Your Questions

Q: Dr. Eppley, Hi, I have a question for the doctor. I had an implant put in on the front and back of head. I was curious what kind of damage could be done to implants if I decided to do boxing. Is there a low or high for damage to implant?

A: Good to hear from you as we just passed our 2 year mark from your skull implant surgery. Your question is a common one and the answer is no such problems have ever been seen or reported. The implants can not be physically damaged by any type of traumatic forces. So think of them a bit like bone which is how they feel. They also have a low probability of being displaced…so low that it is about as close to zero as can be.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am also interested in having my eyebrows set lower to my eyes and reshaped.. would this procedure cover that?

A:Lowering of the eyebrows is always a hard change to make because the brow tissues on the lower forehead are tight and don’t stretch easily. But the subperiosteal tissue dissection and brow release with the placement of the implant pushing down usually provides some modest improvement in the brow position.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, What about iliac crest reduction for us hip dip girlies? Is that an option?

A: It is an option but probably the iliac crest reduction would not get rid of the hip dips completely. I see that having value when combined with fat injections to the hips or even a very small implant.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I read that mandibular angle implants are at most 6mm in width but I am trying to figure out if it is possible to achieve more than that e.g. 12mm per side would be 2 implants per side of 6mm so a total of 24mm added to bigonial distance. Would love to hear if this is possible or if there’s another way to get more than just 6mm on each side. Thank you so much

A:I am not sure where you are getting your implant information. But standard jaw angle implants come in widths up to 11mms and custom ones can have any amount of width.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, My forehead sticks out more making me lower face looked pushed back so if some slope could be added so that the farthest my forehead goes is my browline, that would be amazing.

Here are the pictures of my forehead, you can see that the middle part sticks out and widens and elongates the forehead. While also having this bone lump, my hairline is far back and so are the sides. I was wondering if it would be possible to push in the sides while also lowering the hairline( I inserted a picture to show what I hope it would look like, forehead shape and everything 

A: Let me make sure I understand what you are asking…

If I compare your forehead to that of what you consider to be a more desirous shape in profile you have more of a protrusion and not a smooth forehead slope. This would indicate that a bony reduction is needed in the middle protruding part.

In regards to the hairline the frontal hairline can be advanced to help shorten the forehead but the sides (temporal hairline) can not be changed/moved without major visible scarring.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I think I have what is referred to as frontal bossing and/or frontal horns. My forehead also appears asymmetrical.I’ve just always known that I had an unusually large forehead, which has been a source of insecurity throughout my life.  I am contacting your office to see if anything can be done to address the aforementioned issues, with minimal risk and without significant scarring. justtso you know I am 45 years old. As you will see from the pics, I am also bald, which raises an issue as to whether any needed incision(s) could be readily hidden. 

A:In forehead reshaping surgery in a bald patient there is no good place to put an incision. For the very highly motivated patient (one who is willing to accept some visible scarring) I would use two small mid-forehead incisions placed in the existing horizontal wrinkle lines  and would  not even connect them across the middle. (see attached picture) This gives the incisions the best chance to heal in a location which already has a natural wrinkle and is parallel to the RSTL (relaxed skin tension lines) of the forehead.

That being said, in the end it comes down to the choice between which aesthetic problem does the patient prefer…the present forehead shape with no scar or a reduced forehead with some slight scarring. Every patient will view that choice differently.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, has there been any developments to the wrap around testicle implant  procedure or does the doctor still not recommend it as a viable long lasting option?

A: I remain less than optimistic about it. The only ‘technical advancement’ has been to get a preop ultrasound to determine the exact size of the testicles and then custom design the inner chamber of the implants to match it

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi, I’m considering genioplasty and jaw implants. As a professional bodybuilder, I’m concerned about how long I’ll be unable to train after the procedure and the potential complications that could arise from resuming too soon. How quickly can I safely return to the gym after having both genioplasty and jaw implants?

Also what is the risk of masseter dehiscence if I go for an implant that mostly augment the width and not so much vertically?

And my last question; when can I return to normal daily life, without people noticing I had surgery?

A: In answer  to your jaw augmentation questions:

1) You return to the gym when you feel comfortable doing so. Working out will not hurt the surgery so it is a question of soon you feel compelled to do so.

