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.

September 13th, 2014

Case Study – Natural Blepharoplasty Results

 

Background: Aging is an inevitable consequence of living and its most recognizable effects are on the face. The first place affected on the face by aging is around and on the eyes. The near constant motion of the eyelids and its thin overlying skin are a set up for wrinkles, loose skin and bags and puffiness caused by extruding fat from under the eye. Given that the eyes more than any other facial feature reveal one’s ‘character’ and are a reported ‘mirror of the soul’,  aging changes of them reflect what most would not want others to see.

Beginning in the late 30s and early 40s, the signs of periorbital (around the eye) aging begins. Botox and other neuromuscular modulator injections do a good job of slowing down this process by decreasing the formation of crow’s feet, but it can not prevent the development of loose skin on the eyelids and the herniation of fat on the lower eyelids. These aging eye effects can be quite variable with some people more genetically prone to developing them sooner and more extensively than others. But inevitably everyone will have more of these eye aging signs than they want.

Eyelid (blepharoplasty) surgery is well known and has been around for almost a century in various forms and techniques. Most patient’s biggest fear about blepharoplasty surgery is that they will look like a different person or will look unusual or very obvious that they have had plastic surgery. They can even point to numerous celebrity examples who show exactly what they fear. How is such a result avoided? Will everyone look like they have had surgery? After all, the eyes are seen by everyone and won’t all changes be seen?

Case Study: This 58 year-old female was tired of her tired looking eyes. She wanted to look less fatigued but was afraid that she might look ‘surgical’. She had a large amount of upper eyelid skin with significant hooding. (skin laying on or near the eyelashes) Her lower eyelids show multiple redundant skin rolls and bags. Here eyebrows were not especially ptotic or has any significant sagging.

Upper and Lower Blepharoplasty result front view Dr Barry Eppley IndianapolisUnder general anesthesia, upper blepharoplasties was performed removing 12mms of skin centrally and sparing the underlying orbicularis muscle. Medial fat pockets were also removed.  Lower blepharoplasties were done using a skin-muscle flap technique. A three pocket fat removal, 5mms of tapered skin removal at the lateral canthus and a lateral orbicularis muscle suspension was done.

Upper and Lower Blepharoplasty result oblique view Dr Barry Eppley IndianapolisHer recovery took about ten days to look ‘non-surgical’ and three weeks to fairly normal. Many blepharoplasties will look a little tight for a period of time but by six weeks after surgery this has usually passed. Her results at six months show significant improvement but a result that retained her natural look.

An overdone or unnatural result from periorbital rejuvenation surgery is caused by numerous factors including aggressive tissue removal and an over elevated or exaggerated browlift. It is the browlift that is often at fault for a perceived abnormal eye look after plastic surgery. The effects of aggressive tissue removal, particularly that of fat, are often not seen until much later when the eye may look skeletonized or more hollow. The key to a natural blepharoplasty result is to not try and work out every excess bit of tissue or get rid of all wrinkles. While patients want the best result possible, they also d not want an over operated look either.

Case Highlights:

1) Aging of the eyes is the first facial area affected and is commonly treated by blepharoplasty surgery.

2) Four lid blepharoplasty (upper and lower eyelid surgery) is the most effective method of partially reversing the effects of aging on the eyes.

3) Natural blepharoplasty results occur when the amount of skin and fat removal is not overdone and lid function is not affected.

Dr. Barry Eppley

Indianapolis, Indiana

September 11th, 2014

Joan Rivers – A Comedian’s Legacy to Plastic Surgery

 

Joan Rivers and Plastic Surgery Dr Barry Eppley IndianapolisJoan Rivers, comedian and and, in many ways, a champion of plastic surgery, died last week…ironically, having a minor surgical procedure. (however, not a plastic surgery procedure). She is the second such famous female comedian (Phyllis Diller in 2012) that has been tied to plastic surgery that has died in the past few years; both of them pioneering female comedians and both more than willing to make endless jabs at their own adventures in surgical self-improvement.

No one knows exactly how many plastic surgery procedures Joan Rivers had. Most likely her jokes about them far exceeded what she had done. (minus Botox Cosmetic which does not count as actual surgery). Some of her most well known quotes on plastic surgery include:

‘I’ve had so much plastic surgery, when I die they will donate my body to Tupperware.’

‘I wish I had a twin, so I could know what I’d look like without plastic surgery.’

