Nose Job (Rhinoplasty) Questions and Answers Archive

Jan
2002

Q&A: What can I do to stop the pain and stimulate bone growth in my one undeveloped jaw?

Question:

I was told that the left side of my jaw has not developed since I was a elementary age child or before, and diagnosed with TMJ symptoms. I have had artherosentesis and therapy and a nerve block. Is there anything I can do to ease the pain, or to stimulate bone growth?

- Kacie

Answer:

 David A. King, DDS - LocateADoc.com

The only way to get both sides symetrical is with surgery. Get the TMJ symptoms under control before proceeding to surgery. I would recommend discussing options with your oral surgeon.

-- David A. King, DDS
Wilmington, Delaware



Feb
2002

Q&A: Should I have an Ear/Nose/Throat surgeon or a Plastic Surgery remove the cyst in my right cheek?

Question:

I have a cyst(hard) in my right cheek, over my sinus cavity and need to have it surgically removed. It is about the size of a quarter, but feels like it goes deeper than that. Should I have an ear, nose and throat surgeon do the surgery or an experienced plastic surgeon do it? I have seen an eye doctor (since it is located under my eye also) and he was going to do it, but my insurance will not let an ear, nose and throat surgeon assist him during the procedure. Plus, they will have to cut the outer corner of my eye, then pull down the skin to remove it. This sounds like it would be awful! They said the worst that will happen is I would have some bruising around the outside of my eye. Please give me your input on this and who I might go see to take care of this. It makes me feel terrible to have something like this on my face and I really want it taken out, but I am scared to have surgery on my face. Input, PLEASE!!!!Thank you so much..............

- Kimberly

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear Kimberley, I take it that the cyst is a benign growth and not a cancer and that it is localized under the skin so that there will be no skin defect once it is removed. I would suggest that, at least, you get an opinion of what in involved in the removal, in terms of risks and goals from a plastic surgeon. Hopefully, there is one which will be covered by your insurance plan.

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



Oct
2001

Q&A: What can be done to remove a 6 mm mole from my nose?

Question:

All my life i have had a large raised mole on my nose. It is about 6 millimetres all the way around and i hate it. It makes me feel unattractive and whats more i often worry that one day it may become cancerous. My mum says because i've had it all my life it'll probably be fine because its sort of like a birth mark, but that still doesn't solve that fact that i hate the way it looks. Whenever i meet someone new i can always tell that they are looking at it and it makes me feel selfconsious and embarrased. Because its so big would it be possible to have it removed? would i need plastic surgery? the thought of a big operation really scares me.

- sarah

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

Dear Sarah, You mother is right and there is only a slight chance of this becoming a cancer, however, appearance is very important and I understand how you would like it removed. The procedure would not be a big one but that area is particularly difficult to remove a largish lesion from without special techniques. I would suggest that you visit with a plastic surgeon in your area to discuss the options. Unfortunately, lasers, dry ice, etc. will not permanently remove a mole and so surgery is necessary.

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



Sep
2001

Q&A: What does it mean to be Stage 1 / Level 4 and 0.8 for melanoma?

Question:

Hi Dr. Amy, I wanted to let you know that my husband went to the surgeon, the surgeon told us that the size of the melanoma was 0.8 and that it is stage 1 level 4. I know the staging part but do not understand the level part. He also did tell us about the eyes and we are getting that checked. My husband goes for surgery on Oct 8th, and they are shooting a dye into his back to see which lymph nodes if any the melanoma would spread to and possibly remove them. they are also doing a chest xray and blood work this week. I guess my question is once that gave it a stage does that mean it hasnt spread anywhere? or wont they know that til the surgery? my husband is very upset and I dont know what to do to comfort him, he is a smoker also so he is worried about that. thanks! amy

Answer:

Amy Taub, M.D. - LocateADoc.com

The most important piece of information is that the melanoma is 0.8. This is relatively good news, since the tumor was not that deep. Depending on which scales you go by, less than .76 is the best, .76-1.5 is next best, 1.5-4 is third and over 4 is worst. Some, though make the first cutoff at 1.0 and your husband would be below this. The next most important information will come when they do the sentinel lymph node (dye in his back). If negative, this would be the best news and his risk of it having spread would be very small, since it would have spread to this lymph node first. If positive, one has to assume then that the melanoma has spread, and he would need some type of further treatment to kill off the cancer cells, such as chemotherapy, usually with a drug called interferon. Stage 1 means no clinical evidence of disease spread (can't feel lymph nodes), level 4 means that although the tumor was relatively thin, is went down fairly deep into the skin. I find this odd however because if the melanoma is on his back where the skin is thick then 0.8 and level 4 don't go together. It would be great for your husband to quit smoking, although it would be a difficult thing to do right now. But it would make him feel like he was doing something positive for his health. Try to distract him and give him things he likes, take him to movies or watch sports with him and try to be strong yourself and reassuring, even if you don't feel that way. It is very frightening to be diagnosed with cancer, but most people with melanoma survive and he has a very good chance, too! The surgery itself is not difficult. It sounds like his surgeon is doing all the right things.

--Amy Taub, M.D.
Lincolnshire, Illinois



Jul
2001

Q&A: Could my jaws and TMJ be causing my severe headaches?

Question:

I have been having headaches which have been diagnosed as tension/migraine combos. They have been getting progressively worse. They are here almost 24/7. If I awake w/o one, one comes on within an hour. My last migraine was an 11 day one, which just ended. I have seen a specialist who has almost given up on me & a neuro, who only advised I see a pain management doc. My MRI shows I have degenerative disc disease, but only mildly...normal for a person my age, I was told (I"m 45). My headaches get strong in my neck & wind up turning into migraines as they progress. I turn to the possibility of TMJ because most other options have been excluded. One main reason I am considering this is that I had brain surgery 8 1/2 years ago, removing my right temporal lobe & successfully ending 36 years of seizures due to epilepsy. BUT to get to my RTL, part of my upper jaw had to be removed & replaced. Chewing gum has given me headaches ever since then. I eat 2 apples every morning for breakfast & that seems to bring on the initial pain. If I can't get it under control, it spreads down my neck and up my head, turning into the tension/migraines. The tension in my neck seems to aggrivate the degenerating discs & making neck pain worse. Most of the time, no OTC meds will get my pain under control in time. I've lived on OTC meds for so long that my system is immune to them. I had a CT scan to check for tumors & the radiologist wanted to know what on earth happened to my head. I had told him about brain surgery, but failed to mention my upper jaw removal at the time. When I told him of it, he just kinda nodded & didn't mention TMJ possibilities. I was about to see an allergist & get checked for food allergies when I thought about the possibility of TMJ. Do I need to see a dentist to be checked for it? Can my regular dentist advise me yea or nay about seeing an oral surgeon? I'm searching for answers & am tired of 24/7 headaches for the past 3 years. I failed to mention that there is a very sensitive spot right above my right ear, which is extra sensitive during headaches. I have always attributed it to the jaw removal. I have not had jaw locking problems. If you can help me, PLEASE do. Thank you very much. Sorry if this is too long. Jacque

Answer:

If chewing is painful you could have a TMJ problem. I would think it was in your best interest to see a dentist.

--Charles R. McNamara, DMD
Winter Park, Florida