2) The risk of masseter muscle dehiscence decreases significantly when a width only angle implant augmentation is done

3) Most jaw augmentation patients start to look more non-surgical in 10- to 14 days after the surgery.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Would it be possible to view predictive imaging for my right profile for frontal bossing reduction The left side looks good I just want to see what it looks like in the right.

A: That can be done but the concept of imaging is not to show the patient the exact result they are going to get….as no one knows that with absolute certainty. Its purpose is to convey in this type of surgery how much bony reduction can realistically be expected as the frontal bone is not that thick. Your goal is to look at it on a general basis and determine either a) if I can at least get that amount of change then the surgery will be worth it, or b) it doesn’t look like enough or I am uncertain if it is…then you shouldn’t have the surgery.

The point being…imaging is a concept about what the surgery may do and not an exact detailed prediction of the reductive change.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I have done some mathematical measurements on my face and I wonder how achievable these facial changes.

A:The purpose of the imaging is to determine the patient’s goals…to set the target for which the surgery, which may include custom facial implant designs, can try to achieve.  It is the patient who determines these targets, not me. In essence facial imaging is a visual discussion board so the patient can tell me what looks good to them.

While your Facial Morphometic analysis  is very specific and scientific, surgery is not. Surgery is more of an art for which millimeter level changes can not be accurately predicted and often not precisely achieved. While Facial Morphometric analyses is an educational mathematical exercise, and it has its merits, I would be cautious in trying to extrapolate that degree of precision to real life surgical procedure outcomes. How to tissues respond to surgical manipulations is not a completely predictable outcome.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I was wondering how much it would cost to fix my forehead. This would include a hairline lowering and a fix to some frontal bossing. I include both of these because I saw on one of your pictures it looks like you guys just fixed his forehead bossing, but I can’t tell if he had a hairline lowering. But I know that his forehead is smaller now. I was wondering if there was just a forehead aesthetic “combo” surgery that would ultimately make my forehead more aesthetic. It’s not the worst case you’ve probably seen, and honestly it’s not even that bad. But I just want to shave some bone off and lower the hairline a little, at the lowest cost of course. I hope to hear back soon from you guys

A:You are referring to a common forehead reshaping combination of a frontal hairline advancement with bony forehead reduction. Let’ see some pictures of your forehead so I can do some imaging of potential changes.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am interested in testicular enhancement. Current size approx 15mm x25mm. I had extreme atrophy over the course of 4 years starting around 10 years ago after an issue with varicocele.Size before that was approx 36ml of volume. I have some old ultrasound paperwork from before all of that happened. 

I’d like to have similar to my original size (5.8cmx3.5cm approx) but understand this would be a custom made silicone implant. If the cost of that is too prohibitive for me, I could possible go with the largest standard size depending on what Dr Eppley recommends.

I still have the varicocele. Although not usually painful anymore, I may have it removed before having implants, depending on what Dr Eppley advises.

A: Thanks for the info. The largest standard testicle implant size is 5.0cms. Any size larger requires a custom testicle implant made. (which would be needed for a 5.8 x 3.5cm size)

I would recommend having  the varicoele removed first. My experience with combining varicoele removal with implants is that the risk of complications increases. You may even consider having the one or both testicles removed with such severe atrophy (or at least the one with the varicoele) and because at such small sizes the wrap around concept does not work well and it would be more ideal to go with the displacement implant approach.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello. I’d like to know if I am a good candidate for neck liposuction. Thank you for the help.

A:Neck liposuction for you will only produce a very modest improvement because of your short jawline and not having a lot of fat in your neck. (see attached imaging) The only way to get a significant improvement is to lengthen the jawline with neck liposuction either by sliding genioplasty (most ideal) or a chin implant. (see attached imaging)

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, am l a candidate for upper lip lift. Approx 20mm in length piltruim. Thankyou for viewing and opinion.

A: At 20mms of upper lip length you can have a subnasal lip lift but I would keep at a 5mm reduction or 25% of its existing vertical length. Given the lack of good lateral vermilion height at the sides/mouth corners you can not have the central lip lift alone as it will likely create an A frame aesthetic deformity. (see attached imaging) It would need to be combined with lateral vermilion advancements to have a more homogenous and natural upper lip shape. (see attached imaging)

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, It’s a bit hard to describe, but my face is small, and so is the shape of my head, which makes my face look even smaller. My wish is to have a higher hairline or scalp and also adjust the sides of my head. It that possible and was is the risky? My face look always bigger at the photos but it is smaller. I want a shape like this, so i can do my hair like i want.