‘I have flabby thighs, but fortunately my stomach covers them.’

‘I’m never without a bandage.’

‘I’ve had so much Botox Betty White’s bowels move more than my face.’

‘I saw what’s going on under my chin. I don’t want to be the one the president has to pardon on Thanksgiving.’

‘The only way I can get a man to touch me at this age is plastic surgery.’

‘Every weekend I just go in and I do something….You get a tenth one free. It’s like coffee so you just keep going’

‘I was so ugly that they sent my picture to Ripley’s Believe It or Not and he sent it back and said ‘I don’t believe it’.’

‘Better a new face coming out of an old car than an old face coming out of a new car’.

What Joan Rivers (and Phyllis Diller) are most famous for about their plastic surgery is not their quotes but how they were perceived as classic examples of everything that is ‘wrong’ about having plastic surgery. She was commonly referred to as what patients would say they did not want to look like…over done and unnatural. But such criticism is a bit harsh since at age 81 she looked awfully good and much better than what the natural aging process had to offer.

Dr. Barry Eppley

Indianapolis, Indiana

September 9th, 2014

Forehead Widening Implants

 

Facial implants are commonly used to augment various areas of the face. While historically this had been relegated to the cheeks and chin, their use has been widely extended to many other facial areas as well. One of the newer areas of facial implant use has been the temporal region for correction of excessive temporal hollowing or concavity.

Zone 1 temporal implant results Dr Barry Eppley IndianapolisTemporal implants are uniquely different from almost all other facial implants because they do not augment bone. Rather they are soft tissue implants that augment the amount of muscle volume that exists in the temporal region. What causes temporal hollowing is loss of fat volume and/or muscle, not a change in bone volume. While augmenting the anterior aspect of the temporal bone can be done, it would require a large implant placed very deep under the muscle to create that effect. It is far simpler and more effective to place a smaller implant right under the fascia on top of the muscle which is how newer temporal implants are done today.

High Temporal; Implant Design for Forehead Widening Dr Barry Eppley IndianapolisTraditional temporal hollowing involves the lower half of non-hair bearing aspect of the temporal region just to the side of the eye. (lateral orbit) This is referred to as the Zone 1 temporal region. But other temporal areas can be augmented as well for different aesthetic effects. One of these is the Zone 2 temporal region. This is the upper half of the non-hair bearing area (above Zone 1) which is more to the side of the forehead than it is the eye. It abuts right up against the anterior temporal line of the forehead. Thus augmenting the temporal zone 2 creates a forehead widening effect.

high temporal implant Dr Barry Eppley IndianapolisZone 2 temporal implants, like Zone 1, are placed under the fascia from a small incision in the temporal scalp area. While they are subfascial, the temporalis muscle gets very thin as it approaches the forehead. In addition, the underlying temporal bone no longer is concave but starts to become almost convex as it merges into the forehead. Thus a Zone 2 temporal implant is closer to being a bony augmentation technique rather than a purely muscle implant like Zone 1.

Widening the forehead has been traditionally very difficult. Extending bone cements from a forehead augmentation onto the temporalis fascia can result in a visible line of the material and discomfort. Fat injections can be done but their survival and smoothness if far from assured. Custom silicone implants can be made for forehead augmentation that extends onto the temporalis fascia to both augment projection and width of the forehead. But for those patients that just want a little more forehead widening only, there have been no options to date.

Forehead Widening Implant result Dr Barry Eppley IndianapolisForehead Widening Implant result 2 Dr Barry Eppley IndianapolisZone 2 temporal or forehead widening implants offer s a simple and effective solution to those patients that would like to see just a slight increase in their horizontal forehead width. By placing an implant just to the side of the anterior temporal line under the fascia,  the forehead can be made wider in appearance. This procedure, like Zone 1 temporal implants, has a very rapid recovery with little swelling and discomfort afterwards.

