Lafayette Doctors

Do Rib Cartilage Implants Have to Be Replaced or Revised After a Few Years of Use, Like Silicone and Goretex Implants?

I understand and have heard that silicone, goretex and all other synthetic implants for rhinoplasty will eventually have to be replaced (or revised) after years of wear and tear. From this forum I have heard many surgeons recommending that the best material used for rhinoplasty is our own autologous tissue such as rib cartilage or septal cartilage. I would like to know if autologous tissue used for rhinoplasty will eventually require replacement or revision too?

While every nasal implant material has its own set of unique problems, wearing out or the need to be replaced is not one of  them for any of the materials. The nose is not a place where any graft material is exposed to 'wear and tear' that would cause resorption or weakening of the materials. The concept of replacement or revision of any nasal implant can occur with any material, synthetic or cartilage, due to cosmetic concerns such as  shape or shifting and infection. While I am a big fan of autologous cartilage whose risks of infection and extrusion are very low compared to synthetic materials, any nasal implant material can function well in the long-term if properly shaped and well placed. The concept to grasp is that there is no perfect nasal implant material that can guarantee that there will be no future need for additional revisional surgery.

Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

I Have Had 5 Pregnancies, with One Being Quintuplets. I Am Fight my Insurance About Getting my Muscle Walls Fixed. Suggestions?

Since my insurance wont pay, I cant afford to get all of it fixed on my own. What should I get fixed immediately and is there anything I can do to help. I have a hard time getting out of my bed due to lack of muscles in my stomach. My back hurts all the time since its doing the work that my stomach muscles should do. I get infections due to the flap being so long and it rubbing. I have done physical therapy and they said until I get my muscles fixed, they cant help. I am lost and needing relief.

Unfortunately, the days have long past when insurance will cover repair of a rectus diastasis or midline muscle separation. While this is an integral part of most tummy tuck surgeries, it is not considered a medically necessary procedure unless there is a documented umbilical hernia through the muscle separation. You will have to seek a tummy tuck with muscle tightening done as a cosmetic procedure.

Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

Chose Implants That Are Too Large...how Soon Can I Change This?

I had moderate profile saline implants filled to 425 for 15 years.I always disliked the lack of projection and that they were too wide for my body. I was a very small C. I thought I wanted to be a D so my recent surgery was a change to 550 mod plus salines filled to 625. I feel a lot of pressure right now and my implants are sitting very very high. How long must I wait for a redo if I feel confident that I should have gone for mod plus implants filled to 525. I fear I will be larger than a D

Since you are a replacement of existing breast implants and not a first time breast augmentation patient, your perception about size and how you feel about them is a lot more accurate since you had a known implant size starting point. (you are now 50% bigger by implant volume)  I would give it 6 weeks and see how you feel then. If there has been no change in your perception about size (not pressure), then you could downsize at that point.

Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon