Your Questions

Q: Dr. Eppley, I am 32 years old, 5’ 4” and weigh 148 lbs. I have been struggling my entire life with a very disproportioned body. I have a pear-shaped body with saddle bags and thighs that don’t seem to match what I look like above my waistline. This gives  me a problem when it comes to finding clothes particularly pants. I want to get liposuction to improve this problem but I have two concerns. First, how effective will it really be? Can it really make a significant difference in the shape of my lower body? Second, I have cellulite and stretch marks and am afraid that it will make them look worse. Despite these fears, I am so frustrated with these bulges of flab that I can do nothing about, no amount of exercise does anything. Plus this flab irritates me when I walk as it jiggles.

A:  While your concerns about liposuction is understandable, they should not stop you from eventually getting a positive change from the procedure. This congenital distribution of fat will respond to no amount of diet and exercise as it is not due to a caloric excess. It is the natural proportion of your body. Thus to make a change in its shape, it must be surgically modified. While liposuction will not make your thighs petite or even come to match your upper body, it will make a visible improvement that is most evident in silhouette and in how your pants will fit. While liposuction will not improve the appearance of cellulite and stretch marks, and can even occasionally make cellulite look a little worse, the improvement in your thigh contours make that risk a good aesthetic trade-off in most cases.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am inquiring about a natural method for cranioplasty. I have a forehead defect including a hole through the bone from a prior craniotomy for a brain tumor. The size of the forehead defect measures about 9 x 2 cms and represents the area where the bone flap appears to have settled inward. Can I use my own bone to reconstruct this forehead defect area?

A: Cranial bone flaps, despite using rigid fixation, can heal inconsistently or undergo some resorption leaving an outer contour depression. There are multiple ways to do a cosmetic or reconstructive cranioplasty with a variety of materials, bone being one of the options. If the defect is small enough, one could use natural bone, in other words cranial bone grafts. While natural bone has understandable appeal, it is actually not the best way to do most cranioplasties. Besides having to harvest the bone (and creating another bone defect), bone grafts are notoriously unreliable and predisposed to incomplete or total bone resorption particularly when used as an onlay. The more reliable way to perform most cranioplasties is to use hydroxyapatite cements. They are structurally stable, do not resorb and can be shaped perfectly to any defect whether it is an inlay, onlay or a combined cranial defect. They are also composed of hydroxyapatite, a calcium phosphate mineral, which is highly biocompatible with natural bone. While bone will never truly grow into it and replace it, bone will bond directly to it. The type of forehead defect that you have would do well with a hydroxyapatite cement cranioplasty.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was browsing through your website looking at facial implants and I realize that you are one of the experts in this field. I have a very small mandible and got my overbite fixed with 3 years of braces. However, afterward I still had a very small mandible. I got a silicone chin implant to fix my small chin. I am mostly satisfied with my chin. But I still have a very thin and weak jaw and I would like to get jaw implants to get width and angles on my mandible in the future. I look forward to hearing from you and discussing with you to determine the best possible process.

A: With a very small mandible, the jaw is usually deficient in more than just the chin area. It is really small from front to back throughout its entire length. The means the jaw angle area will be rotated upward, giving one high jaw angles that have little width. While the chin implant provides greater horizontal projection to the front of the mandible, angle implants are needed to improve balance at its back end. But the jaw angle implants must have a very specific style and dimensions to be effective. With high jaw angles, the implants must provide vertical lengthening as well as some width. Most current styles of jaw angle implants don’t provide these dimensions so you have to very careful to get the correct style to get the desired aesthetic result.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have a bump on the top of my skull which appeasrs to have developed by injuring it years ago as a child. It would be difficult for me to send a picture of my bump since my hair covers it so perhaps I can describe it better. I am self conscious of the way it looks with shorter hair and effects the way I can keep my hair. It is like I said at the very top of my head and creates somewhat of a point. It is pretty swelled out and has more of an oval shape. It is similar to a ridge. I would love to somehow get rid of the bump so I can move on with my life. Personally it has had a profoundly negative consequence on my pyche throughout my youth. I am 24 now and am still reminded of its presence everyday. I have learned to deal with it mentally but the honest truth is that its a challenge to pretend it isn’t there. Thanks for listening and hope to gain more feedback from you.