Dr. Barry Eppley

Indianapolis, Indiana

September 7th, 2014

Case Study: Sliding Genioplasty for Obstructive Sleep Apnea Improvement

 

Background: Chin augmentation with a sliding genioplasty is a well known aesthetic technique. It is not done as commonly as a chin implant but in the right patient has its own advantages. One of its benefits is that it brings the chin forward with its attached tongue-side musculature as well as lengthening the jawline. By so doing it can help smooth out the neck better than an implant which just pushes out the soft tissue chin pad and has no direct effect on the neck muscles behind it

genioglossus and geniohyoid muscles attached to the chinThe main muscles that a sliding genioplasty pulls forward is the genioglossus and geniohyoid. The genioglossus is a fan-shaped tongue muscle which comprises most of the tongue. Its origin is the spine on the back side of the chin bone and inserts into the hyoid bone and the bottom of the tongue. Its contraction enables one to stick their tongue out as well as enlarges the upper airway behind the base of the tongue. The geniohyoid muscle lies below the genioglossus but above the mylohyoid muscle. It runs from the back of the chin down to the hyoid bone and its contraction dilates the upper airway as it pulls the hyoid bone upward and forward.

Because of the attached muscles that accompany a sliding genioplasty, it could have an effect very similar to a direct muscle procedure used to treat obstructive sleep apnea. A genioglossus muscle advancement is an intrachin procedure where the genioglossus muscle is brought forward by using a window of bone in the chin. It is usually part of other obstructive sleep apnea procedures and is rarely done alone since obstructive sleep apnea almost always involves various structures at different areas of the airway. It is limited to a forward muscle movement that is no further than the thickness of the chin bone.

Case Study: This 46 year-old male presented with symptoms of obstructive sleep apnea and a short lower jaw.  He wore CPAP at night. He had a class II malocclusion and an overall heavy face appearance. He was overweight but certainly not obese. He had significant daytime sleepiness. A sleep study showed multiple apneic episodes greater than 10 seconds and a drop in oxygen saturations to 84%. His apnea-hypopnea index (AHI) was 25. He did not want a maxillomandibular advancement.

Sliding Genioplasty Technique for Obstructive Sleep Apnea Dr Barry Eppley IndianapolisUnder general anesthesia, an intraoral approach was used to deglove the chin. A mid-level near horizontal osteotomy bone cut was made through the chin keeping the muscles attached to the lingual side of the chin. The chin was brought forward 16mms and stabilized with central step plate as well as two side plates due to the magnitude of the movement.

Obstructive Sleep Apnea Sliding Genioplasty result sidew view Dr Barry Eppley IndianapolisAfter surgery he had a significant increase in chin horizontal position and an improved facial profile. Despite the very large chin movement, his chin projection was not excessive. He had improvement in his sleep apnea symptoms but not a complete cure of it as was expected before surgery. His sleep study numbers improved to an AHI of 15.

Obstructive Sleep Apnea Sliding Genioplasty result front view Dr Barry Eppley IndianapolisFor a genioglossus movement to be effective, its forward movement must be considerable. (greater than 15mms) This is not usually possible with the traditional technique of moving the genial tubercle alone. This sliding genioplasty was beneficial for this patient’s sleep apnea symptoms because of the magnitude of its movement. His initial lower jaw retrusion permitted a large sliding genoplasty movement.

Case Highlights:

1) One type of occipital skull deformity is that of the prominent nuchal ridge which forms a raised horizontal ridge across the back of the head.

2) The prominent nuchal ridge should not be confused with the occipital knob which is a raised button of bone at the center of the nuchal ridge.

3) Nuchal ridge reduction is done through a small horizontal incision over the central part of it.

4) Some patients with a prominent nuchal ridge have intermittent occipital headaches due to tight neck muscle attachments.

Dr. Barry Eppley

Indianapolis, Indiana

September 7th, 2014

Vanquish Treatments for Non-Surgical Fat Reduction

 

The option to get rid of some abdominal and waistline fat without surgery has been a major non-invasive body approach for almost two decades. Numerous devices, injections and technologies have been introduced over the years…a few of which have stayed and most of which have gone. As old ones go, new non-surgical fat reduction methods appear which are usually better than those tried before. Although none of them can be compared in terms of results to actual fat removal surgery.

Vanquish Non-Surgical Fat Reduction Indianapolis Dr Barry EppleyThus enters Vanquish whose names sounds exactly like what it is trying to accomplish…vanquish your fat. Vanquish is a relatively new radiofrequency treatment that targets fat through an external delivery system of paddles. The external paddles create a broad radiofrequency field that is targeted to the fat under the skin. It heats up the fat to around 46 degrees C while keeping the overlying skin and deeper muscle at temperatures no higher than 41 degrees C.  At 45 to 46 degrees C, fat cells will undergo apoptosis or cell death. This causes the cells to shrink and lose their lipid content, resulting in a change of the outward body contour.

