Your Questions
Your Questions
Q: Dr. Eppley, I am potentially interested in posterior temporal reduction surgery because I feel that my head is too large. I also feel that I could benefit from anterior temporal reduction surgery because the area from the side of my eye to my hairline is also a bit too large. I attached a photo that shows what I am talking about.
A: Thank you for your inquiry regarding temporal reduction surgery. To better understand such head narrowing surgery I refer you to the following link which explains the important difference between posterior and anterior temporal reduction surgery:
https://exploreplasticsurgery.com/the-anatomy-of-t…or-the-wide-head/
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello there, just a quick question regarding aftercare post surgery from my custom forehead implant. Everywhere else seems to request the patient wears the head bandages after surgery for one week, can I ask why you suggest removal from the next day?
A:I don’t suggest removal of the head dressing the next day, I take it off the next day as the immediate head dressing is very tight and uncomfortable. A new less tight and more comfortable head dressing (Coban) is applied thereafter and should be worn until at least the drains comes out…which is usually 2 to 3 days later.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I previously had iliac crest implant surgery and it has left me with very obvious hip dips/ indents, even after a fat transfer. I am very thin, so I need to gain weight before having another fat transfer. I was wondering it custom hip implants might be a better option than another fat transfer? Is it normal for iliac crest implants to create hip dips? How much would it cost for custom hip implants? Thank you!!
A: While not common creating hip dips can occur when the greater trochanter sticks out much further than the natural iliac crest. Iliac crest implants work best in straighter profile hip-thigh patients as opposed to a more triangular profile shape.
In the spirit of ‘past history predicts future behavior’ why would fat grafting work better the second time than the first…particularly when one has to gain weight to undergo the procedure? The point is…it won’t.
Now that doesn’t make hip dip implants perfect and they have their own issues. But that is the only remaining treatment option.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I would like to have an online consultation in relation to an osseous genioplasty procedure or jaw surgery.
Over the past 3 years I have conducted some personal research, ~5 consultations, and also previously had a chin implant a number of years ago which I had removed after a few months of having the implant.
I would greatly like to have an online consult given Dr Eppley’s significant experience- and that I have found where I live.
Regarding my condition, I have a good bite – but heavily proclined lower teeth. Despite the proclination, my soft tissue profile actually does not make this ‘dental bulge’ so distinct (see images) – rather I have mostly a small/backwards lower jaw. The primary medical aspect I consider is not bite but sleep apnea related – which is quite bad and has become significantly worse over the recent years.
I have a good range of pictures + CBCT scan that I can send through/and also live display on my computer during the consult to assist in understanding the situation virtually.
Please note some points I would hope to raise/discuss to give some more context given my experience with the situation:
1) The 8mm chin implant I had years ago gave nice projection (see image) – and looked genuinely better overall, but significantly deepened the labiomental fold which led to a somewhat uncanny result – as I understand and have seen other cases – this can be controlled by a genioplasty forward + down movement – hence a key reason for my preference in the procedure.
2) I also have researched and done some consultations for jaw surgery. I hope to avoid jaw surgery because the procedure is more invasive – but open to discussion + have some scans from one other jaw surgery consult.
3) I’d like to discuss some genioplasty cases I have seen online that appear similar to mine (backward and short chin). Some ‘major’ ~8-10+mm advancements in these cases gave surprisingly great results – comparable to jaw surgery advancements. In some cases these people were recommended with jaw surgery as the only solution given their profile (whilst having a decent bite) – but opting for genioplasty still led them to a very good result. Hence a key reason I have been quite interested in osseous genioplasty over jaw surgery.
4) I’d like to get an idea of a procedure plan/cost.
Greatly appreciate your time and look forward to hearing from you.
A: Thank you for your inquiry and detaiilng your concerns and chin implant history. There are three things you have had stated that makes the case for jaw surgery not an isolated chin surgery.
1) ‘Bad’ sleep apnea
2) Heavily proclined lower teeth
3) Deepening of the labiomental fold with the chin implant (the same will happen with a sliding genioplasty)
#1 and #3 are the long term issues that need to be heavily considered. Do you really want to live the rest of your life with that degree of sleep apnea? If you took out the chin implant because of the labiomental fold change why would you feel any better about that same effect with a sliding genioplasty?
While I can certainly understand why one would want to avoid jaw surgery if possible but I would question tjhat decision in a young person. I have seen plenty of patients who opt for isolated chin augmentation or aesthetic jaw implant surgery only to reverse those later when they have decided to have jaw surgery…which they should have done so initially.
