EXPLORE
Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?

Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.

February 27th, 2015

Lateral Canthopexy vs Canthoplasty – Implications for Eye Shape

 

Changing the outer corner of the eye is done for a lot of different aesthetic and reconstructive purposes. The two main reasons are to help correct a lower lid sag from prior surgery (reconstructive) or to create more of an uplifted corner of the eye to change its appearance. (aesthetic) The procedures used to do so are either a lateral canthopexy or a lateral canthoplasty

Lateral Canthopexy Dr Barry Eppley IndianapolisThe changes that occur between a canthopexy and canthoplasty is often subtle but how they are performed, their indications and the effects that result from their use is very specifically different. Understanding these eye corner manipulations requires an appreciation of eye shape.

The shape of the eye is really determined by how the upper and lower eyelids join at the corner.  This is much more so at the outer corner of the eye than the inner. (at least for Caucasians) A youthful eye is associated with a space between the upper and lower eyelids that is narrow and more drawn out to the side. In some ways it is a tight ‘bowstring’ look provided that the bony anatomy of orbit and cheek is normally developed around it. As one ages the shape of the eye changes as the lower eyelid droops. This creates an eye shape that is now rounder and horizontally shorter. In effect the bowstring effect is weakened.

Lower Blepharoplasty without lateral Canthopexy Dr Barry Eppley IndianapolisThe very frequently performed aesthetic lower blepharoplasty procedure has a high incidence of changing the outer corner of the eye. Careful inspection of many before and after surgery pictures of lower blepharoplasties will show some dropping of the lid margin, even some increased scleral show and an eye that appears slightly rounder. The changes that lie below it can show dramatic improvement with elimination of protruding fat and loose skin but the trade-off in some patients can be a slightly rounder eye and lower lid margin. This phenomenon is well recognized and accounts for today’s trending towards more tissue preservation of the lower lid and the addition of orbicularis muscle suspension support at closing.

Lower Blepharoplasty with lateral Canthopexy Dr Barry Eppley IndianapolisThe role of lateral canthopexy is greatest in lower blepharoplasty surgery for prevention of eye shape change or to restore a rounded corner afterwards. In a cnanthopexy, the point of union of where the upper and lower eyelid meet is changed and fixed to the outer aspect of the lateral orbital rim. in essence the corner is ‘pexed’ outward creating a longer and more narrowed eye shape. This is done with small sutures to the periosteum on the bone.

Conversely, a lateral canthoplasty is more invasive and requires fixing deeper tissues of the lower eyelid (tarsus or muscle) to the inner aspect of the lateral orbital rim. This is usually most effectively done by placing drill holes in the lateral orbital rim where a transosseous suture can be passed to ensure that the new canthal attachment is ‘high and tight’ inside the orbital rim.

While effectively restoring the bowstring effect of the lower eyelid against the eyeball, it does so at the expense of shortening the lower eyelid and giving it a rounder shape. For this reason lateral canthoplasties are primarily used as a reconstructive procedure for significant lower lild retraction. It restores lower lid competence but not necessarily a more youthful looking eye shape.

Dr. Barry Eppley

Indianapolis, Indiana

February 27th, 2015

Case Study – Flat Back of the Head Correction with Custom Occipital Implant

 

Flat back of head Dr Barry Eppley IndianapolisBackground: The most common aesthetic skull deformity is that of the flat back of the head. This occurs most commonly from in utero or postnatal infant positioning and also has a strong genetic tendency amongst certain ethnic groups. (e.g., Asian)  While a flat back of the head has no detrimental intracranial or neurologic effects, it can be very psychologically bothersome to some people. To those so affected, it causes a variety of efforts at hairstyle and hat management to camouflage the shape of the skull.

A variety of augmentation procedures have been done over the years for the flat back of the head deformity. It is merely a question of what materials have been used, how they are shaped and what type of incisional access is needed to do so. Injectable materials like synthetic fillers and fat, while appealing, simply do not work. The scalp is not like the face, breasts or buttocks. It is much stiffer and has no real fatty layer into which filler materials be easily placed. While some injected fat may survive, it runs a high risk of being irregular and can never create much overall volume augmentation.