A: Reduction of a prominent bump on the skull is a fairly straightforward procedure done through burring reduction using a small scalop incision. It is always helpful to see a plain skull x-ray from the front and side to see its thickness and how it compares to the surrounding normal skull. That tells me how much of it can be reduced and whether a completely normal skull contour can be obtained with this minor form of skull reshaping.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley. I am a 40 year old male with bilateral gynecomastia of undetermined origin dating back to puberty. I had surgery for it over 20 years ago which was not unsuccessful. By the surgeon’s baffled admission, it resulted in regrowth of breast tissue well beyond the original (pre-surgical), size. Since I had fully understood the procedure’s potential risks and could hardly blame the surgeon for the result, I dropped the issue altogether resigning myself to a lifetime of gynecomastia. However, having just come upon your site, particularly your discussion of the link between gynecomastia and temporal lobe epilepsy in King Tut's case, I cannot help wondering if a similar involvement has been a hidden factor in my own condition. Although I was never diagnosed with epilepsy, I had a fainting episode at 15 (coinciding with gynecomastia onset) followed by severe headaches, blind spells, and dysphoric moods. This was attributed by a neurologist to a “temporal lobe dysfunction due to damage to the sella turcica region of the brain,” possibly as a result of either meningitis or encephalitis. The antidepressants and anticonvulsants I have been prescribed to control what subsequently became recurrent major depression seem to implicate the condition further even as they themselves can either cause or aggravate gynecomastia as a side effect.  I am wondering what your thoughts or suggestions might be in my perplexing case.

A: In regards to the cause of your gynecomastia, it is always an elusive question for most patients. Drugs are a common culprit although for most patients the exact reason is unclear. Whether there is any relationship between your neurological history and gynecomastia is speculative. I have never heard of regrowth of gynecomastia around a prior excision site and I would question that diagnosis anyway. I would wager it most likely represents inadequate resection that only become more evident after all the swelling went down months after the surgery. One of the hardest elements of open gynecomastia surgery through an areolar incision is getting adequate resection of the involved tissues well away from the areolar access area. A common aesthetic complication is to have adequate areolar resection but a surrounding donut of residual tissue that may not become evident until many months later when all the swelling has subsided and the skin has adequately contracted down, revealing the extent or lack thereof of the resection margins. This would suggest that further efforts at gynecomastia reduction may still be successful.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am wondering if I should be at my ideal weight before having breast augmentation?

A: In regards to getting breast implants and your ideal body weight, I think that answer depends on how much weight loss you are anticipating and what your breasts look like now. If you plan to lose a lot of weight (greater than 20 to 25 lbs) and you have some significant breast sagging, then you may be wise to wait until you achieve that weight loss. You do not want to put in implants that will later develop additional breast sagging as the weight loss may cause the breast tissue to slide off of the underlying implant support or ledge, maing the sagging look worse. Also additional weight loss may tip the balance between a marginal breast lift candidate with their implants versus someone who definitely needs a lift with their implants. If the breasts have little to no sagging and the desired weight loss is fairly minimal, then you could proceed with breast implants at any time.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, My question is about the appropriate age for my son’s skull surgery. I wasnt to get the flat back of his head fixed by an onlay cranioplasty procedure that you have described. He is now 18 months old. Should I wait until my son is older? 

A: There is no right or wrong answer to that timing of surgery question. Such 'cosmetic' skull surgery in a child is unique because they are not in a position to pass judgment about the value/benefits of the procedure. (and they won't be for a long time) Thus it requires the parents to determine the merits of the skull reshaping procedure as they look at the child's long lifespan and their psychosocial development. While that is not that helpful, you have to look at the magnitude of the skull deformity and determine if improving it early justifies surgery. It can be done at anytime as age is not a criteria (beyond 18 to 24 months old) for the surgery. You just want to be sure that the deformity has no chance to improve on its own with future skull growth.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have seen several doctors say they can use soft silicone implants to enhance the hips. I am also thinking the newer traditional butt implants can be shaped to be placed in the soft tissue “grove” of the hip found on most men, sometimes called “the boy dent”. Why would it not be possible to do? In my experience those who have gotten injectable silicone, most have never had a problem and they inject it below the facia on top of the muscle and a scar capsule is formed around the silicone. So why not place the implants either there or inside the muscle which are where some butt implants are placed now as seen on The Doctors.