Vanquish Heat Creation for Fat ReductionHow does this radiofrequency approach actually work? In scientific terms, the creation of a high-frequency electrical field allows the transformation of electromagnetic energy in the treated body part to be converted into heat. This works best in tissues, like fat, which have a relatively low flow blood circulation. (so that the heat is not quickly wisked away so a temperature increase can actually occur) Due to the polar molecule oscillation resulting in the treated tissue, the temperature rises in the fat while the surroundiung tissues above and below it remain protected from the high heat. In essence Vanquish is a thermal method of fat reduction. The manufacturere likes to use the term ‘zapping the fat’ but this is not really how it works. (it is not a laser that shoots the fat cells)

Vanquish results front viewWhile Vanquish with its radiofrequency and heat generation sounds uncomfortable, it is not. Treatments are pain-free and have very few side effects. Most people say that their treatments feel like a moderately warm ‘heat treatment’ on their abdomen. The skin will appear red or flushed for an hour or two following treatment as one might expect from any treatment that induces heat. (remember that fat acts just like oil so it retains its heat for some time after the temperature induction has occurred) To help wash out the loose fat oils (lipids) after treatment, it is beneficial to stay well hydrated immediately before and following a Vanquish treatment.

Vanquish results side viewEach treatment session is about 30 min long and requires four to six sessions to get the maximal effect. Many patients report they notice a visible difference after the first treatment but, after the fourth, the average was at least a two-inch waist reduction. Early research indicates that there have been no problems of nerve pain and no damage to the top and middle layers of the skin, muscles or hair follicles. Because of its paddle delivery system, Vanquish is only intended for treatments on the back, love handles and stomach.

Vanquish requires the placement of a grounding pad due to the creation of a radiofrequency field. As a result, there are certain conditions that are contraindications for Vanquish treatments, such as people with metal implants, pacemakers, women who are pregnant or breastfeeding, and people with non-healing wounds.

It is important to understand that Vanquish does not create the same fat reduction effects as liposuction or tummy tuck surgery…no non-surgical treatment approach can. Therefore, it is important to be qualified beforehand for Vanquish to determine if it or surgery is more appropriate.

Dr. Barry Eppley

Indianapolis, Indiana

September 7th, 2014

Case Study: Nuchal Ridge Reduction in Aesthetic Skull Reshaping

 

Background: Aesthetic skull concerns present in a variety of shapes, depressions, bumps and prominences. Some are due to birth defects and trauma but the vast majority are due to genetics and simply how the skull has developed for unknown reasons. But some aesthetic skull anomalies are there for an actual anatomic reason.

Nuchal Skull RidgesSuch is the case of the prominent nuchal ridge on the back of the head. It exists as an attachment area for various neck muscles. While normally barely visible, even in a shaved head, it can become very visible. If the nuchal ridge is thick enough it will protrude out creating an abnormal bulge. This will extend entirely across the back of the head but is usually thickest in the middle. It can be obvious even in close cropped hairstyles and can be aesthetic concern for some men. (I have never seen it yet in a woman)

Calling the raised bone ridge across the back of the skull a single nuchal ridge or crest is a bit oversimplified. The nuchal ridge per se is really a set of four curved lines on the occipital bone. The highest nuchal line is where the galea of the scalp attaches and is a barely visible bone line. Below it lies the superior nuchal line, which is what is commonly called the ridge, because it is more prominent because of its muscular attachments. (splenius capitis, occipitalis and trapezius muscles) Below this lies the very faint median and inferior nuchal lines to which muscles also attach and are closer to the foramen magnum.

thWhy some nuchal ridges are very prominent and others are not is not precisely known. It is assumed that it is present because of very strong muscle attachments. Using the form follows function theory, one can assume those with larger nuchal ridges have very thick and strong muscular attachments. This may also account for why some patients with prominent nuchal ridges have occipital migraines/headaches. (personal observation)

Case Study: This 43 year-old male presented with a prominent nuchal ridge that was aesthetically bothersome. It bulged out at the bottom of the back of his head. It was thickest in the middle and tapered down from the center on each side. He also had a history of intermittent occipital-based headaches and a tight neck.

