ‘whole’.

The creation of a normal paired scrotal sac can be done with a testicular implant. There are two types of such body implants currently available. An FDA-approved saline filled testicular implant an a solid silicone contoured caving block in the shape of a testicle. A solid silicone testicle implant is preferred in my hands because it is a permanent implant that will not fail or need to be replaced because of device failure. It can also withstand high levels of impact and compression without risk of rupture or implant deformation.

Case Study: This 35 year-old male lost his right testicle due to several years previously due to benign testicular tumor. He had an otherwise normal scrotal sac skin and had never received radiation for his tumor. Having only one testicle made him very self conscious and was a source of psychological concern.

Right Testicular Implant result Dr Barry Eppley IndianapolisTesticular Implant and Incision Dr Barry Eppley IndianapolisUnder general anesthesia, he had a size 4 testicular implant placed through a high scrotal incision of 3 cms. The soft compressible features of the implant made it possible to insert a 4.6 cm side implant through a much smaller incision than its width. The inserted implant had a fairly good size match to the opposite left testicle and a very similar feel as well.

Testicular Replacement Implant Dr Barry Eppley IndianapolisSolid silicone testicular implants come in a variety of sizes with the maximum dimensions of 5 x 4 cms. Such an implant size may seem large but it is surprising how often it is needed when men are intraoperatively sized.

Men who are missing a testicle should find reassurance that it can be replaced with an implant that feels very natural in sizes that can match the opposite testicle. The implant operation is short with a similarly limited recovery time as well.

Highlights:

1) Reconstruction of a lost or congenitally absent testicle can be safely performed by a silicone testicle implant.

2) The best testicular replacement is a soft solid silicone testicle implant which can never fail or need to be replaced.

3)  A silicone testicle implant can be placed through a small (3cm) skin incision placed high near the scrotal-groin crease junction.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Male Facelift

Monday, May 9th, 2016

 

Background:  Just like women, men have concerns about facial aging and undergo surgical procedures to improve their appearance. While men do have have facial rejuvenation procedures in the numbers that women do, they have surgery which historically is often later when the aging face problems may be more advanced.

There are numerous characteristics that separate men from women in undergoing facial procedures and facelift surgery is no exception. The key difference in this procedure in the presence of beard skin and the location and density of the hairline around the ear incisions. Keeping beard hair out of the ear and not making visible scars that stray far from the shadow of the ear are key considerations in surgical planning.

Case Study: This 47 year-old male presented after having had a ‘necklift’ by another surgeon. He had scars behind his ears but none in front of his ears. The scars behind the ear were low and back along the occipital hairline. He noticed no significant improvement from this type of necklifting operation.

Male Lower Facelift result side view Dr Barry Eppley IndianapolisUnder general anesthesia, he underwent a more traditional lower facelift approach using a  preauricular incision as well as his existing incisions behind his ears. A submental incision was also added to address the central neck area.

Male Lower Facelift result oblique view Dr Barry Eppley IndianapolisMale Lower Facelift result front view Dr Barry Eppley IndianapolisHis one year after surgery results showed sustained improvement in his neck and jawline that looked natural. His surgical experience shows that neck and jawline improvement really can’t be achieved with incisions that are limited to just behind the ear. It is an appealing approach but without tissue undermining in front of the ear that permits an anterior axis of rotation, the neck and jawline can not really be improved.

Male Facelift ScarThe preauricular incision in the male facelift, while usually healing quite well, will shorten the distance of the non-beard skin area in front of the ear. This is unavoidable ut not usually detectable by most people.

Highlights:

1) The interest of most men in treating facial aging is in the neck and jowl sagging that develops

2) The male facelift usually uses a preauricular ear incision to avoid displacement of the beard skin onto the ear tragus.

3)  Men seek a natural facelift result which has nearly undetectable scars and a smooth and non-tense skin appearance across the lower face and neck.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Macrotia Reduction

Monday, May 2nd, 2016

 

Background: The most common aesthetic ear procedure is that of ear pinning. Known technically as otoplasty, the protruding ear is reshaped and sutured (pinned) back so that it aligns better with the side of the head. This traditional aesthetic ear procedure relies on cartilage manipulation/folding rather than actual tissue removal. Its effects are created by reshaping the deformities in the existing ear cartilage.
Macrotia or the large ear is a very different surgery from that of the more common protruding ear. It is a problem caused by tissue excess having an exaggerated vertical height to the ear. The traditional vertical ear height is around 60mms with slightly more being acceptable for men and slightly less for women. When the vertical ear height exceeds 70mms it is always seen as too big or too long.
Macrotia surgery, unlike setback otoplasty, requires tissue removal. From the bottom of the ear, the earlobe can be vertically reduced by wedge excision. The top of the ear is more challenging as it is composed of cartilage and there is no place to completely hide the reduction incisions.
Case Study: This 25 year-old male had long been bothered by his large ears. They had vertical measurements of 756mm from the height of the superior helix to the bottom of the earlobe. There was also excessive protrusion of the upper ear from the side of the head.
Left Vertical Ear Reduction result (Macrotia Surgery)  Dr Barryt Eppley IndianapolisUnder general anesthesia, bilateral macrotia reduction surgery was performed. The earlobes were reduced by a vertical helical rim reduction of 5mms. The upper ear was reduced by a scaphal-conchal flap reduction with a resection across the midportion of the helical rim of 7mms. The upper ear was also set back by a suture technique.
Right Vertical Ear Reduction result Dr Barry Eppley IndianapolisMacrotia and Otoplasty Ear Reconstruction result front view Dr Barry Eppley IndianapolisHis six month after surgery results showed ears that were more normal in size and vertical length. The earlobe scars along the rim were imperceptible. The only visible scar from the scaphal-conchal reduction was across the central helical rim with a fine line scar.
Highlights:
1) Reduction of a large ear (macrotia) is quite a different surgery than that of traditional ear pinning or otoplasty.
2) Vertical ear reduction requires reduction of the ear as well as tat of the bottom of the ear.(earlobe)
3) The scars from vertical ear reduction are minor with the most visible one crossing the ear at the central helix.
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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