A: I would not disagree with your contention for how hip implants can be used and placed. While there is no standard hip implants, ultrasoft buttock implants can be used as hip implants. You can not place them inside the muscle and the fascia overlying the hip musculature is very tight so the implant has to be placed on top of the fascia. But there is no reason why hip augmentation implant surgery can not be done

The problem with large volume silicone injections for body augmentation is that the material tends to migrate away from where you would want it to be. This would very likely happen in the hip area due to gravity. I would feel more confortable with actual implants rather than silicone injections for hip augmentation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I'm not actually interested in any plastic surgery, but I was compelled to write a thank you to you for not trying to make anyone think breast augmentation will give you perfect breasts. Your work looks good, and I'm sure they look even more amazing in person, but it's nice that you're up front. I fully support anyone who wants to change their look, or enhance it. I'm a beautician myself. I just felt I should say thanks for being real. Thank you for your time.

A: Thank you for your kind comments. While plastic surgery can make some very significant improvements, I have yet to see a perfect result. Every result has some flaws and no patient should expect an imperfect problem to turn into a perfect result with surgery. I am sure in your own field every person you do is much better as a result of your work, and some even amazing, but perfection is always elusive. I try to communicate that in all of my work and it is comforting to know that someone else does appreciate that insight.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I think I may have screws up my chuin surgery. I was washing my face and was pushing really hard on my chin but didn't know because it is numb and then something felt different…on the right the implant was in a different location. Then I protruded my mandible forward and it only felt tight on the left of my chin, not on both sides of it anymore. And then I palpated my implant and on the right the implant is completely on the outside of my mandible and on the left it is under it. It is bad. Now it is in a lot of pain. I tried putting it back in place but it is of no use. I will just injure myself. Now the incident is giving me a lot of pain: my whole chin and the new location of the implant. Before this happened I called about having you call in more pain medication to my pharmacy and I mentioned a painful tumor-like lump on the left side of my mandible. It is hard like bone, and round, and inferior to the bone as well as lateral to it. My pain includes pain in this area. However, the area felt different to the touch than other areas. Now, after what I have caused to happen with the implant, I cannot assess it. It is still painful to the touch, although the lump seems smaller and less obvious. It was causing my chin to look shifted to the left, because the right of my chin was flat and the left protruded where the lump was/is. Where the implant was feels like a dent in the bone of my mandible and somewhat looks like one. Now that the implant, out of place, adds width to the right side, my chin looks more centered than before, where it looked shifted to the left. I am also sending a picture of the area where the fat was inserted, just checking if everything looks normal. Both of the areas containing the transplanted fat feel to the touch like I am touching like hard rubbery rubber implants. Just want to know if everything's normal. Thanks.

A: Thank you for the follow-up and sending your pictures. Let me share with some basic concepts about the recovery process from your chin osteotomy/implant and fat injection surgery. It takes a minimum of at least 6 weeks and closer to 3 months to see the final result. It is very normal to have everything that you are feeling and showing at this point, which is very early at just 9 days after your procedure. Besides the swelling, numbness and bruising, every chin osteotomy patient at this point will have hard lumps at the end of the osteotomy cuts on the side of the jawline. That is what you are seeing on your left side and I would not consider that abnormal at this point. While it is possible that could be a malpositioned end of the implant overlying the osteotomy site on that side, it is just as likely that is swelling and a collection of blood from the surgery. I would be a lot more concerned about that issue if this was 4 or 6 weeks but not yet at 9 days out from surgery. I also doubt that you could have malpositioned the implant by rubbing on the outside. The bone and the implant are secured in placed by plates and screws so it would be very hard to displace it. The fat injections into the nasolabial folds will feel and look exactly how they do at this point and that is perfectly normal. It will take 4 to 6 weeks for them to smooth out, blend in and feel normal.