Bone cements have been the most popular skull augmentation materials. While they can be effective they require fairly long scalp incisions to properly place and shape them. When placing them through smaller incisions they run the risk of palpable irregularities and edge transitions. The kocation of the incision is often needed right near or over the cement application which potentially poses a healing issue when the scalp closure is very tight.

In my practice, bone cements have largely given way to custom skull implants made from the patient’s 3D CT scan. This method offers significant advantages including a precise shape and thickness augmentation, a much lower risk of edge transition and irregularities, shorter operative times and a scalp incision that is located away from the implant’s maximal tension of the overlying scalp

Case Study: This 30 year-old female had long been bothered by the flatness at the top of her head. She styled her hair to puff it up in the back to add volume to the back of her head. She finally wanted a more definitive and permanent solution. She did have a very pertinent prior cosmetic surgery history having had a strip graft harvest from the back of her head for hair transplantation to lower her frontal hairline.

Custom Occipital Implant design Dr Barry Eppley IndianapolisCustom Occipital Implant design 2 Dr Barry Eppley IndianapolisA 3D CT scan was used to design a silicone occipital implant to cover the back of her head. Its maximal thickness was 12mm in the central projection area. Because of her prior hair transplant, she had lost at least 1 cm of scalp flexibility. The thickness of the implant was kept to 12mm to ensure that it would fit without undue tension on the scalp incision and also not to compromise the blood flow to the central scalp over the implant.

Cusytom Occipital Implant Dr Barry Eppley IndianapolisIncision for Custom Occipital Implant Dr Barry Eppley IndianapolisUnder general anesthesia and in the prone position, her prior hair transplant scar was used for access. At the tail end of the incisions the occipital neurovascular bundles were identified and preserved. Long curved instruments were used to develop a subperiosteal pocket around the curved contours of the back of the skull. The custom implant was prepared by placing multiple perfusion holes using a 2mm punch. It was fairly easily inserted, positioned and the scalp incision closed with some tension.

Custom Occipitgal Implant in Female result side view Dr Barry Eppley IndianapolisA custom skull implant for a flat back of the head offers the most predictable outcome with the lowest risk of complications or need for revisional surgery in my experience. Designing the implant shape and thickness that the scalp can tolerate is the ‘art’ in the process and that will differ somewhat for each patient. Some patients will find that the amount of augmentation may be less than they desire as a single stage procedure. If one desires much larger amounts of occipital augmentation, a two-stage approach can be done with a first stage scalp tissue expander.

Case Highlights:

1) Custom designed silicone implants are the most effective method for augmentation of the flat back of the head.

2) The size and thickness of a custom occipital implant is controlled by the incisional access and how much the scalp will stretch to accommodate the thickness of the implant

3) It has been my experience that 12mm to 15mms is as much implant thickness that can be placed on the back of the head.

Dr. Barry Eppley

Indianapolis, Indiana

February 27th, 2015

Technical Strategies – Square Chin Implant and Vertical Cleft Creation

square chin implant dr barry eppley indianapolisChin augmentation is most commonly done by placement of a synthetic silicone implant. Chin implants today come in a wide variety of dimensions, historically providing only horizontal projection, but now available in vertical lengthening styles as well. For men chin implants are even available to provide an increase in width, also known as a square chin look, to provide a more masculine chin/jawline appearance.

One other chin feature that is often desired in men is that of a chin cleft. Certain chin implants have a central cleft in them in an effort to create a midline cleft with the chin augmentation. While it looks good on the implant, it does not translate to creating that effect on the outside after implant placement. It simply is not that easy to create a vertical chin as it does not come exclusively from a defect or notch in the bone, contributions also come from a muscular diastasis as well.

square chin split implant technique dr barry eppley indianapolisvertical chin cleft creation technique dr barry eppley indianapolisTo effectively create a vertical chin cleft at the same time as placing a chin implant, it requires a concerted effort to make it appear. The chin implant is first split down the midline and separated. A 5 to 7mm gap is made between the implant. Because the implant is now in two pieces it is necessary to secure each implant half by screw fixation. Then a bone hole is made through the bottom of the chin in the midline. This allows a permament suture to be placed that is used to pul the mentalis muscle down into the implant gap. A stronger effect can be created by removing some soft tissue under the skin as well before passing the suture. How tight the suture is tied down will impact the degree of cleft creation. The shape of the cleft (its width) is also influenced by the size of the midline implant gap.