That being said there is nothing wrong with a sliding genioplasty as long as one has carefully considered the jaw surgery option which does address the fundamental problem.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Should I have a malar fat pad removed by a cosmetic surgeon?
A: I assume you mean by a malar fat pad you mean the buccal fat pad…since that is the cheek fat that can be surgically removed.
I can not speak for the experience of any other surgeon regardless of their training.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I’m now a year post double jaw surgery. I’m looking at midface implants to address midface recession. I attached a picture of myself from yesterday. I also attached a picture of an implant design I think I’ll need. Is it ok to put all these implants in at the same time as plate removal? The implants would go on top of where the screws were. Will this increase the rate of infection?
Also I am looking to have rhinoplasty after implants heal. I’m nervous about the transition from midface to nose sides. How is the transition between the cheek and nose area made as natural as possible? Thank you for answering my questions!
A: In answer to your custom midface augmentation questions:
1) I would be very cautious about implant placement at the same time as plate and screw removal. In removimg certain screws (and sometimes a plate area) from a Lefort I osteotomy a communication between the maxillary sinus and the implant which increases the risk of infection.. I would have to see x-rays which show the hardware locations which would be very evident in a 3D CT scan. On the one hand you would like to achieve two positive changes during the same surgery as long as does not significantly increase the risk of infection. I have done it many times before and if I see small communication I seal the hole with bone wax and then place the implant at the same time…and it has never caused a problem. But it is still prudent to check and x-ray beforehand.
2) The relevance of a rhinoplasty if an underlying midface implant exists is at the osteotomy line if nasal bone osteotomies are to be done. Thus it relevant in the implant design to keep it away from the nasomaxillary junction.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I had read that a chin implant can also widen the chin or make it appear more square. One trade-off it sounds like is that the implant would not reach as much horizontal projection. But if my goal is to also make my chin/jaw appear more masculine overall, would I noticeably be “missing out” on this aspect with the genioplasty rather than implant, or do you feel that wouldn’t be very consequential in overall appearance? Or, would any benefit from the width be negated by added vertical height from the implant (if I already have more than needed)?
A:You have corrected surmised the basic concept of the dimensional differences between an implant vs an osteotomy in your chin augmentation. Neither one is perfect and there are dimensional tradeoffs for each option. You make that decision based on which of their liabilities can you live with the best
IMPLANT = makes the chin square (if it is a custom made implant) but less horizontal projection and keeps the same the same vertical length (and probably risks making it just a bit longer) (particularly if it is not custom made implant)
OSTEOTOMY = maximizes horizontal projection and can reliably keep the same vertical length or even make it vertically short, can not make the wider or more square.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hi, I’m considering a sliding genioplasty to correct lower jaw asymmetry.Was considering a bsso but the procedure seems intensive.What would you suggest?
A Forget about whether one procedure is more ‘intensive’ than the other. What counts is what procedure(s) is most effective for correcting the asymmetry. The first step in any facial asymmetry is to understand the exact anatomy of the jaw asymmetry. Before selecting a procedure you have to know the exact shape of the jaw which requires a 3D CT scan. But I don’t need a 3D CT scan to tell you this:
1) Your jaw asymmetry involves the entire lower jaw, not just one part of the lower jaw. The entire lower jaw is tilted/twisted
2) Neither a sliding genioplasty or a BSSO are the correct procedures to improve the asymmetry as they are 2D procedures for a 3D problem. There is not a bone procedure alone that will solve the problem in its entirety.
3) The most effective jaw asymmetry correction comes from a custom jawline implant as it is a 3D procedure built on an exact visualization of the misshapen jaw bone.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have a forehead scar. Had an obagi blue peel for mild acne scars with good results. 4% hydroquinone for 4 weeks then bumped up to 10% compound for several weeks before procedure. Have been wanting scar revision. Assuming similar skin prep. Have had sever attempts at fillers with no results. Would prefer scar revision. Please reach out for consult.
A:Deep inverted scars in the glabellar furrow area always require excision/scar revision to get the best contour. You simply can’t push them out with filler or fat injections due to their deep inversion. But I also find that scar revision may still be prone to some postop inversion. albeit a lot better than preop. For this reason I will sometimes place an ePTFE implant or a dermal-far graft on the bone below it to help push out and maintain the contour along the w-plasty scar line.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have a very large bulbous-shaped head / large forehead that I have been derided all my life over. I never thought there was a corrective surgery though it has always been a dream. Would like to look into what’s available which would be a dream of mine.