Hang in there as it is still very early in your recovery process.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was wondering if it were possible for a bump caused by hitting the very top of my head when younger could be removed. It creates a rounded point at the peak of my skull. I know it was caused by the impact and always thought it would just reduce on its own, but never did. I believe it hardened when the bone healed from the injury. It is something that I often think about and am trying to research to see if it could ever be realistically and safely renewed to its original shape.

A: You are correct in deducing that the bony bump that you have acquired is due to scalp trauma, particularly when it occurs at a young age. Any small amount of bleeding from perforating vessels from the bone causes an accumulation underneath the periosteum of the bone. The blood will cause the periosteum to turn it into bone, thus making the round bump that you have. That could be reduced by a simple skull reshaping procedure using a small incision to burr the bone down to the level of the surrounding bone.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, A friend of mine from another country who is in his mid twenties had a temporal lift.He didn´t had any excess skin and for this reason no skin was removed. He only wanted to have a slightly exotic look of his lateral corner of his eyes and his lateral eyebrows…. now he has this sexy Keanu Reeves look. He had this surgery three years ago and it still looks fantastic – no relapse at all! I would like to have the same surgery. Unfortunately he doesn´t remember how it exactly was performed by his surgeon. He has a 6 cm long scar behind his temporal hairline and he remembers that his surgeon told him that it is important that there is no pull on the skin and only the deeper tissue has to be lifted. Otherwise the result wouldn´t be permanent and the corner of the eyes and the eyebrows would pull back to their original position again after a few months.
Do you have experience with this kind of surgery? Could you please describe to me how this surgery is done properly, what tissue is actually lifted and what has to be done that the results are long lasting? What is the cost and recovery from this surgery?

A: Temporal lifts have a long history of being done and the techniques range from skin only excision to deeper tissue release and fixation. Old style temporal lifts removed only skin and that may still work well in older patients who have significant brow ptosis and loose forehead and temporal skin. But in younger patients with minimal to no loose skin or brow ptosis, skin excision only will relapse quickly and end up only leaving a wide scar due to elastic recoil of the younger skin. Contemporary temporal lifts usually use minimal to no skin excision and rely on superficial temporalis fascia mobilization and posterior fixation. The periosteum around the lateral orbital wall and the lateral brow area is the key to mobilization and must be released for the entire tissue unit to move up and back…and stay there on a long-term basis. This is a technique somewhat similar to an endoscopic browlift and a SMAS facelift, both of which rely on tissues deeper to the skin to create their effect.

The recovery from this type of  temporal brow lift is all about how much swelling and bruising one gets around the eye area…and there will be some due to the periorbital tissue release. Expect it to take  two to three weeks for all such swelling and bruising to clear.   

Dr. Barry Eppley

Q: Dr. Eppley, I bite down on my cheeks sometime when chewing my food which makes it uncomfortable and sore. Sometimes I can barely eat they are so sore. My cheeks are also sunken in. What are your recommendations for submalar surgery to correct this problem and get it covered by insurance.

A:  Biting down on one’s intraoral cheek mucosa is not rare but occurs more frequently in some people. This can occur because of the cant of the occlusion, broken teeth, a swollen cheek lining and particularly if one is wearing hardware on their teeth such as braces. Once the cheek lining gets swollen, it is bigger and creates a protruding ridge which is a viscous cycle for recurrent biting on it.

Having a sunken cheek, however, is not an anatomic reason why one would bite their cheeks. This make seem like a logical explanation but the fat atrophy of the buccal fat pad occurs on the outside of the buccinator muscle and does not effect the shape of the inside of the cheek lining. The buccinators muscle is like a stretched trampoline and what occurs on the outside (visible submalar area) does not effect what lies on its opposite side inside of the mouth. (buccal mucosa) Thus performing submalar augmentation by injecting fat or placing an implant will not improve the shape of the lining inside the mouth…or improve the cheek biting problem.

