Your Questions

Q: Dr. Eppley, I have some questions about rhinoplasty and how it it planned and performed. How do cosmetic surgeons measure the profile of the face? From where to where? Is there a ratio that is considered perfect? Was it derived from the great medieval sculptors?

A: Contrary to popular perception, plastic surgeons do not use specific anthropometric measurements in planning and subsequently performing rhinoplasty surgery. While there are many known angle and measurements of the nose, and plastic surgeons are well aware of them, they are only roughly applied in performing the procedure. Surgeons use a gestalt about these anthropometric values and measurements rather than a precise application of them. Plastic surgeon may learn these measurements in their training or through experience but they do not use such precise measurements in surgery. This is because actual surgery does not translate well to afew millimeters or degrees of angulation.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am a healthy 50 year old male. I have had liposuction and fat transfer to my buttocks two years ago along with fat removal from my chest area. I am happy with the results of these body contouring procedures. I have however put on more weight and I am wanting to have fat transfer now to my shoulders along with sculpting of the waist, lower back and flanks. My question is will this give me a more athletic look. And is fat transfer to shoulders a successful procedure. How much fat will be saved in the shoulders as the shoulders are my first priority. If I have fat left I want my buttocks still a little more fuller. So in a nut shell I am trying to get a V shape look. Is this possible?

A: Fat transfer to the shoulders (fat injection shoulder augmentation) is just as successful as most other area of fat grafting such as the buttocks. The argument can be made that it may be a more favorable area for fat injections since the recipient site is largely muscle, always the most preferred site for optimal fat take. I almost always mix the harvested fat with platelet rich plasma (PRP) to optimize fat graft take. The real rate-limiting step in any fat grafting procedure is the amount of donor material one has to harvest and process for injection. All one can do in any patient, particularly a male, is to harvest as much fat as possible from the abdomen and flanks for injection. This should certainly help in obtaining more of a V body shape.

Dr. Barry Eppley
Indianapolis, Indiana