Friday, November 30, 2007

Dear Dr. Eppley:

In answer to some of your comments regarding what you called my "bizarre and irrational" behavior, I wish to point out the following:

>>a) Showing up for surgery believing that you were going to have it done under local anesthesia. This is something that we specifically discussed during your prior consultation.<<>>b) Showing up for surgery and having no mechanism to pay for it. Then immediately after surgery, canceling the venues that had been established to pay for it.<<

To the contrary, my bank statement shows a cash deposit and balance on April 18, 2001 in an amount MORE than sufficient to cover ALL costs. A cash deposit for $10,000 was made 2 days before my surgery; irrefutable proof that I had every intention of making PAYMENT IN FULL upon presenting for surgery. Therefore, your above statement is nonsensical, and only meant to divert attention from the real problem, which is the negligent manner in which you performed my surgery.

I was not aware that Fleet Bank imposed a $4,000 withdrawal limit per 24 hr. period. Meridian staff discovered this just before I was taken to the OR. I gave your staff my bank PIN code, to facilitate withdrawal of the entire amount. However, the bank said they would have wait 24 hours between each withdrawal. Therefore, you revieved $4,000 initially.

My reasons for stopping payment on the BALANCE, after the initial $4,000 was paid:

1.) Upon my return to the hotel after seeing you the day after surgery for removal of the drain, I found a phone message from Meridian informing me that an additional fee would be withdrawn from my account for "an extended stay" at the facility. In light of the reason I decided NOT to stay, (waking from anesthesia, unattended,and unable to breathe), I was obviously being exploited. In total, I received four very nasty calls regarding MONEY, but not a single inquiry about how I was doing.... NOT ONE. (Meridian notes LIE about this, as they state a call was made to find out how I was doing. THIS IS A LIE.

2.) By the second day I ascertained that you did NOT perform a full facelift on me as we had thoroughly discussed. You had NOT dissected down to the nasolabial fold (as per my previous facelift of which you had the operative report, accurate in every detail). Since the agreed PURPOSE of the surgery for which I engaged you was an attempt to re-establish adhesion between tissue planes that had become lax and detached from the muscles of expression (as stated in your consultation notes) this clearly could not have been achieved without dissection of the areas undermined in previous surgery. During our meeting 2 months before surgery, I explained that the hydrodissection had been carried down to the nasolabial fold and fibrous attachments freed at that juncture, as per Dr. Driscoll's report. Your comment was: "They all say they do that, but they really don't." I told you I was CERTAIN it HAD been done in my case, and showed you the intra-op photo which clearly depicts, in vivid color, the extent of the undermining.

A message left by your secretary, Machele Hebert, stated that she " would have a credit agent call upon me". In my debilitated post operative condition, ALONE in a hotel room 1,000 miles frohttp://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw

m home, I found this to be an extremely callous, if not threatening.