A:I believe you are referring to the convexity/width at the sides of the head as one issue for which temporal reduction is the correct surgery. (see attached imaging) You have also referenced a large forehead for which bony forehead reduction can be done as well with the temporal reduction. (see attached imaging) Besides their aesthetic differences what distinguishes temporal reduction from forehead reductio is the location of the incision. While temporal reduction surgery may be considered ‘scarless’, because the incision is done in the crease of the back of the ears, forehead reduction requires a less hidden incision location.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I’m a 34 y/o male interested in improving the horizontal projection of my chin and the contour of my chin/jawline overall. I’ve read about both chin implants and sliding genioplasty, is there one you would recommend more in my case for superior aesthetic result? Would liposuction be of any benefit in combination? Photos attached. No prior surgery.
A:With a chin that has a horizontal deficiency of 10mms or greater and is rotated backward (long) the best procedure is a sliding genioplasty to bring it forward and make sure it becomes just a bit vertically shorter. Submental liposuction is always concurrently beneficial to achieve the best cervicomental angle improvement.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley,Can a supraorbital rim and infraorbital implants (periorbital augmentation) give 1.5cm forward projection or does it need to be combined with a forehead implant to avoid protrusion or bossing?
A: That would depend on doing some side profile computer imaging to see what that change would look like. But as a general rule any periorbital bone augmentation that exceeds 7mms or so (0.7cms) would likely need a forehead augmentation as well.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I was considering a paranasal and premaxillary implant but came across a lot of negative reception regarding how the implants “ruin” your smile.
1) What kind of ruining would they be referring to? Is it the increased philtrum distance and flattening of the top lip? If so, could this be mitigated via lip lift?
2) Some say that they can see something protruding when they smile, is it because their implant is too large? How many mm would you say is the maximum for an implant?
A: Nasal base implant augmentation has a history in which many of these implants were placed through the nose into the subcutaneous tissues. This has the potential to place a physical block when trying to smile. A more contemporary implant location is in the subperiosteal location through an intraoral approach which lowers this negative smiling effect significantly. Besides placement location the size of the implant also can have an effect if it is too large. While each patient is unique I wold not add more than 6mms of augmentation in the nasal base area….and even less so across the anterior nasal spine area.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I found you online and I read about the reverse frenectomy question and that was exactly what happened to me. My smile has changed drastically and I’d like to see if there is a consult or get more information.
A: You are referring to a central lowering vestibuloplasty procedure…which is the equivalent of a reversal frenulectomy procedure.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I wanted to ask if a patient has to have a procedure in mind for the virtual consultation or can you also book it to get ideas what can be improved with a procedure? And would it make sense to have scans ready for a virtual consultation?
A: It would usually be most helpful if the patient provided some insight into their concerns and/or their goals. The greatest likelihood of high patient satisfaction is if the surgeon performs surgery that aligns with the patient’s primary concerns.
A scan usually does not tell the surgeon what procedures to perform, it merely provides a platform on which to design the surgery. (e.g., custom facial implants)
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I have had chin ptosis with prier chin implant.Could I have a distant consultation with you (zoom meeting) to have some advise as to what procedure would you advise to correct my problem. My current surgeon does not know what to do to correct my problem. He said he had to think about it. I need advise.
A: I assume the chin pad ptosis occurred because of implant removal. Assuming that no further chin augmentation is desired thern a submental chin pad excision is needed. If secondary chin augmentation is desired then a sliding genioplasty would be best.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am interested in hip implant surgery and I’d like to know more. I’ve had fat grafting done in the area, but I’m not satisfied with the result. Here are some photos. As you can see, I have a blocky shape in addition to the hip dips. I’d like to have a pronounced hourglass figure- especially to balance out my top half (I have 800cc silicone implants).
A: Thank you for sending your pictures. I believe you benefit by waistline narrowing with some hip dip augmentation. Since larger hip implants are associated with a higher rate of complications it is best to keep them small.(hip dips) This then requires a maximal waistline reduction approach. (type 1 or 2 rib removal)
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello. I saw on your web site a procedure you’ve had success treating angular chelitis. It involves the corner of the mouth. Is that the only area that’s focused on? In other words would it be necessary to raise the upper lip too? I’m trying to find the least invasive, yet effective, treatment.
A: The success in surgically curing angular cheilitis is to remove all chronically infected mucosa and skin. How that may affect the shape of the corner of the mouth depends on the infected/resected area.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am soon going to undergo maxillomandibular advancement. I currently have an optimal amount of tooth show. In the post-op simulation, my philtrum lengthens a bit. I suspect this is due to the advancement vector being a little downward relative to my natural head position (which is about 6.5 degrees downward from the frankfurt plane). I am not yet certain this will look bad, but I have always had a strong dislike for long as well as convex philtrums. I am wondering:
1. Is it possible to shorten the philtrum without increasing tooth show? I find mixed answers when it comes to this.
2. Is it possible to turn a concave philtrum convex again, also without altering tooth show?
Depending on the effect of my maxillomandibular advancement on the philtrum, I may be interested in one or both of these.
