Q: Dr. Eppley, Looking to have jaw implants done. I’ve had TMJ replacement, so my ramus on one side is titanium as my joint is a prosthetic. I would think I can still have jaw implants, but I would like clarification. This will explain if your unsure what this is. A: I am very familiar with the Total TMJ Joint Replacement system since I served as one of the clinical investigator sites in the late 1990s for its FDA approval. An implant can be placed over the the titanium ramus component but should be done through the external incisions to lower the higher risk of infection that exists from an i ..read more

Q: Dr. Eppley, I had jawline implant removal in South Korea which caused masseter muscle dehiscence and I would like to have it corrected. I attached some pictures and would like to know if this can be done and how much it costs. Additionally, I might replace my implants and want to know if I should do this before or after the muscle correction procedure. Please let me know. A:The first concept to grasp about masseter muscle dehiscence is that you can not move the muscle back down over the bone. The muscle fibers have become shortened and fibrotic and basically are not going to move. Howe ..read more

Q: Dr. Eppley,I have a pronounced sagittal keel and an osteoma an inch lateral of it. Due to MPB I would like to shave my head, unfortunately they are preventing an aesthetic appearance. I’m looking to get them removed/reduced. How can I go about determining if the sagittal keel is a thickened region or a raised intracranial region. Can you use an old CT scan?(5 years ago). I’m hoping an operation is possible. Thank you. A:Such sagittal crests are reducible, the only question is by what amount. That is the role of the CT scan to make that determination. A previous head/skull CT scan should suf ..read more

Q: Dr. Eppley, I’m planning to get a head widening implant. Does a implant on the side of the head above the ears cause any complications to the muscles that moves the ears up and down? Especially the top auricularis muscles? A:Since a postauricular incision is used for placing most head widening implants I make the assumption that the auricular muscles will be adversely affected. Thus one will probably not be able to wiggle one’s ears after the surgery. Dr. Barry Eppley World-Renowned Plastic Surgeon The post Will I Be Able To Wiggle My Ears After Getting Head Widening Implants? appeared ..read more

Q: Dr. Eppley, I am interested in deltoid implants do to atrophy caused by spinal stenosis. I have been a body builder for most of my life and wish to address the shoulder asymmetry. Thank you. A:Thank you for sending your pictures in which the atrophy of the deltoid muscles is very apparent and disproportionate to the rest of the well developed body musculature. There are two submuscular approaches to implant augmentation  of the deltoids, anatomic and non-anatomic implant placements. The anatomic approach is to place implants that paralllel the natural orientation of the three muscle be ..read more

Q: Dr. Eppley, I am interested in having plastic surgery to remove the temporal muscle. I would like to know if there is pain, visible scars, hair loss in the postoperative period, or any side effects. A:I am not yet certain which part of the temporal muscle to which you refer. But assuming it is the posterior portion above the ears that is a procedure from the sulcus in the back of the ears so there is not visible. Within a day after the surgeyr most people have minimal discomfort. There is no hair loss in the overlying temporal scalp nor is there any negative effects on jaw opening and closi ..read more

Q: Dr. Eppley, I just wanted to reach out as I’m looking for more information regarding plagiocephaly. I think I suffer from it as one side of my head is misshaped quite noticeably on one side, my ear is also lower and my jaw is misaligned too. My left eye is much more stuck out than the right and altogether It’s really effecting my mental health as when I am out on a day to day basis people stare or laugh and it’s damaging my confidence massively. I would like to see if theirs any way I can I can help fix this asymmetry? And if so what sort of price would something like that be? Hopefully you ..read more

Q: Dr. Eppley, I was hoping after seeing the videos we would have some modifications to my jawline implant designs. I agree with less is more. Still very uneasy over the unknown. I understand that every patients anatomy is different but would you guys be able to share any before and after photos with me with specification on implant design measurements just so I can see what that looks like, because at this point I really have no idea. Either way I will trust your recommendations and expertise. A:Your dilemma is a common one in custom facial implant designs. You are trying to understand/determ ..read more

Q: Dr. Eppley, I managed to take a very symmetrical picture of my face and it shows that I definitely have vertical orbital dystopia, and not just facial asymmetry like I used to think. I have for a long while been conscious about my eye asymmetry so I’m wondering what the treatment could be? Thank you for answering. A:To determine if and what surgery may be effective for VOD the workup includes a true straight on facial picture (not with the head bent slightly down) and a 3D CT scan of the face. Until then  only the general concepts of VOD surgery can be discussed but not if it would be ..read more

Q: Dr. Eppley, I have large conchal bowl on both ears and this is something I don’t see many surgeons can correct, I believe it is because that scar it will leave due to the wedge resection. I don’t know how else the conceal bowl can be reduced but I wanted to see if the doctor could help as this is a concern that I’ve had for many years. I’m not sure if the photos show it but in person my conchal bowl is very large compared to the rest of my ear. A:You have correctly surmised that only a mid-ear wedge resection can reduce the size of the concha and that the resultant scar to do so may not be ..read more