A:The shape of your head is one I treat all the time. It is a narrow head shape from the side of the forehead around the sides of the head to the back. This requires a custom forehead-temporal skull implant similar to skull implant design attached. This changes the shape of the head to a wider forehead/temporals and somewhat taller head shape. (see attached face/head prediction) The only debate in these type of skull augmentations is the amount of augmentation change the patients wants and whether the implant volume needed to achieve would require a first stage scalp expansion or not. The implangt design design and prediction images attached are based on NO first stage scalp expansion. However we would still need to factor in a side view picture for a more complete assessment of the forehead change.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I was wondering if I would be a good candidate for brow reduction. Have attached some pictures for you to have a look at

A: The best way to assess the merits of brow reduction is a good side view picture where the full face is seen and imaging can be done. The supplied pictures are taken too close and at angles that are not favorable for such imaging.

But as a general statement the merits of any type of forehead/brow reduction is based on two issues: 1) how much reduction ca be achieved and 2) is the scalp scar tradeoff to do so worth it. In your case it is #2 of which I would be most concerned.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’m reaching out due to concerns about my facial appearance, particularly related to asymmetry and changes in my smile. Over time, I’ve noticed that my right jawline appears more collapsed, and I no longer show my teeth when I smile. Despite having one syringe of filler on the right side of my jawline and additional filler in my chin, I’m not satisfied with the results and am looking for more permanent solutions.

In the past, I’ve had jaw reduction surgery and my cheekbone repositioned, but now I’m interested in exploring options to achieve a more balanced and defined jawline. Specifically, I’d like to consider a customizable wraparound jawline and chin with enhanced volume on the right side, as well as potential improvements to my cheek area to reduce the visibility of my nasolabial folds. Additionally, I’d like to know if it’s possible to push my upper and lower teeth forward, as I’m experiencing changes in how my smile looks.

Given my history of previous surgeries, I’d appreciate your guidance on whether these adjustments are feasible.

Thank you for your time and attention. I look forward to your response!

Please see the attached photos of me:)

A: Thank you for your inquiry and sending your pictures to which I can make these initial comments:

1) Only orthodontics or upper and lower jaw advancements can being your teeth forward.

2) Cheek augmentation, unless it is of significant size,  is not going to reduce the appearance of the nasolabial folds. Such a cheek augmentation seems contrarian to your prior cheek reduction efforts.

3) While jaw augmentation can be effective at addressing asymmetries, particularly after V line surgery, as well as creating more jaw definition, it is not going to affect your smile in any positive manner.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’m writing to inquire about the possibility of narrowing my rib cage. I understand that you specialize in procedures involving the ribs, and I’m hoping to learn more about what options might be available to me.

I have a very wide rib cage, and I’m not sure that removing or reshaping the 10th, 11th, and 12th ribs would address this issue.  I’m wondering if it’s possible to narrow my entire rib cage, including the upper ribs that are attached to my sternum.

I would appreciate it if you could share any insights you have on this matter.  I’m eager to learn more about the potential for rib cage narrowing and the associated procedures.

A: You are correct in that any manipulations to the lower ribs is not going to create true ribcage narrowing. You are also correct in that the only way to achieve that effect is at the sternal level. The cartilaginous attachments to the sternum must be disarticulated, removed and the bony ribs pulled closer to the sternum with plate and screw fixation.

Thus the question is not whether it can be done by how motivated is the patient to accept the scars to do so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am looking to get correction surgery for my chin ptosis & also some subtle liposuction of my cheeks, because around 2 years ago, I had a different doctor transfer fat to my cheeks, but I find it now looks puffy/saggy.

A: You have a dynamic chin pad ptosis in which it maximally appears when you are smiling. This reauires a submental tuck procedure to remove some of the chin pad and secure it to the bone to prevent its descent when smiling. While microliposuction to the cheeks can be done it is important that you phrase the desired effect as ‘subtle’ as that is the effect that is obtainable. Not all of the injected fat in the cheeks can be removed.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hello! I would like to know if it is possible to create hollow cheeks and the OG Curve with custom cheekbone implants? I would also like to know if jaw angle implants are capable of creating everted gonions as shown in the image, or if a BSSO would be necessary?

