Dr Yaremchuk

[eastcoastian1]

I don’t think Dr. E is a scammer at all. In fact, he tried to talk me out of revision implants saying there’s no way to guarantee symmetry. He just tends to go along with whatever the patient wants. If the patient comes with a design that simply doesn’t fit the face, Eppley will go along with it cause that’s what the patient says they want. Dr. Y will push back and actually say that it might look weird.

Also, Dr. Y is very direct and quite short. If you ask more than a few questions, he gets very visibly annoyed.

[ben from UK]

He just tends to go along with whatever the patient wants. If the patient comes with a design that simply doesn’t fit the face, Eppley will go along with it cause that’s what the patient says they want.

Which is totally absurd and that's why he produces the most freakish unaestethic unnatural results like this: https://imgur.com/a/7HckHZi. The client has no clue about what should be done technically to have a good result. He might know how to morph his pic into a good pic, but he doesn't know how big an implant should be or how much millimeters should be taken off from bone. Only a surgeon is able to know this based on years of experience and his artistic eye (or better said: should know this). 

Trust me, E. has no clue about aestethics. I have way more experience with this than you, who only had a consultation with him. I could go into details but I won't. You just don't understand that a surgeon should never go precisely along with what a patient wants, unless a patient is right in his dimensions, which is almost never the case.

Dr. Y will push back and actually say that it might look weird.

Which is what should be done when you deal with patient's stupidity. But you seem to defend stupidity.

I have way more experience with this than you and I can tell for sure that you have no clue about how aestethics work, about how to choose a good surgeon etc. I was once as stupid an naive as you.

Also, Dr. Y is very direct and quite short. If you ask more than a few questions, he gets very visibly annoyed.

So what? There is no correlation between someone's character and the results he produces. Again, this why I know you have no experience with this.

Do you have a basis for this claim? This is a pretty serious one.

Ofcourse I do. I'm not going to put it out publicly. Like I said, I talk based on experience, the others don't talk based on experience, but based on his blogs and one appointment which has nothing to do with reality and real practical skills. 

And no, I'm not going to go into details through pm to people that defend E. based on one appointment and didn't do any work. They don't deserve my time. And to be honest, I just want them to follow their stupidity and have a procedure done by E.

I think he just has a unique philosophy, in that he lets the patient have almost full control of what kind of augmentation they want.

Which is the same as asking a passenger to fly a plane. Like I said, you can be a great morpher, but it doesn't mean you're able to calculate the right design, that you know how much and at what place precisely something should be added or cut. This a whole different thing. Also, there's a difference between a morph and reality.

Apart from that, E. just doesn't have the aertistic eye, doesn't have the subtility to create good results. He has great charm and seems to bond well with clients. That makes him even more dangerous.

I see him as an innovator and love seeing what kind of weird interesting s**t he's doing to his patients.  That said, id never let him touch me.

O, so you never had anything done by him but you can tell for sure that he has great philosophy and is a great surgeon and great innovator? Are you aware of what you're saying? It's like saying person X is a great soccerplayer without ever having seen him perform or person Y is a great chef without ever ordering a meal at his restaurant.

and how open-minded he is about aesthetic modifications. love seeing what kind of weird interesting s**t he's doing

It's not difficult to create a monkey. You really don't know what you're talking about.

[eastcoastian1]

Which is totally absurd and that's why he produces the most freakish unaestethic unnatural results like this: https://imgur.com/a/7HckHZi. The client has no clue about what should be done technically to have a good result. He might know how to morph his pic into a good pic, but he doesn't know how big an implant should be or how much millimeters should be taken off from bone. Only a surgeon is able to know this based on years of experience and his artistic eye (or better said: should know this). 

Trust me, E. has no clue about aestethics. I have way more experience with this than you, who only had a consultation with him. I could go into details but I won't. You just don't understand that a surgeon should never go precisely along with what a patient wants, unless a patient is right in his dimensions, which is almost never the case.

Which is what should be done when you deal with patient's stupidity. But you seem to defend stupidity.

I have way more experience with this than you and I can tell for sure that you have no clue about how aestethics work, about how to choose a good surgeon etc. I was once as stupid an naive as you.


So what? There is no correlation between someone's character and the results he produces. Again, this why I know you have no experience with this.

Ofcourse I do. I'm not going to put it out publicly. Like I said, I talk based on experience, the others don't talk based on experience, but based on his blogs and one appointment which has nothing to do with reality and real practical skills. 

And no, I'm not going to go into details through pm to people that defend E. based on one appointment and didn't do any work. They don't deserve my time. And to be honest, I just want them to follow their stupidity and have a procedure done by E.

