Rhinoplasty (Nose Job, Nose Surgery) Questions and Answers

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Question:

I have 2 questions: 1. My daughter who is nearly 7 years old, has inherited Class III, skeletal malocclusion. Two out of three orthos we've consulted recommend starting treatment right now. Treatment would consist of expanding the upper arch and the use of a chin cup with anterior traction to upper teeth. We've read studies that indicate that in the short-term results from this treatment are very effective but that long-term, growth of the lower jaw can resume, in adolescence. What is the success rate for permanent treatment of class III at an early age? Can early treatment lead to greater problems later on to correct additional growth at a later age? Do you recommend treatment at this age? 2. My other daughter who is nearly 9 has excessive overcrowding. Two orthos we've consulted recommend we wait until more adult teeth come out. One ortho recommends the extraction of 7 baby teeth and the use of a space maintainer to allow more room for the adult teeth. Do the baby teeth not already act as a space maintainer, therefore making this apparatus unnecessary? Is there a chance that her jaw will develop normally allowing room for all her adult teeth? What do you recommend? Any info. you can provide would be greatly appreciated, as we are a little confused given the differences of opinion. Thank You

Answer:

1) Class III malocclusions are very difficult to correct. If the discrepancy between the upper and lower jaw is too great, jaw surgery in combination with orthodontics is required to achieve a correction. Consequently, children in the 7 to 9 year range who demonstrate class III growth are frequently treated to re-direct this unfavorable growth. I treat each patient individually addressing their specific circumstances. Sometimes I do begin treatment at 7 years of age. 2) While I can't diagnose a patient without seeing him/her, generally the space for the permanent teeth in front of the first permanent molars has been determined as soon as these molars erupt. There are appliances available to expand the dental arches to some extent. Although all orthodontists have similar goals for the patient, the method of achieving those goals can vary from orthodontist to orthodontist. Sometimes there can be a significant variance in the treatment plan.

Question:

Im a competitive strongman athlete. I have been out of the gym for several weeks now. Recently I was diagnosed with spondylolysis and a herniated disc. The spondylolysis is on the L5 bilaterally. The herniated disc is at S1. What is the best course of action for me to take so I can ensure quick and 100% full recovery? My doc is suggesting surgery but I wasnt wanting to go that rout. Thank you for you help!

Answer:

Spondylosis is another name for degenerative joint disease or Osteoarthritis. This is a fairly common thing as people get older. I dont know your age, but I am guessing you are at least in your 30s. The disc can also become affected just like in your case. Unfortunately the L5 S1 disc that is herniated will never be 100% again. If you are experiencing neurological problems such as radiating pain or severe leg spasms, then you may need to consult an Orthopedic surgeon. However Chiropractors have great success with this type of problem. I am living proof. I also have a disc herniation that was helped by Chiropractic. Give chiropractic and their treatment a chance, then if no relief consult a surgeon. If you are in NJ look me up.

Question:

My daughter needs orthodontic treatment. The orthodontist is recommending surgery to expand her top jaw and shorten her bottom jaw. Is this common? What alternatives are there to surgery? I do not notice a severe underbite when I look at her. My daugther is currently 12 1/2.

Answer:

Although I cannot diagnose a patient with seeing him/her, in general at age 12 expansion can be accomplished with a non-surgical approach. Another factor to consider is the severity of the problem and how much expansion is required. If a child of 12 has a disproportionately large lower jaw sometimes a trial non-surgical approach is recommended. Lower jaw growth usually continues until the bodily growth is complete. So if the patient has surgery at 12 years of age, he/she could outgrow his/her treatment. Talk to the orthodontist about your concerns. If you still dont feel comfortable with his/her advice, get a second opinion.

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?

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

Question:

is there a cure for post nasal drip? I constantly have to blow my nose, and cough all the time.

Answer:

My recommendation would be to contact someone who specializes in sinus care and surgery (often an Ear, Nose & Throat specialist).In the Los Angeles area, I can recommend contacting Dr. Lorenzo Brown (310)412-3277. Good luck. Dennis Thompson, M.D.

Question:

I am having trouble finding a OBGYN. I was diagnosed with endometriosis and might need Laparospic surgery. I found one who seems good. He is a member of the Amer. Assoc. of Gyno. Laparoscopists and Society for Endoscopy. Plus other things, but he is not board certified and doesn't have a FACOG after his name. Is this the right Doctor for me. What does FACOG mean anyway?

Answer:

FACOG mean Fellow of the American College of Obstetricians and Gynecologists. One must be certified by the American Board of Obstetricians and Gynecologists before becoming a Fellow. There are two steps to board certification. The first is passing the written exam. This is generally done at the completion of residency. The candidate then must practice for two years. A case list is then submitted to the board. IF accepted, the candidate then may take the oral exam. Passing the oral exam makes them a Diplomate of the ABOG and qualifies them for FACOG. MDs who are have recently finished their training may not yet have taken the oral part of the board. They are what is referred to as "board eligible". Membership in the AAGL and SE does not require competency testing. THis said, your MD may be a great laparoscopist and excellent physican. Try to speak to people in the community (especially former patients) about his reputation. FACOG also does not = excellence in laparoscopy. Good luck.

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