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Dr. Barry Eppley

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Posts Tagged ‘plastic surgery products’

Plastic Surgery Products: Ocumend Gel Pads for Facial Recovery

Sunday, January 25th, 2015


Bruising is a common sequelae of many aesthetic facial surgeries. While all bruising eventually goes away on its own, every patient would like it to be sooner rather than later. Besides surgical technique, the use of cold compresses and oral Arnica taken before and after surgery have been the most commonly used strategies for both prevention and the treatment of bruising and swelling.

Ocumend Gel Pads Dr Barry Eppley IndianapolisOcumend gel pads (Cearna Aesthetics) provide a topical hydrogel pad that contains Arica and Ledum. While Arnica is a well known homeopathic remedy, Ledum is less well known. Derived from the wild rosemary herb, Ledum is useful in healing bruising around the eyes as well as has antiseptic properties. The gel pad is purported to deliver fifty times the concentration of Arnica over other topical preparations. A recent study showed that Ocumend improved healing times in blepharoplasty and rhinoplasty surgery patients. Blepharoplasty patients had less swelling and bruising at one week after surgery than those patients that did not use the gel pads.

Ocumend Gel Pads Indianapolis Dr Barry EppleyOcumend gel pads are applied right after the procedure and are worn as much as possible the first day after surgery. They are then applied at night for the next five days to a week. They contain no adhesives so there is no residue left behind on the skin.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Products: Dermapen 3 for Skin Needling

Sunday, January 25th, 2015


Almost everyone is familiar with laser resurfacing and its improvements offered by today’s concept of fractional laser resurfacing. By cutting into the skin layers in closely spaced holes created by a laser beam, improved skin quality results through collagen regeneration and remodeling. While there is no question about the benefits of fractional laser resurfacing, other non-laser devices can create similar patterns of skin ‘holes’

Dermapen Skin Needling Dr Barry Eppley IndianapolisOne of these devices is Demapen 3. This is a mechanized device use to fractionally rejuvenate the skin. Its tip contains 12 microneedles in a spring loaded sterile cartridge which is single patient use. The depth of needle penetration can be adjusted to go as deep as 2.5mms if desired. With 12 needles and an oscillating vertical motion with a top speed of 108 movements per second, 1,296 skin holes can be created per second to create a fractional skin rejuvenation effect. With the creation of some many skin holes, topical nutrients/agents (e.g., PRP) are applied and theoretically absorbed into the skin via the open channels. Interestingly, the oscillation movements helps dampen the transmission of nerve pain fibers making the treatments possible with little or no topical anesthetic.

Because Dermapen 3 does not create heat to make the channels (unlike a laser), it is safe to use on all skin types with no risk of post-inflammatory hyperpigmentation and a more rapid recovery period.

Like fractional laser resurfacing, Dermapen can treat a variety of skin issues from the treatment of wrinkles, skin texture irregularities and acne scars.  Its use is being increasingly used for hypertrophic scars, vitiligo and in the treatment of alopecia for hair regeneration.

The role of skin needling, which has been around for decades, has taken a quantum leap forward with Dermapen technology. This mechanized handpiece offers a more consistent method of making skin channels and has a real role to play alongside fractional laser resurfacing. For those patients who want less recovery and a lower treatment cost than that of lasers, Dermapen skin needling offers an effective alternative.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Products – Bellafil Injectable Filler

Thursday, December 11th, 2014


Over the past decade there have been many new injectable fillers that have become available for clinical use. And just about every year a new one is commercially released either by an existing or new manufacturer. As we end 2014, there is a new injectable filler that has become available…although it is new in name only.

Bellafil Injectable Filler Dr Barry Eppley IndianapolisArtefill (which originally was called Artecoll before becoming Artefill) has changed its name now to Bellafil in the U.S.. It appears the company (Suneva Medical) opted for the name change because it better describes the outcomes associated with the filler and provides the opportunity to rebrand the filler product.

Bellafil Artefill Injectable Filler Indianapolis Dr Barry EppelyAmongst the wide array of injectable fillers, Bellafil is unique in that it is a semi-permanent particulated type material. Bellafil is a combiantion of polymethylmethacrylate (PMMA) microscpheres and collagen. The ratio is 80% collagen and 20% microspheres. The collagen in Bellafill acts as a carrier for the microspheres and allows them to flow through a needle in a near laminar pattern. While the collagen does eventually resorb and go away, the PMMA microspheres are permanent and induce an ingrowth of collagen to create a permanent matrix for lasting volume improvement.

Since each injectable treatment results in only a 20% to 30% volume retention of the initial injection, repeated treatments are usually needed to build up ‘layers’ over time. This eventually results in a permanent volume result. This feature is what makes Bellafil distinctive from almost all other injectable fillers.

Bellafil was originally approved (as Artefill) in 2006 for the treatment of nasolabial folds or smile lines. Because of its bovine collagen carrier, patients should be skin tested before treatment to ensure they have no allergic reactions to it.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Products – Natural Contour Silicone Buttock Implants

Sunday, August 31st, 2014


Buttock implants are undergoing a renaissance today largely due to the popularity and widespread use of fat injection buttock augmentation. (Brazilian Butt Lift = BBL) The societal interest in the aesthetics of buttock shape and size combined with the body contouring benefits of liposuction has generated large numbers of such buttock augmentation procedures being performed.