Nuchal Ridge Reduction burring technique Dr Barry Eppley Indianapolis intraopUnder general anesthesia in the prone position and without shaving any hair, a 5 cm long horizontal incision was made parallel to it. The raised ridge was dissected out at the subperiosteal level, releasing the muscle attachments at the bottom side of it. A handpiece and burr was used to completely flatten the ridge from side to side, reducing it by as much as 9mm in the middle. Bone wax was used to fill any bleeding bone holes. Closure was done in multiple layers with small resorbable sutures for the skin.

Nuchal Ridge Reduction result Dr Barry Eppley IndianapolisNuchal ridge reduction produces an immediate and aesthetically satisfying occipital skull reshaping procedure. Recovery is quick and patients do not complain of much discomfort other than some initial upper neck soreness. It remains to be seen whether such bone reduction and muscle release result in headache improvement.

Case Highlights:

1) One type of occipital skull deformity is that of the prominent nuchal ridge which forms a raised horizontal ridge across the back of the head.

2) The prominent nuchal ridge should not be confused with the occipital knob which is a raised button of bone at the center of the nuchal ridge.

3) Nuchal ridge reduction is done through a small horizontal incision over the central part of it.

4) Some patients with a prominent nuchal ridge have intermittent occipital headaches due to tight neck muscle attachments.

Dr. Barry Eppley

Indianapolis, Indiana

September 6th, 2014

Technical Strategies in Plastic Surgery – Sonopet Ultrasonic Aspirator for Facial Bone Contouring

Reshaping of different parts of the facial bones is often required to either reduce or smooth certain facial prominences to get a desired contour. This is traditionally done with a handpiece and burr with saline dripped over it to reduce heat build-up and prevent bone ‘burning’. Using a high speed rotary instrument inside small and restricted tunnels under and inside the face must be done with care and protection of surrounding tissues. It is very easy to have this fast turning burr inadvertently grab onto adjacent tissues (e.g., nerves) and create injury and bleeding.

Sonopet Burr for Facial Skeletal Contouring Dr Barry Eppley IndianapolisSonopet Indianapolis Dr Barry EppleyOne technologic improvement in craniofacial and maxillofacial bone contouring is the Sonopet Ultrasonic Aspirator. This system allows for fine bone dissection and contouring with prevention of damage to any adjacent soft tissues. This instrument removes bone through ultrasonic cavitation and not a rotary or spinning motion of a fluted burr. Thus the burr does not spin or rotate but rather vibrates by ultrasonic energy. This creates the cavitation process by which the bone is ‘fragmented’ off in small pieces under direct saline irrigation. The sharp points on the Sonopet burrs will engage the hard bone but not the soft tissues since it has no spinning or rotary motion. The visualization, manipulation, ease of use, and speed of bone removal with the Sonopet is definitely better than with traditional drills or rongeurs.

Sonopet Jawline Contouring Dr Barry Eppley IndianapolisThis is an excellent innovation in technology for bone removal in craniomaxillofacial surgery. Since much of facial surgery and some skull surgery is done through limited access incisions, it can be hard to precisely shape bone. The size of traditional handpieces and burrs and the need to irrigate while they are on puts adjacent tissues at some risk of injury. The Sonopet with its ultrasonic energy allows for better control and eliminates the concern about any collateral damage from the bone work.

Dr. Barry Eppley

Indianapolis, Indiana

September 5th, 2014

Orbital Rim Augmentation in Graves Eye Disease

 

Graves eye disease, while well known, does not have one standard way that it presents itself. It is a complex eye disorder that presents with differing anatomic involvement of the periorbital tissues that varies based on the stage of the disease. But the classic findings include proptosis/exophthalmos (bulging eyes), upper eyelid retraction and restriction of eye movement. These occur because of infiltrating fibrosis and edema of all tissues surrounding the eye.

Besides the visual problems that may occur from Graves eye disease, there is also a significant associated aesthetic disfigurement as well. The bulging eye look creates a classic but unusual appearance that is socially distracting and psychologically burdensome. Fortunately once the thyroid function is under control (for at least six months), improvement in these symptoms is possible with surgery that typically includes orbital decompression and intraorbital fat reduction.

In the September 2014 issue of the journal Plastic and Reconstructive Surgery, an article appeared entitled ‘Aesthetic Refinements in the Treatment of Graves Ophthalmology’. This paper presents the addition of bone augmentation as an adjunctive technique in improving the aesthetic appearance of the eye area of the Graves patient. Through a lower eyelid approach, orbital decompression is initially performed through medial and lateral orbital wall decompression and the removal of excessive infraorbital fat.