Square Chin Implant with Cleft result Dr Barry Eppley IndianapoliisA vertical chin cleft can be done at the same time as a square chin implant augmentation in men. Breaking up the wider square chin with a cleft helps add a visual feature of interest and disrupts a completely flat horizontal line across the bottom of the chin.

Dr. Barry Eppley

Indianapolis, Indiana

February 27th, 2015

ASPS Plastic Surgery Statistics 2014

 

American Society of Plastic Surgeons Dr Barry Eppley Indianapolis2014Annual statistics for plastic surgery in the U.S as gathered by the American Society of Plastic Surgeons showed that almost 16 million cosmetic procedures (nearly 14 million were non-surgical) were performed in 2014. This represents an increase of about 3% from 2013. Like many years before, breast augmentation was the top cosmetic surgery while Botox injections lead the way for non-surgical procedures performed. To put this in perspective, only one-third as many reconstructive plastic surgery procedures were reported. (just under 6 million)

The top five cosmetic surgery procedures in 2014 were breast augmentation (286,000, down 1%), rhinoplasty (217,000, down 2%), liposuction (210,000, up 5%), blepharoplasty (206,000, down 4%) and facelifts (128,000, down 4%)

The top five cosmetic non-surgical (minimally invasive) procedures on 2014 were Botox injections (6.7 million, up 6%), injectable fillers (2.3 million, up 3%), chemical peels (1.2 million, up 7%), laser hair removal (1.1 million, up 3%) and microdermabrasion. (882,000, down 9%)

Some of the most interesting trends have been the tremendous surge in buttock augmentation procedures done in 2014. Fat grafting (Brazilian Butt Lift, BBL), buttock lifts and buttock implants all methods of buttock enhancement that are increasing in total numbers performed. BBL procedures were up 15% (11,500), buttock implants up a startling 98% (1,800) and buttock lifts up 44%. (3,500)

Male plastic surgery also continued to increase in 2014. Male cosmetic surgery procedures such as pectoral implants (1,000, up 208%) and male breast reductions/gynecomastia reductions. (26,000, up 29%)

It is important to remember that these cosmetic procedures statistics only reflect that reported by members of the American Society of Plastic Surgeons. While it is the largest society of board-certified surgeons who perform cosmetic procedures, it does not acclunt for a significant number of cosmetic procedures performed by other surgical societies.

Dr. Barry Eppley

Indianapolis, Indiana

February 24th, 2015

Volumetric Sizers in Breast Augmentation

 

The selection of implant size is one of the most important and debated choices in breast augmentation surgery. Women understandably spend considerable time considering this choice and on today’s internet a lot of breast implant results are available for viewing. While many results give the woman’s height and weight and breast implant size used, that is rarely a good way to determine what the viewer needs or would look best getting.

Numerous individual methods of breast implant sizing exist from the ‘rice test’ to 3D virtual imaging. Any of these are far superior to choosing what one sees on the internet or from a size that a relative or friend would suggest. Breast implant sizing is about what looks good on you as you see it.

350cc vs 450cc sizersOne very good method of choosing breast implants is through the use of Volumetric sizers. Since the plastic surgeon picks breast implants ‘off the shelf’ based on volume and not cup sizes, it is critically important to create an accurate correlation between the look one wants and what volume would create that look. Volumetric sizers do just that by having breast molds in different volumes that fit over the patient’s natural breasts. (from 150cc to 650cc molds)

Side View Comparison of 350cc vs 450cc sizersBy overlying the different sized breast molds and comparing volumes, it is very easy to quickly establish the high and low range of implant sizes that a woman wants. (ranging within 100ccs) The first step is to quickly go up in size until one finds when the chosen volume is too big. Along the way one also finds out what is too small. From there one can hone in the final size range within 25 to 50cc. Once in this narrow range of sizes, any choice is not going to be wrong since these small volume differences are not visually discernible.

