Craniofacial Surgery Questions and Answers Archive

Nov
2001

Q&A: Where can I find a surgeon who specializes in scar revision for a temple-to-temple scar on my 14 year old daughter?

Question:

My 14-year old daughter needs scar revision for a scar that runs from temple to temple just behind the hair line. The scar is a remnant of surgery at 4 months of age to correct craniosyntosis(fusing of the plates of the skull on the right temporal side). She had corrective surgery at age 11 to try to revise the scar and fill in a concave area on the right temple with porex. The scar is instead wider and the porex implant may need to be trimmed back to give a more symmetrical appearance. I am looking for a surgeon or surgical group that has extensive experience with this type of problem. Thank you for any information or referral you can provide. This is covered by our insurance which has a nationwide network so we are willing to travel wherever it takes to get the proper attention to this problem.

- James

Answer:

 Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear James, The scar revision and skull contouring should be able to be corrected by any plastic surgeon with additional training in craniofacial procedures. I would suggest that you contact Dr. Henry Kawamoto in Santa Monica, CA (310) 829-0391 who may be able to refer you to someone competent closer to your home.

-- Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Aug
2001

Q&A: How do I locate an appropriate plastic surgeon in central Kansas?

Question:

yes I have another question. I am having trouble finding a doctor could you help me in that area? I live in the centeral part of kansas. Can you give me any kinda of help as to locating a doctor to get my surgery done for my eyes?

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

I would suggest thay you contact a major hospital near your area and ask to speak to the head of the plastic surgery department. If he or she does not perform this type of surgery themselves, they will be happy to refer you to a competent craniofacial surgeon.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Mar
2001

Q&A: What is the next step drooping upper eyelids if I am slightly bug-eyed?

Question:

first, i must say that this an excellent forum for q & a re: plastic surgery. your feedback is excellent. thank you. my question relates to my eyes. because my upper eyelids sag and droop, (a hereditary problem) a believe i need blepharoplasty surgery on my upper eyelids. however, my eyes do protrude somewhat (not severely) and appear slightly bug-eyed. i read your comments to another patient about the exopthalmos issue and have already been checked for thyroid and endocrinology problems which revealed no concerns. given these two concerns, what are the appropriate next steps. should i consult with an ocuplastic surgeon before i consult with a plastic surgeon for the blepharoplasty? can an ocuplastic surgeon do both? can you tell me a bit about the procedure for the bug-eye issue? please advise. thanks again. katy

- katie

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear Katie, I am glad that you find the forum helpful. I would visit with a plastic surgeon since I believe that they are best able to assess your needs in terms of whether an upper eyelid blepharoplasty, brow lift or orbital expansion procedure is best for you. Oculoplastic surgeons will tend to be familiar with only the first of those procedures and, actually, much less well trained (for the most part) for the orbital decompression, if necessary. I would suggest that you visit with not only a cosmetic plastic surgeon but try to find one with additional training in craniofacial surgery. It is very likely that you will be able to do very well and get a very nice result without directly correcting the exophthalmos but you certainly do not want to make that appearance worse with a simple blepharoplasty. I hope that this helps you and doesn't confuse too much.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Mar
2001

Q&A: Would a cheek implant be used to fix a broken cheek that was not popped into place after the first surgery?

Question:

My brother had a tripod fracture or broken zygomatic Arch (cheekbone). We went through the first surgery of trying to "pop" the bone back in place. this was unsucessful. Is there a way to put in an implant to correct the apprearance of the cheekbone? What type of material would be used and what would be a ballpark figure on the surgery?

- Melisa

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear Melisa, The popping out procedure, when it doesn't work, is usually followed by actually re-breaking the bone (if necessary) and repositioning it forward using tiny plates and screws. A good craniofacial surgery should be able to help you in this regard. An implant is rarely necessary.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Feb
2001

Q&A: Is there a surgery to get rid of bug eyes and what is the risk and pricing?

Question:

Is there a surgery to make someone with bugeyes look normal? If so what are the dangers, if any, and the price of the surgery?

- matro

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

The treatment of exophthalmos is dependent upon the extent of the problem and the different factors contributing to it. For small corrections, the fat in the orbital area is removed. Many times, however, the problem is more severe and requires bony alteration of the orbit. This is usually performed by a plastic/craniofacial surgeon. I also agree that endocrinologic problems must be ruled out. Hope this helps.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Jun
1999

Q&A: Is my 3 year old daughter too young to have surgery for open bite and how do I find info on Lefort I Osteotomy?

Question:

Dear Dr., My 3 year old daughter has an open bite. We have been reffered to an oral surgeon and told that surgery would be required. Are these procedures usually preformed on children of this age and if so, how does this affect future bone growth and development? Also, could you help me find more information about Le Fort I osteotomy on the web to help us better understand this procedure?

- Anna

Answer:

The correction of an open bite is often done with a Lefort I osteotomy. The majority of the patients that undergo this procedure are older than 15 years old enless they have been diagnosed with a facial syndrome that requires a staged surgical correction. In these patients the final effects on overal growth and developement is unclear because of their underlying condition. For this reason I would be perfectly clear about your childs long term treatment plans as well as the primary diagnosis. Once you know this information you will be able to make a much better decision. For additional information about Lefort I osteotomies I would reccommend researching these key words on the web and at your local public library. Orthognathic surgery Craniofacial surgery Jaw corrective surgery good luck

--Priveer Sharma, D.M.D.
Winter Park, Florida