losing face

Date: 03/07/2002 8:15:24 AM Eastern Standard TimeFrom: beppley@iupui.edu (Eppley, Barry L.)To: luciacovelli@aol.com ('luciacovelli@aol.com')Dear Lucille, In reponse to your recent faxed letter and the overall situation in general, I would like to offer the following comments (particularly, since you have taken the numerous opportunities to voice yours through many venues): 1) Your overall behavior as a patient has been unacceptable. While I have a great obligation to any patient that I put through surgery, patients also have some responsibility to act in a rationale manner. Your behavior since the inception of surgery has been, to say the least, bizarre and irrational. This has been demonstrated by you in the following manner: a) Showing up for surgery believing that you were going to have it done under local anesthesia. This is something that we specifically discussed during your prior consultation. I have never done, nor will ever do, any major surgery under local anesthesia. Just because this is the way your prior surgery was done does not obligate me to do the same. How you could have believed that this was the way it was going to be done is unknown. b) Showing up for surgery and having no mechanism to pay for it. Then immediately after surgery, cancelling the venues that had been established to pay for it. (e.g, cancelling checks) This was particularly disappointing given the compassion that everyone showed in allowing the surgery to proceed in the first place. We all felt bad that someone had come so far and we didn't want you to have to make another trip so we trusted your integrity. c) Your vulgar behavior to the nurses in the recovery room. The kind of language that was used can not be explained by an 'anesthetic' reaction. No prior patient has ever demonstrated this kind of postoperative reaction. Such language and behavior is not acceptable from any patient. The comments that 'people were trying to kill you' in the recovery room is very unusual. d) Your hostile letter writing and threats of reprisal to anyone (e.g., Meridian Center) that made any inquiry as to the paying of the surgical services that you opted to undergo. e) The posting of web pages that describe your horrible ordeal at the Meridian Center. This is particularly disappointing given how everyone went out of their way to help you through your surgery and recovery as an outpatient for this procedure. f) Your communications that describe how you feel there is a conspiracy to prevent you from getting the proper information from your surgery or the people have communicated with other physicans about your surgery and are preventing you from getting the care that you need. To set the record straight, I have only ever spoken to one other physican (that one who took out your sutures after surgery) about your surgery. Other than sending records to Dr. Carey, I have never even been contacted by anyone else about your surgery. Furthermore, the obtaing of medical records on anyone, including the patient themselves, requires authorization and releases on the proper institutional forms. Simply sending a letter with your signature is not a prope release form. We have been fully compliant and timely, when the proper forms have been obtained, about the release of your medical records. 2) The facelift operation that was performed on you with a full SMAS plication was not an unusual procedure of which the details of its execution are hard to fathom. You simply had an extended SMAS, from the cheek to the neck, which was plicated with overlying skin resection. As per your request, this was tightened significantly to deal with your preoperative complaints of subcutaneous tissue and skin laxity. This procedure was very similar to most patients that undergo facelifts with significant face and neck tissue laxity. There was no mystery to the procedure that makes it difficult to understand. You,unlike most patients, have a better preoperative understanding of the anatomy of the face based on our preoperative consultations. Therefore, it should be more understandable to you than most patients. 3) Your postoperative symptoms of facial pain and 'severe physical problems' from this procedure, which is now done almost a year ago, is certainly uncommon at one which I have never seen or heard of before your procedure. While certain facelift patients may have some aesthetic concerns about their postoperative result, the issues of unmitigating pain, difficulty with eating, and non-facial physical problems one year after surgery is difficult to medically explain. I know of no solution for them and certainly further surgery is unlikely to be of help. As you can see from the above, the postoperative path that you have chosen to undertake has made yourself a difficult patient. While I would not question the symptoms that you currently have or the desire/need for further plastic surgery, your behavior has made my continued participation in your care untenable. Proper medical care requires that both parties, physican and patient, act responsibly and in the best interest of obtaining a good outcome. I do not feel in our relationship that you have demonstrated good faith in that regard. I will certainly continue to provide any records to or talk to any other physican about your specific procedure that you deem may be helpful. I would only ask that you makesuch requests formally in writing (not e-mails) that have the appropriate medical release forms. I will continue to make every effort to aid you in obtaining further medical care. Lastly, it should be understood that the my aforementioned comments to you are held in the strictest confidence. I will not share with anyone those thoughts/comments that I have detailed above. I am very sorry that a more favorable postoperative outcome has not been obtained for you. Respectfully, Barry L. Eppley, M.D., D.M.D. Associate Professor of Plastic Surgery Indiana University School of Medicine Read my response:http://groups.msn.com/LosingFace/yourwebpage3.msnw
http://groups.msn.com/LosingFace/dreppleysresponse.msnw
http://groups.msn.com/LosingFace/aftertheoperation.msnw
http://groups.msn.com/LosingFace/immediatedenial.msnw
http://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnw
http://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnw
http://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnw
http://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnw
http://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnw
http://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnw
http://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnw
http://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnw
http://groups.msn.com/LosingFace/yourwebpage3.msnw
http://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnw
http://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnw
http://groups.msn.com/LosingFace/documentationofphotographs.msnw
http://groups.msn.com/LosingFace/documentationofmyappearance.msnw
http://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnw
http://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnw
http://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnw
http://groups.msn.com/LosingFace/modifiedbariumswallow.msnw
http://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnw
http://groups.msn.com/LosingFace/mbs503and1203.msnw
http://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnw
http://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnw
http://groups.msn.com/LosingFace/entreport02july2004.msnw
http://groups.msn.com/LosingFace/entreportjuly162004.msnw
http://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnw
http://groups.msn.com/LosingFace/comparisonofxrays.msnw
http://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw
Subj: Lisa Harris e-mail Date: 02/03/2002 Dear Dr. Eppley: I wish to call your attention to the e-mail at the end of this message, containing statements by Lisa Harris regarding her discussion of me with you and a member of the Meridian staff. These are excerpt from some lengthy messages, but I have no desire to embarrass Lisa by sending you the entire contents at present. They are authentic, and I have the tracking information which appears at the end of the messages. Dr. Eppley, I have reason to believe that similar comments passed between you and another surgeon whom I consulted regarding the serious problems I have had since my surgery with you. This doctor expressed his willingness to help me until his conversation with you. I think it is time you and I have a talk. I do not want to cause any problems of ANY kind for you, and only ask that you either provide me with a much more detailed explanation of my surgery or that you make every effort to provide another surgeon with sufficient information regarding my procedure, WITHOUT embellishment of derogatory comments that will preclude my receiving the necessary SURGICAL intervention I require to correct the functional problems resulting from my operation in April. My health is deteriorating as a direct result of the PHYSICAL complications caused by my inability to lift my head, which causes my jaw to pull down and back and my tongue with it, thus obstructing my airway with my head in an upright position. I have a very severe pulling downward of the lip depressor area and I am CERTAIN you plicated the SMAS in that area, which has made even normal animation impossible without the restriction of the platysma pulling down the plicated area in a severe contraction upon repose. Dr. Eppley, I could cover, point by point, why the techniques you used created these problems, but quite frankly, I shouldn't have to. All I want is the possibility of regaining some function lost from your operation and a chance to return to the good health I enjoyed before last April. I hope you will see your way clear to calling me as soon as possible. It would be a great relief to us both to clear the air. I am not the "dangerously mentally ill" person that Lisa Harris and others would have you believe. The only thing of which I am guilty is being smart enough to know what has gone wrong with my operations and why. If I do not hear from you by February 10th, one week from today, I will assume that you do not wish to amend our differences one on one, and that you would prefer doing on a more official level. Sincerely, Lucille Iacovelli _____________________________________________________________________ Subj: lucille Date: 01/26/2002 11:41:01 AM Eastern Standard Time To: Wallpepper@aol.com i don't know about all the financial stuff, but i do know that because of her threats to kill her last surgeon and her obvious unstable nature, dr eppley is afraid she could come back and kill him... i talked to him about that... i think that is probably the reason he didn't pursue the money. lisa _____________________________________________________________________ Subj: Re: ps.. ?? Date: 01/26/2002 3:22:42 PM Eastern Standard Time To: Wallpepper@aol.com by the way... as for the length of time spent, did she tell you that she threw a fit when they told her that she had to have anesthesia? it took over an hour to get her to understand that she could not go into surgery without it... could be that was one of the reasons things had to be 'rushed' along... lisa _____________________________________________________________________
Subj: Re: ps.. ?? Date: 01/26/2002 To:
>>did she tell you that she threw a fit when they told her that she had to have anesthesia? it took over an hour to get her to understand that she could not go into surgery without it.. <To: Wallpepper@aol.com actually one of the ladies who works there i know who is a friend of mine. _____________________________________________________________________
Here is the TRUTH about the above:>> i do know that because of her threats to kill her last surgeon and her obvious unstable nature, dr eppley is afraid she could come back and kill him... i talked to him about that...<< This is a blatant LIE. The doctors who sued me and obtained restraining orders against me NEVER made such an accusation. Why did Lisa?
>> as for the length of time spent, did she tell you that she threw a fit when they told her that she had to have anesthesia? it took over an hour to get her to understand that she could not go into surgery without it... This so-called "fit" is another flagrant LIE. My operation, for which Meridian charged the full fee for the 4 1/2 hours time estimated by Dr. Eppley, was cut short when the nurse came rushing into the OR just before I got on the table with my consent form in hand, and pointed out the line I crossed out stating that I allow the surgeon to use the anesthesia of his choice, and wrote in "NO GENERAL/INTUBATED ANESTHESIA". The very first thing I establish with all surgeons I have ever consulted is that I would never, under any circumstances, agree to surgery if it involved general anesthesia. Dr. Eppley was no exception. Therefore, when he said he could not perform my operation after reading my changes to the consent form, I was shocked. I reminded him of our first conversation and my making conscious sedation a prerequisite of any elective surgery. He claimed that there must have been a "misunderstanding", and then proceeded to take me into a room, where he and his anesthesiologist proceeded to cajole me into having the surgery with general anesthesia. (I later learned the so-called anesthesiologist was NOT an anesthesiologist at all) Given that I had planned this surgery with him for several months, after extensive written and verbal communication, had made the trip of 1,000 miles 2 months previous, for a face-to-face, lengthy consultation, and was then 1,000 miles from home, totally alone, I made the biggest mistake of my life in going through with the operation ... an operation he cut short to 3 hours from the 4 1/2 hours ... and operation he assured me was his "big case of the day" and therefore, he had booked it last, so he could "take his time".
These lies, which to him, were nothing more than sales tactics, are factors upon which I chose him to perform my operation. When I awoke from anesthesia, unable to breathe, only to learn that Dr. Eppley was in the OR with another case, I had my first realization of his capacity for deceit. What happened to my being his "last case of the day" so he could "take his time"? This makes the vicious lies in which he and his staff are guilty, all the more despicable. A more rational question to ask would be: What surgeon in his right mind would agree to operate on a patient who was "throwing a fit"? The motivation for such lies by Dr. Eppley and the Meridian staff are self evident, but what was Lisa's reason?
>>actually one of the ladies who works there i know who is a friend of mine.<