But not everyone is a good candidate for a BBL procedure, due to inadequate fat to harvest, or has a satisfying result from the procedure due to graft resorption. This makes buttock implants as the only option for achieving a bigger buttock size. Most commonly the ‘ideal’ candidate for buttock implants is a relatively thin or small framed person who not only has little fat to harvest but does not necessarily desire a very large or disproportionate buttock size increase.

Buttock Implants Indianapolis Dr Barry EppleyThe use of buttock implants has a checkered history with a not insignificant incidence of complications. (although it is not necessarily higher than that of breast implants…it just seems worse since having to sit or walk with buttock implant problems is a lot more functionally disabling than that of breast implant problems) The debate is whether buttock implants should be placed above the muscle (subfascial) or in an intramuscular position. There are advantages to either approach but the intramuscular position offers the least risk of complications long-term even though it has a longer recovery.

Buttock Implant Surgical Technique Dr Barry Eppley IndianapolisThe intramuscular implant location logically requires a different implant shape and size that what may be used for the subfascial location. The intramuscular pocket is more limiting and it is very difficult and ill-advised to try and place implant volumes greater than about 350ccs in them.

Natural Contour Buttock Implant Dr Barry Eppley IndianapolisThe Natural Contour round buttock implant (Implantech) provides an option for buttock augmentation that are designed specifically for intramuscular use. The Natural Contour shape provides permanent volume with an implant profile that stresses the overlying tissues less and is easier to use. These buttock implants are touted as the softest and most natural-feeling silicone buttock implants available. Their flexibility and softness means they can be easily rolled and inserted through smaller incisions. The tapered smooth edges result in a more natural fit into the intramuscular pocket. They are available in sizes of 230cc, 275cc and 330cc with maximal projection of 3.2 cms. (base width 13 cms)

It is important to realize that intramuscular Natural Contour buttock implants are designed for long-term success and a lower incidence of complications. Their use will not be successful for someone seeking a very large or visible round buttock implant size and shape increase.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Product Review – Premvia Hydrogel Wound Healing

Tuesday, August 19th, 2014


Wound healing and soft tissue regeneration requires the production of collagen and extracellular matrix to lay the foundation for cellular ingrowth from fibroblasts and epithelial cells for overgrowth. (coverage) A wide variety of biologic signals and other factors are required for this process to occur in a timely manner. Many wound healing products have appeared over the years, each with their own advantages and disadvantages.

Renevia Dr Barry Eppley IndianapolisAlong has come the newest wound healing, Premvia (BioTime Inc) which has just received FDA clearance for marketing. Premvis is the first FDA-approved product from a family of hydrogels, who mimic the natural structures of the body’s extracellular matrix. Such a structure allows for the cross-linking of collagen and hyaluronic acid. Technically this is a hydrogel formulation composed of cross-linked thiol-modified hyaluronan and thiol-modified gelatin. Due to its high water content, Premvia can donate donate water molecules to a wound surface and maintain a moist environment therein. It is also a biodegradable matrix which provides a structure onto which cells and small blood vessels can latch into to promote healing.

Premvia hydrogel can be useful for a wide variety of wounds from burns, ulcers, surgical insult, delayed healing. While this is useful at the present for open wounds, the future of this product lies in the company’s future plans to use it as a carrier of stem cells. A clinical trial in Europe is ongoing in that regard. (Renevia) This will be a much more difficult FDA hurdle to overcome but the product is worth watching to see if it will eventually turn into an injectable product that can be cell-loaded.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Products: SERI Silk Scaffold for Soft Tissue Support

Saturday, June 28th, 2014


SERI Silk Scaffold in Plastic Surgery Dr Barry Eppley IndianapolisSERI silk surgical scaffold is a knitted, multifilament bioresorbable  bioprotein-based scaffold. It is derived from silk that has been purified to yield very pure fibroin. It is tear resistant, holds sutures well and can be cut to any shape. It provides immediate mechanical stability across a tissue defect due to its inherent strength and scaffold construction. It is designed to gradually resorb as new tissue grows into it. It is to be used as a temporary scaffold for tissue support and defect repair of soft tissues in plastic surgery.

This silk-derived biological material has favorable biocompatibility and causes minimal inflammation. Ordinary silk sutures are not traditionally thought as of very biocompatible because contain sericin which causes a profound inflammatory reaction. Commercial silk suture is made of fibrous proteins that are first processed into strands, then braided, and may be dyed and coated with wax or silicone. These silk sutures typically can become encapsulated and do not integrate into the native tissue. SERI surgical scaffold undergoes a proprietary purified engineering process which removes sericin and other impurities for a very pure sterile product. Tissue response to SERI Surgical Scaffold exhibits minimal inflammation that is confined to the silk-derived scaffold. This helps promote favorable integration and neovascularization as the scaffold is replaced over time with natural collagen. Studies have shown that this silk-based product is resorbed at slower rates than other types of synthetic polymers.

SERI Silk Surgical Scaffold Indianapolis Dr Barry EppleyThe SERI silk scaffold received FDA approval in 2009 and is distributed through Allergan for soft tissue repair. It has had its biggest application in various breast augmentation and reconstruction deformities, most notably for secondary breast procedures.  It has been primarily used as a supporting scaffold or sling to correct breast implant bottoming out, rippling and holds promise to treat breast implant capsular contracture. It shows promise for other plastic surgery procedures that need additional soft tissue support such as tummy tucks, breast lifts and facelifts.

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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