I look forward to hearing your response.
A: In my experience 1) No and 2) No.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hi. If I had cheek bone reduction and too much of the bone was cut off. Is it possible to get cheekbone implants? I’ve lost so much volume so my face is saggy and I have extra skin. My smile changed as well
A: The typical subtotal or total cheekbone reduction reversal is to use implants to build the cheekbones back out. This is best done with a custom implant design to control the amount of augmentation and to address any bony asymmetries which now may exist.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am interested in a consultation for possibly a lower eyelid pinch procedure. I am 32 years old and am experiencing extra skin that Botox is only making worse. My smile pull is a rather large area from cheek to brow.
A: No form of a lower lid blepharoplasty is going to help get rid of wrinkles thaf primarily appear in animation. (smling) Surgery treats static problems not dynamic ones. While you have a small amount of redundant lower eyelid skin (with scleral show) its removal is not going to make much a difference in the wrinklers while smiling. Those wrinkles appear because of the push of the cheek tissues upward.
While there may be some modest benefit to a lower eyelid pinch bleph and TCA lid peel, it is important to realize what that procedure does and does not achieve.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I’ve recently seen a question online asked by a user in regards to a midface shortening surgery using the lefort practice. You responded that such a surgery would not help since this would just burry the teeth if there were no abnormally long gums to begin with.
Now to my question. Would a lefort 1 for example make sense if the outside skin or soft tissue could be removed from the above the lip, for example cut a bit of an area from above the lip then sow it back to the upper lip, or would a bullhorn liplift be enough to reduce the soft tissue for it to look normal?
i understand that im not a professional but i think if only about 0,5cms of bone are removed it would be manageable, no?
A: While you can shorten the upper lip that will do nothing for the rest of the midface. In short there is nothing thaf can be done to shorten the long external midface. A LeFort I impaction reduces excessive gum show of the upper teeth but will not change the long external soft tissue midface.
Changing facial dimensions involves more variables than a diagrammatic exercise on a skeletal model. The effects on the external soft tissues do not correlate on a linear basis to what is done on the bone…and in the case of the midface bone shortening these is virtually no effect at all.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello! I saw a thread before regarding a question about having dents in the forehead.I have several dents in the forehead. The first one is quite big and is located in the middle. Its like a U: in the middle of the forehead. Then I have one more in the middle that is like a bullet hole and one on the left side which makes the whole forehead uneven. What can be done here to make it look more normal
A:You have two forehead treatment options, fat injections and a custom thin forehead implant to smooth the whole forehead out. Each one has its advantages and disadvantages.
FAT = autologous, minimally invasive but unpredictable survival and persistence
IMPLANT = permanent, smoothest result but it is an implant that has to be surgically placed
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello I saw that you’re doing mouth widening surgery and I have some question about it. Actually I’ve not so wide mouth, and that’s bothering me in many ways. Does mouth widening increases opening of the mouth? I can open my mouth 4cm would be nice to open more than 5cm. I’ve not so small face and my lips doesn’t fit my face too, have juicy lips but small mouth.
A: Mouth widening surgery is an aesthetic procedure that lengths the width of the mouth. It will have no functional improvements in how far the mouth opens…which is controlled primarily by lower jaw motion not that of the lips.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I had a genioplasty, jaw shaving and facelift done 5 years ago. I was hoping to have revision work done to make the chin a little smaller to match the jawline and have the chin ptsosis corrected and the skin under the neck tightened.
A:While I don’t know what your chin bone looks like the anatomic reality is that the thickness of the overlying soft tissues is the limiting factor in any further chin reduction. This is evident with the presence of the existing chin ptosis. (too much soft tissue for the amount of bone that now exists). While submental chin ptosis correction may be effective I wouldn’t count on the chin getting much smaller.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I am a 34 year old male and previously a few years back underwent forehead contouring surgery and fat grafting to the parasagittal areas of the skull (simultaneously) to correct a minor u treated case of craniosynostosis from childhood.
On the right sight of my skull in the parasagittal area, some of the fat grafts either did not take and/or were not distributed evenly because there is a slight concave area which is somewhat noticeable when my hair is cut very short. I previously had an injection of bellafil to correct that spot and I was supposed to go back for more but then ended up relocating to here in the bay area. I would like to correct the rest of that spot if possible.