http://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw

To whom it may concern:This is to inform the reader that I photographed my tenant, Lucille Iacovelli, for documentation of her post operative appearance including views taken in February, 1999 which appeared on the Internet. Views of face, head and neck were taken with the subject standing in natural light with 35mm film at angles comparable to pre-operative photos taken by plastic surgeons. The photos accurately represent her natural appearance at the time they were taken. Every effort was made to achieve accuracy and detail.I also verify that pictures 1, 3 and 4 on the attached page under heading “Before” are cutouts of pictures in which she appeared with myself and others. These photos were taken in August 1997 by the former pastor of St. Peter's Church in Osterville and are an accurate representation of her smile in August, 1997, a few months before her operations. I swear to the truth of the above statements and place my signature to this document under penalty of perjury.(signed)Karen E. Crosby Osterville, MA 02655Date: May 30, 2002
http://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw

This was Dr. Eppley's response to my pre-op correspondence..Wouldn't anyone reading this rightly assume that this man had a thorough understanding of the problem? Would you agree that I had a RIGHT to believe that he would lift my face and neck in vectors of tension APPROPRIATELY UPWARD, AND NOT LATERAL AND DOWN?? The operative word here is LIFT, isn't it? 'You would have trusted he knew what he was doing and appreciated how much TRUST I had placed in his hands? That is what makes the deception all the more hurtful and destructive.___________________________________________________________Subj: RE: Wednesday's surgery (long!)Date: 04/16/2001 6:35:28 PM Eastern Daylight TimeFrom: beppley@iupui.edu (Eppley, Barry L.)To: LucilleIacovelli@aol.com ('LucilleIacovelli@aol.com')Dear Lucille, I appreciate and understand all of your concerns, even the financial ones. I fully realize that this is not just a trivial adventure for you. I feel fully confident that you will get a fairly significant change. By addressing both the skin and SMAS, in different vectors, I dothink http://groups.msn.com/LosingFace/dreppleysresponse.msnwthat what is achieved simply by pulling it back with the fingers can be done surgically. Because you have had a prior facelift and do not smoke, one can be fairly aggressive with the amount of skin removed and the tension placed on the closure. Obviously, I can show you better in person but your video was very helpful. The only slightly unrealistic expectation is to maintain that kind of result in the 90 degree bending over position.Dr. Eppley
http://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw

In March of 2001, just one month before my surgery, I sent Dr. Eppley a 3 minute video of myself simulating the facelift effect I wanted by lifting with thumbs and forefingers, the areas just below and behind the earlobes at the angle of the jaw and preauricular area in line with the eye. This "lifting" with my fingers in an UPWARD, vertical or cephalid vector, produced the desired effect on the lower face, in particular, the platysma, and lifted the severe laxity from the previous surgery, accentuating a high hyoid position. My neck has always been long and slender, and until the first signs of platysmal banding appeared in my last 40's, I always had a well defined cervicomental angle. The lifting with forefingers in the preauricular area created a bunching of skin at the outer aspect of the eye, and correcting this would involve an extended lower blephroplasty incision, which Dr. Eppley and I discussed during our meeting in February, 2001. Remember, I flew out to meet with him BEFORE sending this video, the purpose of which was to further clarify the goals of the operation and make certain we were both "on the same page", to use one of his favorite expressions. I think it is evident that I am not placing an inordinate amount of tension on my face, however, I AM LIFTING UPWARD, which I expected Dr. Eppley to do in my operation. The post op pictures are also stills taken from a video, and show the cervicomental angle as MORE OBTUSE, not improved. Dr. Eppley actually SHORTENED the platysma and pulled the SMAS in a vector lateral and slightly DOWNWARD. He also "folded" or plicated the excess SMAS which appears to be sagging skin in my pre-op photos, but was actually laxity of both skin AND SMAS, which was "blown out" by the excessive swelling after the rhinoplasty, in which edema tracked along the path of least resistance, i.e., the insufficiently healed facelift dissection planes. Aside from the obviously "thicker" neck and the pulling downward of my jaw from the downward tension of Dr. Eppley's face "lift" (?), nearly 2 years after this surgery, the tension pulling downward on the auricular cartilage, to which he fixed the SMAS, (though he denies this, it is evident) continues to cause worse pain than it did even one year ago. If, as Dr. Eppley's e-mail response regarding this video indicates, he did, indeed, understand the necessity for lifting the skin and SMAS in APPROPRIATE vectors of tension, why did he do something so predictably injurious and INAPPROPRIATE as this? Why? His operative report states that I never had a previous platysma plication, yet he went in through the OLD INCISION from Dr. Driscoll's platysma plication and had a copy of this op report. This is only one error in a long list of Dr. Eppley's thoughtless misdeeds which resulted in changing an aesthetic problem with good chance for correction, to an irreversible surgical disaster that has left me suffering excruciating pain every day since the day her operated on me, inability to have any kind of normal facial animation whatsoever, turning an already strange countenance into physically painful and grotesque contortions with the slightest facial expression. Deafness, tinnittus,.. Dr. Eppley's operation makes what happened at MGH seem like a picnic in comparison.
http://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw

INDIANA UNIVERSITY MEDICAL CENTER DIVISION OF PLASTIC SURGERY MERIDIAN NOTE PATIENT NAME: Lucille Iacovelli DATE: 2-21-01 Lucille is a 48 (my correction: 51) year old female who presents for consideration for facial surgery. She has significant aesthetic facial surgery history. In 1997 she underwent an initial facelift followed 6 weeks later by a rhinoplasty both of which were performed by the same surgeon in Boston. According to her, her postoperative course was complicated after by tremendous facial swelling which she feels occurred due to the use of the tumescent technique for hydrodissection of her facelift. Her subsequent rhinoplasty was then followed by an inordinate amount of facial swelling which resulted very quickly and a considerable of postoperative skin elasticity of which she has never recovered. i have had the opportunity before today of to have discussions with her several times by email and by phone as well as l have received a 2 inch thick portfolio of facial photographs which documents in great detail and number her preoperative to her postoperative course to the present time. Therefore I have had some significant insight into her problem before today. When asked to list the areas that bother her in order of priority she has come up with the following list which includes: 1 . The down turning and stretched out look of her commissures which creates a significant postoperative difference in her smile. 2. The feeling that she has excess skin and that the skin is not really attached to the underlying bone. I believe this represents the fair amount of skin elasticity that she has. 3. She is bothered by the appearance of her eyes and neck which appears to be relatively straightforward aging concerns. 4. The sunken appearance to her cheek and lateral facial areas. On examination she has well-healed preauricular scars which go in the standard fashion with exception of that they run in front of the tragus and they block out the hairline running with step excision running horizontally across the preauricular hairline and then in front of the temporal hairline just above the level of the lateral canthus. Palpation of her overall skin demonstrates that it is fairly thin and there is not a lot of substance of soft tissue, particularly in the lateral facial area to the ,underlying bone. She has very prominent nasolabial crease with falling over the superior skin. Her overall skin quality is modestly thin and she has a fair amount of pitied acne scars throughout the cheek areas as well as multiple areas of hyopigmented scars throughout the neck areas. After a 2-hour discussion with her we both agreed to an overall treatment plan. This includes an initial nasolabial fold excision with simultaneous corner of the mouth lift. She has read a great deal particularly about these procedures and is well aware of the resultant scars of which she is very willing to accept. A second stage would then be, followed by a full facelift with platysmal plication through a submental incision of which she has not had before. In addition, she did ask about and showed an article connecting the lateral canthal incision from the lower blepharoplasties to her temporal line. She feels that this is a good procedure and is willing to accept the scar in an effort to get rid of more the skin in this direction. Having discussed this her this is not an unreasonable request given that the distance between the 2 is only about 15 mms. While it is an unusual place to place a scar, she has researched this out and has found an article which does report it being done. She again is aware of the resultant scar, is aware according the article that the majority of the patients were not happy with result, and she still desires to precede with it. l agreed that l would consider this option on an lntraoperative basis and would use it only if l felt the redundant skin in that area would merit the scar and could be improved by its placement. After our very lengthy discussion, l have asked her to put more thought into it and then get back to me in regards to scheduling. She is interested in scheduling the first stage within the next several weeks. Barry L.. Eppley, M.D., D.M.D.
http://groups.msn.com/LosingFace/dreppleysresponse.msnwhttp://groups.msn.com/LosingFace/aftertheoperation.msnwhttp://groups.msn.com/LosingFace/immediatedenial.msnwhttp://groups.msn.com/LosingFace/dreppleysoperativereport4182001.msnwhttp://groups.msn.com/LosingFace/omittedmostimportantpartofoperation.msnwhttp://groups.msn.com/LosingFace/neveransweredthisormanyotherquestions.msnwhttp://groups.msn.com/LosingFace/emailtodreppleyoneyearlater.msnwhttp://groups.msn.com/LosingFace/mystoppaymentdreppleycutshislosses.msnwhttp://groups.msn.com/LosingFace/dreppleystalentfortwistingthetruth.msnwhttp://groups.msn.com/LosingFace/confidentialitynotatmeridianplastsurgcenter.msnwhttp://groups.msn.com/LosingFace/dreppleyplaysblamethevictim.msnwhttp://groups.msn.com/LosingFace/yourwebpage3.msnwhttp://groups.msn.com/LosingFace/expertsquestiondreppleyshighinfectionrate.msnwhttp://groups.msn.com/LosingFace/massachusettsgeneralhospitalresidentsclinic.msnwhttp://groups.msn.com/LosingFace/documentationofphotographs.msnwhttp://groups.msn.com/LosingFace/documentationofmyappearance.msnwhttp://groups.msn.com/LosingFace/opinionsfromexperiencedradiologists.msnwhttp://groups.msn.com/LosingFace/evaluationofbrilliantradiologist.msnwhttp://groups.msn.com/LosingFace/entspecialistconfirmsdrdoaksopinionandmore.msnwhttp://groups.msn.com/LosingFace/modifiedbariumswallow.msnwhttp://groups.msn.com/LosingFace/mbsreportbyspeechpathologist.msnwhttp://groups.msn.com/LosingFace/mbs503and1203.msnwhttp://groups.msn.com/LosingFace/consultationwithpulmonaryspecialist.msnwhttp://groups.msn.com/LosingFace/followupreportfrompulmonologist.msnwhttp://groups.msn.com/LosingFace/entreport02july2004.msnwhttp://groups.msn.com/LosingFace/entreportjuly162004.msnwhttp://groups.msn.com/LosingFace/april2002reportofconsultationwithsurgeon.msnwhttp://groups.msn.com/LosingFace/comparisonofxrays.msnwhttp://groups.msn.com/LosingFace/myexperienceatmghresidentsclinic.msnw