What really counts in judging breast augmentation size results is how they look. Cup sizes or volumes used are just numbers and is not as important as to how they ultimately look. Volumetic sizes make it easy to make that judgment directly on the breasts.

Dr. Barry Eppley

Indianapolis, Indiana

February 23rd, 2015

The Safety of Injectable Fat Grafting

 

Fat grafting and its liposuction harvest has become mainstream in 2015 for both aesthetic and reconstructive plastic surgery needs. While ongoing clinical studies and experience will continue to evaluate its effectiveness, there is no debating that its use has become adopted by most plastic surgeons. Several of the reasons for its popularity is that most patients are adequate donors, it can be accessed by very familiar liposuction techniques, it is easy to process and inject, and can be injected just about anywhere on the body.

But one reason for its popularity is almost never discussed but is widely known amongst plastics…it is an injectable tissue graft that has few complications. No matter how well a graft or implant may work, it will never have widespread acceptance or use if it has a high rate of complications. While it has been acknowledged that human body is remarkably tolerant of processed fat loads, few studies have reported on it.

In the March 2015 issue of the Annal of Plastic Surgery journal, a paper was published entitled ‘ Autologous Fat Graft by Needle: Analysis of Complications After 1000 Patients’. The authors performed a retrospective study of 1000 consecutive fat transplantation at their hospital since 2005. Complications were determined and divided into either harvest site or recipient-site complications. Of the 1000 procedures, donor site complications were two hematomas (0.2%)  and eighty three contour deformities caused by liposuction. (8%) In the recipient sites, there were four infections. (0.4%) There was no skin necrosis in the grafted areas and no systemic complications from the harvest such as pulmonary embolism or deep venous thrombosis.

Liposuction Fat Aspirate Dr Barry Eppley IndianapolisIt can be seen that the overwhelming complications in injectable fat grafting is that from the liposuction harvest. These are contour deformities whose likelihood is based on how much fat is needed and how much needs to be injected. It is easy to see that large volume fat injections often require aggressive liposuction harvests and that is a setup for the creation of donor site irregularities. Often the liposuction harvest for fat grafting is viewed differently than the liposuction for aesthetic body contouring. It is important to not trade-off one aesthetic problem for another.

The very low complications in the recipient site show that injectable fat grafting has a very high safety level. I am surprised that using a needle to inject the fat did not have a few more minor complications due its sharp edges. I have long ago abandoned needles for injection and replaced them with blunt tipped cannula with side injection ports.

Dr. Barry Eppley

Indianapolis, Indiana

February 22nd, 2015

Plastic Surgery Case Study: Custom Jawline Implant in Surgically Altered Mandible

 

Background: A prominent and more defined jawline is a facial feature that has always been in vogue for men and more recently that of women as well. While there are differences between jawline augmentation methods and objectives for man and women, a smooth jawline from front to back is characteristic of both of them.

Custom Jawline Implant design Dr Barry Eppley IndianapolisWith few exceptions in my jaw reshaping/augmentation experience, the most assured method of total jawline augmentation is with the use of a custom jawline implant. Using the patient’s 3D scan, a complete wrap around jawline implant can be made of almost any dimensions one wants as along as the overlying soft tissue can accommodate the expansion. (this is really an issue for the chin area only) Its jawline augmentation results are so superior than any other method of jaw augmentation using separate preformed implants should only be done for cost considerations only.

With the emergence of custom jawline augmentation, I have run into a whole host of patients who have had prior surgeries with various forms of implants and other materials placed along their jawline. These include previous sliding genioplasties, silicone and Medpor implants, titanium plates and screws and hydroxyapatite blocks and granules. While in days gone by some of these would have been a surprise,  3D CT scans can pick up what is there and the implants can be designed with their virtual removal or made to fit around them.

Case Study: This 52 year-old male wanted a stronger jawline and had made prior surgical attempts to achieve it. He ha d a prior procedure that included a sliding genioplasty and the placement of a large amount of hydroxyapatite (HA) granules from the chin back to the jaw angles. While this provided some benefit to the chin, it had little success in making a stronger and more defined jawline.