A: What changes are possible depends on the face that the patient has to start. But as a general statement it is unlikely any procedure can achieve the ideal facial shape you have attached.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Hi, for mandible implants and conform silicone mandible implants specifically, there are 4 sizes off the Inplantech shelf:8mm,10mm,12mm and 14mm. If I have a normal sized jaw, will 10mm be very clearly obvious that I have had cosmetic surgery done? Or will people just think I look better without being able to pinpoint why exactly.

A: A qualified answer to your question can not be answered without knowing what you actually look like. But as a general statement about facial augmentations is that natural results come from using smaller implants.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’m interested in frontal bossing reduction due to my large, square overly protruding forehead. However I don’t want to have hairline advancement yet, possibly in a few years and would rather not have the coronal incision either. I know surgeons use these two incisions to access the upper forehead. Is it possible to reduce this area through the pretrichial incision? I’m a cis woman if that helps. I would also like my orbital bone reduced and I know this area can be reduced via the upper eyelid. Can the forehead or the frontal bossing be reduced partially via this incision also?

Looking forward to you’re reply

A: To clarify incisions used for forehead reductive reshaping:

A pretrichial incision is a frontal hairline incision which is the only way to access the forehead short of a coronal scalp incision.

The upper eyelid incisions accesseds the tail of the brow bone only, it is not adequate for forehead reduction.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr,. Eppley, I am a transgender man (FtM) and I am interested in your iliac crest reduction surgery. I have a slightly wide-set pelvis that bothers me quite a lot. And because I am already a low body fat there isn’t really anything I can do to change the shape of my hips with fat transfer. After doing some research online, it seems you are the only surgeon that performs this surgery. I am interested and have questions about the recovery of the procedure, such as what kind of scaring I am going to receive (as I’ve been told by others that have had reconstructive surgery on their pelvis that the scaring is invasive) and would I have the same mobility I did prior to surgery? I am an athlete and long term I want to retain my conditioning so I don’t want this surgery to impede my conditioning long term.

A: Iliac Crest reduction removes a portion of the outer portion of the most lateral wing off the ilium. (aka iliac crest) This does not detach ant significant part of the TFL or gluteus medialis fascia. As a result there is no long term limitation in mobility or function.

The important question is whether this amount of bone removal will result in enough bony hip reduction for you. To help make that assessment I would need to see some pictures of your hips.

Dr. Barry Eppley

World-Renowned Plastic Surgeon 

Q: Dr. Eppley, . I would appreciate if you would reply to this question by email. Attached are two photos. The first photo, unedited, is how I look now. The second photo, marked up, is roughly about how I would like to look after surgery. I’m sure certain factors make it so that you aren’t fully able to tell, but do you think my marked up photo is a possible expectation to have for my face to look after surgery if I scheduled a genioplasty with you? Your time and response means so much to me.

A: You are showing an unobtainable chin reduction result by any method. At best you could only achieve about ½ of that result. Chin reduction poses surgical and anatomic challenges that do not exist in chin augmentation.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, , I am 22 year old girl with chubby face that contains a lot of fat on face which eventually led to perioral mounds over my lower cheeks and fat deposition on my lips corners and even extended till upper lips . The fat deposition on upper lips led to slowly sinking my uper towards inward and I am really concern about it . How this will be reduced . Does after liposuction I have to maintain healthy weight or it will come back after weight gain and once I removed my perioral mound will it develop into marionette lines in future.

A: In my experience with perioral/cheek liposuction recurrence of the fat deposits has not been reported to me. But maintaining a good weight in any location of liposuction would be prudent. I am also not aware that such facial liposuction creates marionette lines or nasolabial folds.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I had a chin implant removal about more than 2 months ago. It was a small button chin implant, placed intraorally for 8 years. It is also worth noting that my button implant rested a little higher than usual, close to the lips. The removal would be my 3rd intraoral chin surgery. I went to a new surgeon and he kept convincing me to remove the implant because it was making me look “masculine” rather than “feminine”. However, I regret removing the implant because of the following:

1. I actually prefer how I look with the implant as it gives me more definition and structure especially at the side view. In fact, since the removal the shape looks broader and longer, and retracted which makes me look more masculine which is the opposite intended effect. 