Which is the same as asking a passenger to fly a plane. Like I said, you can be a great morpher, but it doesn't mean you're able to calculate the right design, that you know how much and at what place precisely something should be added or cut. This a whole different thing. Also, there's a difference between a morph and reality.

Apart from that, E. just doesn't have the aertistic eye, doesn't have the subtility to create good results. He has great charm and seems to bond well with clients. That makes him even more dangerous.

O, so you never had anything done by him but you can tell for sure that he has great philosophy and is a great surgeon and great innovator? Are you aware of what you're saying? It's like saying person X is a great soccerplayer without ever having seen him perform or person Y is a great chef without ever ordering a meal at his restaurant.

It's not difficult to create a monkey. You really don't know what you're talking about.

Jeez man, why the personal attack all of a sudden? I merely made a single post on this thread going off my experience with him (couple consultations) vs Yaremchuk (surgery). Maybe I’m wrong though, especially if you have more experience. Just don’t get where the random defensiveness came from.

[kavan]

Which is totally absurd and that's why he produces the most freakish unaestethic unnatural results like this: https://imgur.com/a/7HckHZi. The client has no clue about what should be done technically to have a good result. He might know how to morph his pic into a good pic, but he doesn't know how big an implant should be or how much millimeters should be taken off from bone. Only a surgeon is able to know this based on years of experience and his artistic eye (or better said: should know this). 

Trust me, E. has no clue about aestethics. I have way more experience with this than you, who only had a consultation with him. I could go into details but I won't. You just don't understand that a surgeon should never go precisely along with what a patient wants, unless a patient is right in his dimensions, which is almost never the case.

Which is what should be done when you deal with patient's stupidity. But you seem to defend stupidity.

I have way more experience with this than you and I can tell for sure that you have no clue about how aestethics work, about how to choose a good surgeon etc. I was once as stupid an naive as you.


So what? There is no correlation between someone's character and the results he produces. Again, this why I know you have no experience with this.

Ofcourse I do. I'm not going to put it out publicly. Like I said, I talk based on experience, the others don't talk based on experience, but based on his blogs and one appointment which has nothing to do with reality and real practical skills. 

And no, I'm not going to go into details through pm to people that defend E. based on one appointment and didn't do any work. They don't deserve my time. And to be honest, I just want them to follow their stupidity and have a procedure done by E.

Which is the same as asking a passenger to fly a plane. Like I said, you can be a great morpher, but it doesn't mean you're able to calculate the right design, that you know how much and at what place precisely something should be added or cut. This a whole different thing. Also, there's a difference between a morph and reality.

Apart from that, E. just doesn't have the aertistic eye, doesn't have the subtility to create good results. He has great charm and seems to bond well with clients. That makes him even more dangerous.

O, so you never had anything done by him but you can tell for sure that he has great philosophy and is a great surgeon and great innovator? Are you aware of what you're saying? It's like saying person X is a great soccerplayer without ever having seen him perform or person Y is a great chef without ever ordering a meal at his restaurant.

It's not difficult to create a monkey. You really don't know what you're talking about.

This comes off like you are more mad at yourself for having chosen Eppley than you are at EastCoast's statements. Could you have been one of those 'back seat' drivers he accommodates who requested a look seen on someone ELSES face but was off target for yours?

As to not difficult to create a monkey, could it be more like 'Monkey's paw' where someone gets EXACTLY what they WISH for but it ends up being a curse.

[ben from UK]

Jeez man, why the personal attack all of a sudden? I merely made a single post on this thread going off my experience with him (couple consultations) vs Yaremchuk (surgery). Maybe I’m wrong though, especially if you have more experience. Just don’t get where the random defensiveness came from.

Because this is just no argument in defense of him:

He just tends to go along with whatever the patient wants. If the patient comes with a design that simply doesn’t fit the face, Eppley will go along with it cause that’s what the patient says they want

But I admit I was too defensive.

This comes off like you are more mad at yourself for having chosen Eppley than you are at EastCoast's statements. Could you have been one of those 'back seat' drivers he accommodates who requested a look seen on someone ELSES face but was off target for yours?

No, never asked for that, but that's just Eppley's default mode. He smacks a ridiculous chin, jaw or cheek on everyone.

As to not difficult to create a monkey, could it be more like 'Monkey's paw' where someone gets EXACTLY what they WISH for but it ends up being a curse

If a guy asks for more angular jaws or a broader chin and ends up looking like a comic pencil head superhero figure he got exactly what he wished for?

[kavan]

Because this is just no argument in defense of him:

But I admit I was too defensive.

No, never asked for that, but that's just Eppley's default mode. He smacks a ridiculous chin, jaw or cheek on everyone.

If a guy asks for more angular jaws or a broader chin and ends up looking like a comic pencil head superhero figure het got exactly what he wished for?