Sliding Genioplasty and HA Granule Jawline Augmentation Dr Barry Eppley IndianapolisA 3D CT scan showed the sliding genioplasty plate and screws and a large amount of irregular and lumpy radiodense material (green color) along the sides of the jawline back to the angles. To prepare the bone surface for implant design, the HA material was electronically removed showing an irregular jawline bone surface and edges

Custom Jawline Implant Dr Barry Eppley IndianapolisCustom Jawline Implant Indianapolis Dr Barry EppleyA wrap around jawline implant was designed to provide 6mms horizontal and 5mm vertical chin increase as well as 7mm vertical and 5mm width increase at the jaw angles. The chin and jaw angles were connected between them with material that made for a  very smooth jawline implant.

Custom Jawline Implant over sliding genioplastyUnder general anesthesia, the mandibular implant pocket as developed through a combined submental and bilateral intraoral incisions. The tissues were very adherent and much of the hydroxyapatite granules had become overgrown and encased with bone. The bone surface was scrapped and rasped to make is as smooth as possible. The custom jawline implant was inserted in one piece through the submental position and its posterior position checked through the intraoral incision. Due to the irregular bone surface the implant was secured with multiple small 1.5mm titanium screws.

Despite prior jaw surgery and implants, a custom jawline implant for augmentation can still be done. A 3D CT scan to make the implant helps identify potential jaw issues and materials. If needed the 3D CT planning can ‘remove’ what will serve as an obstruction and adjust for those bone surfaces changes in the custom jawline implant’s design.

Case Highlights:

1) Custom designed implants are the most effective method for complete jawline augmentation.

2) Prior mandibular surgery and jaw implants do not prohibit or prevent the design and placement of a total jawline implant.

3) 3D CT assessment and designing of jaw implants is essential for an optimal result in the face of altered mandibular anatomy.

Dr. Barry Eppley

Indianapolis, Indiana

February 22nd, 2015

Plastic Surgery Case Study – Breast Augmentation in Widely Spaced Breasts

 

Background: Breast implants can change many feature’s of one’s breasts including obvious size and creating a rounder and fuller shape. But there are other characteristics of  the breasts in which they can not and may even make some features worse. If the nipples, for example, are horizontally at two different levels initially, augmentation will usually make them become more horizontally askew.

Cleavage in Breast Augmentation Dr Barry Eppley IndianapolisOne such issue to play particular attention to is that of the spacing between the breasts prior to breast augmentation. Most women expect that the enlarged breast mounds will naturally bring the breasts closer together and create braless cleavage. In reality this rarely occurs in submuscular implant placement as the sternal attachments of the pectoralis muscle will simply not allow the implants to go that far medially. Cleavage can be created if the implants are placed above the muscle (subglandular) as there is no muscular obstruction to their pockets being made closer to the sternum. (but with that positioning comes other potential complications)

Case Study: This 33 year-old female wanted larger breasts but was particularly focused on ending up with cleavage as well. She had a large sternal gap between her breasts with nipples that were oriented more to the sides of her chest wall. It was pointed out to her during the consult that this was an outcome she should not expect.

Wide Spaced Breast Augmentation result front view Dr Barry Eppley IndianapolisUnder general anesthesia, she underwent silicone gel breast augmentation through an inframammary approach. Gummy bear breast implants of 450cc size were placed using a funnel insertion technique. Care was taken to not develop much of a lateral pocket and keep most of the pocket dissection towards the sternum with release of some of the pectoralis muscle fibers.

Wide Spaced Breast Augmentation result oblique view Dr Barry Eppley IndianapolisWhile some or better cleavage can result in some cases of breast augmentation, women should not come to expect it. Subglandular placement and large implants can make cleavage but that is not what most women usually want for their breast augmentation procedure. Any better inward positioning of the breast mounds should be considered a bonus but may not always predictably occur.

Case Highlights:

1) Breasts that are widely spaced often will maintain that wide spacing after breast augmentation.

2) Breast augmentation patients should not expect that cleavage will result from the placement of breast implants.

3) The best way to try and close a sternal gap in breast augmentation is to medialize the implants as much as possible without overdoing the muscle release.

Dr. Barry Eppley

Indianapolis, Indiana

February 22nd, 2015

World of Plastic Surgery – Ireland

 

Plastic Surgery in Ireland Dr Barry Eppley IndianapolisIreland, technically the Republic of Ireland, is an enchanting island that is in the Atlantic ocean northwest of Great Britain. It covers over 32,000 square miles (or almost 85,000 square kilometers) and is one of the biggest islands in all of Europe. It’s history and politics divide the island into ‘mainland’ Ireland which is about 5/6s of the island and a smaller Northern Ireland which is part of the United Kingdom. It has a total population of about 6.5 million of which close to 2 million live in the much smaller Northern Ireland.

Irish Association of Plastic Surgery Dr Barty Eppley Indianapolis IndianaDespite its relatively small population, Ireland has five medical schools. (Dublin (2) , Cork, Limerick and Galway) Training in plastic surgery is done through the oversight of the Irish Association of Plastic Surgeons (IAPS) which is the voice of plastic surgery on the island. It is the only body of plastic surgeons that is recognized by the Royal College of Surgeons in Ireland and the national Medical Council. Its registry lists 32 accredited plastic surgeons with more than half located in Dublin. (Cork and Galway make up the rest) With prerequisite of 2 to 3 years of general surgery training, followed by one year of research, plastic surgery training then encompasses an additional six years.

In Ireland the formal name for a Plastic Surgeon is…Plastic, Reconstructive & Aesthetic Surgeon. As a result, aesthetic procedures are available all over the island at many major hospitals and clinics. Costs of various face and body cosmetic procedures is often only available on enquiry and few plastic surgeons openly advertise their prices and or even provide a general range on their websites. This may reflect adherence to the code of ethics from the Medical Council and endorsed by the Irish Association of Plastic Surgeons. Free consultations are common and costs of breast augmentation  (4900 euro) and mini-facelift (3700 euro) are the few actual procedure prices that could be found.

Dr. Barry Eppley

Indianapolis, Indiana

February 21st, 2015

Plastic Surgery Case Study – PMMA Cranioplasty for Moderate Flatness of the Back of the Head

 

Background: Excessive flatness of the back of the head can affect women and men equally. While shorter hairstyles reveal the shape of the back of the head most clearly, women with longer hair can be similarly affected and use various hairstyling methods to camouflage it.

PMMA Cranioplasty Material Dr Barry Eppley IndianapolisThere are various materials by which the back of the head can be built up. Each has their own distinct advantages and disadvantages. PMMA bone cement has been used for many decades for various forms of inlay and onlay cranioplasty. As an onlay, PMMA is most commonly thought of as a forehead augmentation material. But it can work just as well on the back of the skull as it does on its front side.

Case Study: This 35 year-old male had long been bothered by the flatness of the back of his head. It had been present since birth and he felt that the shape of the back of his head was unusual and out of proportion to the rest of his skull shape. Building up the back of his head would help give him a more normal shape.

PMMA Occipital Cranioplasty Dr Barry Eppley IndianapolisPMMA Bone Cement Occipital Augmentation results side view Dr Barry Eppley IndianapolisUnder general anesthesia, am 11 cm long incision was made across the top of his head near the back. The occipital skull was exposed and the flatness at its superior aspect evident. Three small 1.5mm screws were placed with their heads above the surface of the bone for cement anchorage. Using 60 grams of PMMA cement mixed with antibiotic powder, the putty was applies and shaped until set to give the back of his head a more rounded shape. The scalp incision was closed with resorbable sutures.

PMMA bone cement remains an historic and proven method of occipital augmentation for treatment of moderate degrees of back of the head flatness. Because the cement must be placed as an initial putty and then shaped after application, it requires an open approach with careful attention to its symmetry of shape and edge transitions. Because the cement is initially ‘soft’ it has a limited ability to create much scalp push. This limits the amount that can be placed to 60 to 90 grams through more limited scalp incisions and flap elevations.

Case Highlights:

1) Flatness of the back of the head can be corrected by a variety of onlay augmentation methods.

2) The use of PMMA bone cement is the most cost effective form of occipital cranioplasty.

3) PMMA cement is useful for small to moderate amounts of occipital augmentation requirements.

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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