Submalar augmentation  can be performed to improve the aesthetics of the face and would not be covered by insurance under any circumstances. If a palpable ridge of mucosa exists along the occlusal level inside the mouth, its excision may remove the cheek mucosa that is getting in the way of the upper and lower teeth biting together.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I have been considering getting cheek implants for a while now. I understand that one of the risks associated with them is asymmetry and I was wondering, what is your stance on revision surgery should it be required? I understand that the OR and anesthesiologist's fees will still be payable by me, but do you still charge your surgical fee or will it be waived/subsidized for your patients? I ask this because my financial resources are limited, and I would just like to be prepared for any financial contingencies should it be required.

A: Your question is a vey thoughtful and forward thinking one that every patient should get clarified before they have surgery. You are correct in asssuming that in most cases my professional fee for revisional surgery is waived or dramatically reduced but the OR and anesthesia costs are still borne by the patient. It is important to clarify what constitutes a revisional procedure also. If there is a problem induced by the execution of the surgery, such as infection, asymmetry, malposition or other implant placement issues, then that would constitute such professional fee reductions/eliminations. If a patient desires additional improvement/enhancement on an already acceptable result (particularly months to years later), then that may modify this revisional fee consideration.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I had breast implants placed three years ago which were 375ccs. I want to go bigger but am not sure what size implant to go to. Do you think 450ccs would be enough?

A: When one desires to have bigger breasts with indwelling implants, the question of how much bigger is obviously very subjective. But most women are not going to go through the effort and expense of surgery if they did no want to see an appreciable difference, at least being a 1/2 cup to a full cup bigger. One of the common mistakes with breast implant replacements for a size change is to not go big enough. While numbers like 500cc or 550cc can seem daunting, the reality is that represents only a 33% to 45% increase in your current breast size. As a general rule, you have to have at least a 25% to 33% change in volume to ever see much of a difference. Another commonly stated number is that it takes 150cc to make a cup size change, although this would be highly influenced by the size of the woman’s chest and her body frame. So you can see that changing from 375cc to 450cc is not going to make much of a difference when it comes to a breast size change. That will make your current a little fuller but that is about it. For those woman that want just a little change or more perky, a 75cc volume implant change may be adequate. But for most women seeking a breast size change through an implant exchange, it will not have been worth the money to do so.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I had a fat transfer to remedy malar crest. Now there is still a prominent dent across the upper line. What do I do now?

A: I would have to see some pictures of your concern, which I assume is a residual malar crease that was unlikely to be improved by fat grafting alone. Malar crescents are rarely completely eliminated by fat grafting alone because there is a tissue sag component to it. It is not just a volume depletion issue alone.. Ballooning the crescent up with fat may be helpful in some cases but often can lead to a fuller crescent but one that still has a visible crease or dent. If you are more than 3 months after your fat grafting procedure, you may need to consider a cheek lift which can be done multiple ways depending on the aging condition of the lower eyelid. Cheek lifts are most effective in middle-aged to older patients who have a more significant aging component to their midface. A combined lower blepharoplasty with cheek suspension can work well in these patients. Cheek lifts in younger patients are more problematic because the lower eyelid is tighter and less aged. This leaves little eyelid skin to be removed with the cheek lift.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I already had several consultations with other surgeons, but nobody seems to understand my “problem”. I would like to have cheekbone augmentation, but I already have high and prominent cheekbones.But in my opinion there is a difference between the body of the zygomatic bone (where the cheekbone goes around the corner and what is usually called “the cheekbone”) and the arch of the zygomatic bone (the very lateral part of the cheekbone that extends to the ear and looks like a rather thin bow). My surgeons always acted like I was crazy after I explained that difference to them and that I only would like to have an augmentation of the arch of he zygomatic bone. They told me they have never heard of this kind of augmentation and there are even no implants out there that could address this problem. Then I found out, that there is a very popular kind of surgery around South Koreans.Many South Koreans have very wide zygomatic archs that stick out of the sides of their face although they often have a rather flat body of the zygomatic bone. For some reason (I think because they prefere a more western look) many Koreans don´t like this wide zygomatic arch and get zygomatic arch reduction surgery. It is a reduction osteotomy of this bone, that is done through an incision just in front of the ear. (like a face lift incision). I thought if it is possible to reduce the zygomatic arch, it should be also possible to augment this area. After I told this another surgeon, he said that this is called a preauricular incision that is only done in superficial layers, for example to do a face lift, but it is not possible to have a safe access to the bone via this incision, because the facialis nerve lies there. But I don´t belief him, because I have seen many pics on the Internet of this kind of incision that goes right down to the bone. It is used for correction of a fractured zygomatic arch or for operations on the temporomandibular joint. Does this sound crazy to you, Dr. Eppley?
Is there a way to augment only the arch of my zygomatic bone? Is it possible to carve impants for this area? I know that midface implants are usually placed through the mouth, but it seems logical to me that it would be easier to put a “zygomatic arch implant” through a praearuicular incision. Is it possible to have save access to the bone through this incision?