I don't know what that guy asked for. I just know that he accommodates a lot of outlandish requests and has a lot of guys wanting to look like block heads but don't know they are asking for that. What he's good at is WRITING and search engine optimization.

[Bowie]

I will be having consultations with both Dr Y and Dr E with regards to implants. I had cartilage with Sailer but unfortunately steroid sprays have really shrunk them. If I get something man-made then at least I don't have to worry about the resorption. Seems both doctors have their pros and cons: Dr Y pushes back if he doesn't think that the patient's request will be naturalistic yet his bedside manner seems to be contemptible whereas Dr E's bedside manner is very much like Sailer's yet he just gives the patient what they ask for.

I don't think that a doctor's demeanour is inconsequential, the easier you can discuss your ideas with the surgeon then - in theory - the better he will understand your wishes and requirements.

[ben from UK]

I will be having consultations with both Dr Y and Dr E with regards to implants. I had cartilage with Sailer but unfortunately steroid sprays have really shrunk them. If I get something man-made then at least I don't have to worry about the resorption. Seems both doctors have their pros and cons: Dr Y pushes back if he doesn't think that the patient's request will be naturalistic yet his bedside manner seems to be contemptible whereas Dr E's bedside manner is very much like Sailer's yet he just gives the patient what they ask for.

I don't think that a doctor's demeanour is inconsequential, the easier you can discuss your ideas with the surgeon then - in theory - the better he will understand your wishes and requirements.

Cartillage? For what? Nose? I only read once about cartillage for jawarea. But I think there's a chance cartillage resorbs unless same cartillage is used for same area, for example nose cartillage to build up nosebridge.

[Bowie]

Cartillage? For what? Nose? I only read once about cartillage for jawarea. But I think there's a chance cartillage resorbs unless same cartillage is used for same area, for example nose cartillage to build up nosebridge.

It was cadaver cartilage from Germans. I really liked the results, it is a shame it resorbs.

[ben from UK]

he just gives the patient what they ask for.

I already said this before: most patients have no clue about aestethics. I see most of them make ridiculous morphs for example. In case they do have aestethic eye, most of the time, they don't know how much millimeters an implant must be to get it exactly like a morph. Only a surgeon knows this, and he'll only know in the early phase of surgery, before the swelling kicks in. He's able to estimate the dimensions during the 2d design, but it will be what it is: a 2d design and nothing more. The face is a 3d form and not 2d. This means, nine out of ten times, an implant has to be shaved during surgery to make it as natural as possible. Problem is: most surgeons don't know how to handcraft it. This is an artform. Sometimes, they just don't care or they're too lazy: "The patient agreed with the 2d design, that's what he wanted, so I put it in and that's it". And then you'll end up with an unnatural looking face, cause the surgeon couldn't care less.

Also: time = money/costs. The more time a surgeon works on your face, the more costs. But it's really really important that a surgeon puts in the required effort and time to get it right. Precision is highly important.

One of the secrets/tricks of wrap around implants is preserving the forward growth of the face AND make the jaw more angular and/or broader and/or creating vertical dropdown. Doing the latter without preserving the former may lead to a bloated face and worse aestethics. That's why quite alot of fillers seem good (but don't stay) and quite alot of implants fail. Because fillers only target the areas that should be targetted (lower border of the jaw) and implants might add volume on areas that shouldn't be targeted, ruining the ogeeline, forward growth, cheekbone portrusion and facial shadows underneath the cheekbones. Many surgeons just don't know this or don't care. The ideal surgeon is a technician AND an artist. It,'s an artform.

The lower border of the jaw is where the additional volume must be. Not above the lower border. And when you look at almost all designs, I see they go high up the face, putting silicone on areas where there shouldn't be any additional volume. These areas need to stay 'lean' in order to avoid a bloated face. Many implant designs are just aestehtically wrong in my opinion. They should be much leaner. Sometimes, with some faces, it's a trade off: more width will lead to less forward portrusion (at least optically).

Most important: every face is different and should be treated with utmost care and precision. Facial harmony is key. Untill someone matelhematically breaks down facial harmony, it's art and not just geometry. Overdone/unnatural looking garbage like the pic posted here should be something from the 80s. Unfortunately it's not and many surgeons keep producing this garbage.

[kavan]

I already said this before: most patients have no clue about aestethics. I see most of them make ridiculous morphs for example. In case they do have aestethic eye, most of the time, they don't know how much millimeters an implant must be to get it exactly like a morph. Only a surgeon knows this, and he'll only know in the early phase of surgery, before the swelling kicks in. He's able to estimate the dimensions during the 2d design, but it will be what it is: a 2d design and nothing more. The face is a 3d form and not 2d. This means, nine out of ten times, an implant has to be shaved during surgery to make it as natural as possible. Problem is: most surgeons don't know how to handcraft it. This is an artform. Sometimes, they just don't care or they're too lazy: "The patient agreed with the 2d design, that's what he wanted, so I put it in and that's it". And then you'll end up with an unnatural looking face, cause the surgeon couldn't care less.