You can’t see it in a picture really but I attached a photo circling in red the outline of where the concavity is.
I was wondering what options there could be to smooth the concavity and fill the “indented” area. I know there’s fat grafting, spot cranioplasty with bon cement, fillers etc, many of which you offer. I’m wondering what would be effective and also cost efficient?
A: An implant augmentation of some form is going to produce the reliable and sustained effect. A custom skull implant would produce the most effective result. ePTFE sheeting would provide the most cost efficient approach although the aesthetic outcome may not be quite as good as a custom skull implant..
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Thank you for confirming the suspicion. I see now that it was positioned as a standard chin implant rather than how a VLC implant is designed to be placed. Since the implant is positioned incorrectly, how much vertical height (if any) do you think it is giving me currently? The edit looks much better than what I have now. I am most interested in improving my frontal view the most; I was wondering if you could send an edit of the frontal view photo (if it is not too much trouble). I want a look that is similar to the lower thirds of the reference photos that you and I reviewed. One of my main fears is that I won’t be able to achieve the vertical length of those photos without an 8mm+ movement. Ideally, I’d prefer an implant over genioplasty because of the invasiveness, but I’d like your opinion on the most appropriate procedure knowing what we know now.
I have a few questions:
1) How much vertical movement do you think that I would need to achievethe height in the goal photos?
2) What is the maximum vertical and horizontal projections of a custom vertical lengthening chin implant?
3) How much more vertical length can I get from a custom chin implant in comparison to the VLC standard that I have in?
4) Taking my goal photo references into account, which procedure(s)would you recommend most to achieve my goals? My options are: modifying the existing VLC implant, vertical lengthening genioplasty w/ standard chin implant overlay, and a custom chin implant with an extended wing design.
A: In answer to your vertical chin lengthening questions:
1) Probably 5 to 7mms vertical
2) The tissue tolerances of the soft tissue chin pad for any implant augmentation is the number 12mms. (any amount of horizontal and vertical changes when added together)
3) It doesn’t matter whether it is custom or a standard chin implant you can not usually exceed the 12mm number)
4) Based on the information I know I would choose the custom extended chin implant. Then you control all variables including how it blends into the jawline behind the chin.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I wanted to enquire about a cosmetic ‘lip commisuroplasty’ to make the mouth less wide. I plan to get cosmetic surgeries to make my overall face smaller, but when I edit my face my wide mouth looks awkward. I’m not a fan of large lips and don’t want my mouth to stand out. I hope to make my mouth 2-3mm thinner if possible. How does this surgery work? Where and how large is the scar? Thanks in advance.
A:You are referring to a mouth narrowing procedure as opposed to a lip reduction procedure. This is done by a V-Y corner movement technique. This is the opposite of the Y-V mouth widening technique. Normally I am not in favor of mouth narrowing surgery because the scar trail left behind by the corner moving inward. (the straight line of the Y-closure) But for a 2 to 3mm change such a scar line may be more acceptable.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, I’m interested in having cheekbone reduction surgery. Approximately 1.5 years ago, I had the procedure performed by another surgeon. The results weren’t what I wanted. He didn’t remove enough bone. So I am thinking of having a revision done but with you. If at all possible, that is. I’m not sure if a revision can be done for this type of surgery. I keep reading conflicting information online. At any rate, how would you approach such a procedure? Would I need extensive bone work done again via osteotomy? Or can the bones near the temple be shaved down for a simpler/safer approach? Also, what will the risks be?
I’ve attached pre-op and post-op photos, including a recent photograph of myself and a model whose cheekbones are what I hope to achieve. Hopefully, they help you in determining my options. Have a nice day, doctor. Thank you.
A:Thank you for your inquiry sending your pictures and 3D CT scans. I would agree that the only way to get closer to your result is further cheekbone reduction. Since there is no effective cheek shaving procedure that leaves the type of cheekbone reduction osteotomies you had done the first time. Since I don’t know how much inward movement was done we have to look at the scans to make that determination and see if more can be achieved. The views that will provide that information are either the top or basal (submental) views. This allows one to see how much inward movement was done. Those are the key views that are not in the 3D images that you have sent.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
Q: Dr. Eppley, Hello I had brow bone reduction surgery done 3 years ago. I love the results since my bone was very prominent and unattractive although I have been feeling my forehead area is less masculine now and wanted to see if it was possible to contour with slight augmentation. Please let me know if this is possible! I am a 31 year old male.
A: Secondary brow bone augmentation can always be done after a brow bone reduction. The only question is what material to use to do so which is yet to be determined.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