InfraOrbital Rim Implants in Graves Ophthalmopathy Dr Barry Eppley IndianapolisA Medpor infraorbital rim implant was then also placed combined with a midface lift. The intent is to improve the eyeball-cheek relationship through the combination of the eye setting back into the orbit (decompression) and the infra-orbital rim/cheek implant bringing the position of the bone outward. (augmentation) Over a three year period, a total of 13 patients (26 eyes) were treated. Besides the aesthetic improvement obtained, diplopia improved in 3 patients (23%) and almost all patients (92%) discontinued the use of eye lubricants.

The addition of lower orbital bone augmentation is a logical treatment extension for the Graves eye disease problem. While Graves disease does not cause loss of bone or a weakening of the lower eye socket, it is a compensatory maneuver to help camouflage the residual eye bulging that orbital decompression alone can not completely solve. It adds little risk to the overall orbital decompression procedure. It is usually necessary to add cheek tissue suspension (midface lift) over and on top of the implant to lower the risk of lower eyelid sagging (ectropion) afterwards.

Dr. Barry Eppley

Indianapolis, Indiana

September 2nd, 2014

Masseter Muscle Changes After Jaw Angle Reduction

 

Jaw angle reduction surgery, technically known as reduction gonioplasty, is a well known procedure to help reduce a square lower face. It is particularly common in Asians who often have more of a wider face with thicker masseter muscles and greater posterior jaw bone width. It has been practiced for years and is often part of other facial reshaping procedures with the goal of an overall thinner face.

Jaw Angle Reduction (Removal) Surgery Dr Barry Eppley IndianapolisJaw angle reduction surgery can be done by one of two techniques, a oblique ostectomy (amputation) and a sagittal reduction. (outer table ostectomy) Each has their own advantages and disadvantages with an ostectomy being a more aggressive bone reduction method than an ostectomy. But either jaw angle reshaping techniques involves the need to raise the masseter muscle off the bone to perform the surgery. What effect this has on the long-term result has never been studied. Although it has been hypothesized, based on other jaw angle surgeries, that some muscle thinning effect may occur as well due to muscle trauma and disinsertion.

In the September 2014 issue of the Journal of Craniofacial Surgery, an article appeared entitled ‘Long-Term Changes in the Masseter Muscle Following Reduction Gonioplasty’. In this paper, 56 patients were studied before and four years after jaw angle reduction surgery with 3D CT scans. The changes in the volume and shape of the masseter muscle were analyzed. Their results showed that the masseter muscle shrunk an average amount of 21% in the lower part of the masseter muscle in long-term follow-up.

This study confirms what would be suspected with elevating the masseter muscle for any surgery, whether it be jaw angle reduction, jaw angle implants or sagittal split osteotomies. Elevation and disinsertion of the muscle results in some degree of atrophy and loss of muscle bulk afterwards. This can potentially create a skeletonization of the jaw angle area which may account for some of the facial narrowing effect. This could have a positive or negative effect on the jaw angle reduction result depending upon how much bone is removed.

Dr. Barry Eppley

Indianapolis, Indiana

September 1st, 2014

The Rise in Male Cosmetic Procedures

 

Male Facial Plastic Surgery Dr Barry Eppley IndianapolisMale cosmetic procedures are on the rise. While men undergoing some cosmetic procedure will never surpass the number of women that do, over 1 million surgical and nonsurgical procedures were done by men in 2013 according to the American Society of Aesthetic Plastic Surgery. In overall numbers this represents 9% of the total cosmetic pie for men with 91% still belonging to women. Over the past fiteen years, this represents an increase of nearly 300% in men having some cosmetic procedure. A major reason for this increase are the non-surgcal procedures as they largely did not exist back then. They accounted for nearly 84% of the procedures men had done in 2013 so their role is understandably significant The top five non-surgical procedures done by men were Botox, injectable fillers, laser hair removal, photorejuvenation and chemical peels. Injectable non-surgical treatments lead the way just as they do in women.

Men still undergo invasive surgery and the types of procedures men have not changed much over the years. The top five surgical procedures were liposuction, blepharoplasty, rhinoplasty, gynecomastia reduction and otoplasty for 2013. The first four mentioned are very common in my practice and otoplasty only makes the list if one considers males under the age of 18 years old. But the age distributions of the procedures do affect the males that have them. Younger men will have gynecomastia reduction and rhinoplasty while older men will have liposuction and blepharoplasty.

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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