2. My lips (particularly the lower lip) has gone backwards and inwards. It is significantly thinner. My original lips have always been full and everted. I can’t find much information on this online. I also feel like the lip angle has changed. Right now I have to use effort to close my lips and it keeps making a “pursing” mouth effect. I also have lower teeth which were not present before. Also, it’s strange but somehow my top lip also looks thinner and droop downwards (probably to reach my bottom lip) which is elongating my philtrum and I hate this effect as it makes me look so aged and sunken. Is my philtrum already permanently stretched? Or will it be back to normal once the bottom lip is restored, but how will it be restored?

3. Overall lower face looks sunken because the chin and lips went backwards and now I look so much older and less youthful. I prefer my lips rolled forward and chin to be forward as well.

4. My labiomental fold used to be deep (which I like actually, despite many people preferring a shallow one). Now it became more shallow which is strange to me because from what I read in your articles online, the labiomental fold cannot be changed and is a fixed structure

Anyway, the point is, I brought these issues up to my surgeon but he insists I 100% do not have chin and lip ptosis, despite me feeling that the symptoms are evident. He also attributed these to the botox he put in my chin 1 week after the removal, as a precautionary measure to not overwork the mentalis muscle while it is healing. So he is saying the botox is contributing to my lip problems. I am unsure of this and feel it is likely a ptosis or mentalis issue.

Right now, what I really want is to revert back to how I looked before the chin implant removal. I want the same implant back, and the same fullness and eversion of lips back. I want a more forward looking face rather than a sunken one. Somehow this chin implant removal has caused a slight “facial collapse” effect on me.

A: You can certainly have your original chin implant style/size put back and the new chin implant removed. That is not the question and is undoubtably what you need to do based on your comments. How close you would return to how you looked before  can not be accurately predicted but, even if it is not 100% the same, you will feel better about it than you do now.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I am an 18-year-old male student living in South Korea. I have a wide facial width and am considering skull surgery. I have some questions: 

Is it possible to perform surgery that involves cutting both sides of the skull vertically and reattaching them to reduce facial width?

How long will I need to stay in the hospital for recovery after the surgery?

How much can the facial width be reduced?

What is the total cost for the entire procedure?

Have you performed this type of surgery before?

A: I believe when you say facial width you mean the width of the side of your head??? (aka temporal width) If so that is a common procedure that I perform. It is done under general anesthesia usually with an over nite stay in the facility. But to be clear on this issue I would need to see a front view picture of your face/head to fully understand what you mean by excessive facial width.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, Big fan here. I read lots of stories about you and know many people who have consulted with you in the Looksmax community.

I wanted to ask what the price for small Supraorbital Silicone Implants are. As far as I know the surgery would be next to minimally invasive which made me think of you and Silicone instead of other materials like Peek/Titanium. I have had a jaw surgery just last year and got a really good result but I would rather not undergo another big surgery.

A: Supraorbital or brow bone implants have to be made custom since there is no such standard implant for that facial area They are usually placed through an endoscopic approach with small scalp and upper eyelid incisions.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, . I have a rather short and wide face and my jaw and cheekbones are visibly asymmetrical. One side of face is ”lower” than the other and the skin is not as tight as on the more developed side. I would also like to do rhinoplasty since I’ve been unhappy with the tip and slight hump on my nose for a long time.

I’m wondering if it would be possible to schedule a virtual consultation where we could discuss the treatment options and I could address some other concerns that I have about my face.

A: What you have is classic right-sided facial asymmetry. It can be seen that the right side of the face from the position of the eye down to the jawline is vertically shorter or compressed…fortunately only to a modest degree. The three most affected structures are the eyeball, cheek and jawline…all of which can be managed by custom implant designs for asymmetry correction during the same surgery. A rhinoplasty can also be concurrently done.

I would need to see some facial pictures from different angles to do an imaging analysis.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

Q: Dr. Eppley, I’m proceeding to have orthognathic surgery next month (BSSO, Lefort 1 and genioplasty) to fix skeletal jaw issues and a 8mm overbite. I currently have a full silicone wrap around jaw implant. The surgeon is going to attempt to maintain the posterior portion of the the implant (jaw angles) and just remove the anterior portion and chin in order to execute BSSO and genioplasty. My surgeon has admittedly never tried to salvage existing jaw implants. My question is, do you foresee any issue with the surgeon cutting through and removing only a portion of the implant while attempting to keep the jaw angles intact? Thank you!

A: It makes little sense to try and keep any portion of your existing jawline implant. The risks of infection of it dramatically increases and it makes it harder to do the BSSO.

Dr. Barry Eppley

World-Renowned Plastic Surgeon