A:  I think you have a very good grasp on what you are trying to achieve. Can you just augment the zygomatic arch with an implant…absolutely yes. While wide zygomatic arches are reduced by osteotomies, expanding or augmenting the arch requires an implant not an osteotomy. Since they are no specifically designed zygomatic arch implants, they would have to be fabricated by either modifying an existing stock implant (such as by using the wings or flanges from an anatomic chin implant) or hand-making custom ones. Which implant technique would  be better depends on how much augmentation you are desired the exact location on the arch. When it comes to placement, zygomatic arch implants could be put in either through the mouth (anterior access) or from a preauricular incision. (posterior approach) Which method of access would depend on the shape and thickness of the implant, although I would likely prefer the posterior approach because the implant could be secured to the bone much easier this way.

In conclusion, your request for zygomatic arch augmentation is very uncommon but most certainly not crazy. One should not confuse unfamiliarity with impossible.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, my son had gynecomastia surgery last year and has developed severe scarring from this surgery. We have tried creams, silicone sheets, several rounds of shots and laser treatments as well.  Nothing has helped for his scarring.  It is so sad that a 17 year old young man is unable to remove his shirt in front of anyone, due to the embarrassment from these scars.  He often has sharp pains from the scarring that requires him to rub out the pain. As you can tell from the attached pictures, the scarring on his right side is much worse than the left.  This is due to the fact that he formed a hematoma under his right nipple after surgery and required a second surgery on the right side to remove the hematoma. I would appreciate your opinion to see if a scar revision and possibly radiation to prevent new keloids from forming is a possibility.

A: Thank you for sending your son’s pictures. I can clearly see that he had an initial periareolar approach to his gynecomastia reduction surgery. Due to the maturity of his scars, it appears that surgery was done at least a year ago. While I have no idea as to the magnitude of his original gynecomastia problem, I see the following current problems; wide hypertrophic periareolar scarring, a residual mega-areola deformity and some persistent gynecomastia fullness. His periareolar scarring does not represent keloids but rather is hypertrophic scarring, a not uncommon reaction to periareolar mastopexies in general. This is normal scarring that develops from tension and/or suture reactions from this type of procedure. It is not pathologic scarring nor would ever merit being treated by radiation after revision. While I can appreciate all of the scar treatment strategies done after his surgery to try and improve his scarring, re-excision was only ever going to be a strategy that has a chance to work. No scar treatment other than excision will ever make wide scarring more narrow. The main benefit to all these other scar treatments was that they have allowed time to pass for the scar tissue to settle down as well as being proactive along the way.

He clearly would benefit from periareolar scar revision combined with further areolar reduction and maybe some additional gynecomastia tissue reduction. The burning question is will this scarring problem recur and what can be done to prevent it. While I have my own techniques for how I do this surgery, it is always helpful to know what was done in the past. As the old motto goes ‘past history predicts future behavior’. From that perspective, I would need to see his previous operative note to understand what closure techniques were done so what didn’t work well would not be repeated.

Dr. Barry Eppley

Indianapolis, Indiana