Also: time = money/costs. The more time a surgeon works on your face, the more costs. But it's really really important that a surgeon puts in the required effort and time to get it right. Precision is highly important.

One of the secrets/tricks of wrap around implants is preserving the forward growth of the face AND make the jaw more angular and/or broader and/or creating vertical dropdown. Doing the latter without preserving the former may lead to a bloated face and worse aestethics. That's why quite alot of fillers seem good (but don't stay) and quite alot of implants fail. Because fillers only target the areas that should be targetted (lower border of the jaw) and implants might add volume on areas that shouldn't be targeted, ruining the ogeeline, forward growth, cheekbone portrusion and facial shadows underneath the cheekbones. Many surgeons just don't know this or don't care. The ideal surgeon is a technician AND an artist. It,'s an artform.

The lower border of the jaw is where the additional volume must be. Not above the lower border. And when you look at almost all designs, I see they go high up the face, putting silicone on areas where there shouldn't be any additional volume. These areas need to stay 'lean' in order to avoid a bloated face. Many implant designs are just aestehtically wrong in my opinion. They should be much leaner. Sometimes, with some faces, it's a trade off: more width will lead to less forward portrusion (at least optically).

Most important: every face is different and should be treated with utmost care and precision. Facial harmony is key. Untill someone matelhematically breaks down facial harmony, it's art and not just geometry. Overdone/unnatural looking garbage like the pic posted here should be something from the 80s. Unfortunately it's not and many surgeons keep producing this garbage.

Custom Jaw Implants have to be continuous over the bone surface. They just can't jump out selectively in one place. So, there will be a gradient where the thinner areas of it would be to the bone surface least needing augmentation and the thicker areas being over areas needing the most prominence. Some designs show the gradient via color coding. Others don't.

There's no jaw implant that selectively builds the lower border of the mandible downward. There would be nothing to hold it in place if it didn't have another part of it that made contact with an area of bone surface above. With filler, it's held in place by the soft tissue envelope it's injected to.

Jaw implants need a FOUNDATION to build on. Filler just needs an envelope to put it in.

As to the face being a 3d form and not 2d, what form is it when you look in the mirror?

[ben from UK]

Custom Jaw Implants have to be continuous over the bone surface. They just can't jump out selectively in one place.

Yeah, I understand, there needs to be a gradient. But the gradient needs to be as minimal as possible imo, especially the area underneath the masseter.

Jaw implants need a FOUNDATION to build on. Filler just needs an envelope to put it in.

I understand that. But it can cause additional problems. That's one of the problems with implants. Sometimes, it's needed to fix the implant (technically) bit it doesn't add anything aestehtically or makes it worse aestethically.

[kavan]

Yeah, I understand, there needs to be a gradient. But the gradient needs to be as minimal as possible imo, especially the area underneath the masseter.

It usually is. But if a person has CHUB over the area the implant has to adhere to, there is no way to cover the bone surface needed for a continuous gradient with a thickness of 0 or for the implant to lose the chub for them.

I understand that. But it can cause additional problems. That's one of the problems with implants. Sometimes, it's needed to fix the implant (technically) bit it doesn't add anything aestehtically or makes it worse aestethically.

The implant needs to stay fast on the bone. It is not only art or 'pure aesthetics' in the absence of brass tacks. There are technical logistics involved, in particular they need a foundation to build on which seems to be the part you don't like.

[ben from UK]

That photo did shock me, another problem is when people who have small mouths like that guy get huge jaws, it looks strange.
Also, a lot of chin implants seem to make the chin look shiny, why is that?

There is this Eppley result too, what do you think to that? https://www.realself.com/review/chin-implant-custom-jawline-cheek-implants-1#media-review-8673471-image-3432729.

Someone posted a Yaremchuk result in this thread which looked very natural.

No one has a ridiculous jaw like that in real life, unless he has something like acromegaly. But the guy seems happy (I'm just wondering if he sees himself the way I see him).

Cheekbones are too feminine (men's cheekbones are more lateral, wile women's cheekbones are more interior). Jaw is too wide, chin is too broad, area between chin and jaw is too broad).  But I guess some men like to walk around like a plastic superhero.

Shiny chin might be the material (silicone) or too much volume I think. It's a good question.

[Bowie]

These reviews for Eppley are pretty concerning... https://www.complaintsboard.com/complaints/dr-barry-l-eppley-carmel-indiana-c243012.html