Rhinoplasty (Nose Job, Nose Surgery) Questions and Answers

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Question:

I'm 31 y.o. For few years I couldn't concieve, because my husband had many problems of sexual dysfunction + only 0.1 ml semen volume + < 5% functional sperm cells. My doctor put me on clomid and we tried one cycle of IUI, which didn't work. Following the clomid I developed a polyp in the uterus. Now my doctor wants to do hysteroscopy to remove it + diagnostic laparoscopy in general anasthesia. My questions are: 1. Is it possible to go on with the IUI without removing the polyp? I'm a little scared of the surgery. 2. Does it make sense to go through the laparoscopy, in spite of the fact we have enough reasons to explain the infertility (the male factor)? 3. Later on, is it really necesaary to use the clomid, when no ovulation problem was diagnosed, and it may cause additional damage as another polyp? Thank you.

Answer 1:

Dear Ronit The polyp needs to be removed. The paraoscopy is plus/minus. However, you are wasting your time with clomid and IUIs. It seems to me (with the info on your husband's semen analysis) that you need to have IVF with ICSI since his sperm is so weak. Why don't you discuss this with your doctor (is he a board certified reproductive endocrinologist?). I can only go with the info you gave us, so I cannot make a comment on whether your doctor is doing the right thing for you. Good luck

Answer 2:

Hi Ronit, You need to IMMEDIATELY see a Board Certified Reproductive Endocrinologist. If your partner's sperm is truly as bad as you make it sound to be, it really seems to me like you've been wasting your time with a doctor who is not a true infertility specialist. Since you're located in our tri-state area, you're welcome to come here for an opinion by a qualified RE - otherwise, you should see an RE in CT ASAP! Hope this helps! Dr. Roseff, Director W.E. C.A.R.E. in NJ Visit us at http://www.reproendo.com

Question:

I am still in high school(a freshman,14) and i was wondering the following: in and around how much a nose job would cost, the youngest i can be to receive it, and how long I will have to wear a splint or an object over my nose after the surgery. If you would please write back I would really appreicate it. Thanks in advance.

Answer:

Age 14 would be old enough to have nasal cosmetic surgery were you a female. The age of 15 would be more appropriate for a male. Costs vary but range from 5 to 8 thousand dollars. The splint is usually worn for about 1 week.

David Ross, MD
Chicago, IL

Question:

Thanks for answering my first question I appreciate it. I did not know that x-rays were not used (except for broken bone)for the surgery. My cousin just had a rhinoplasty (right now has his cast on) and saw a personal website from a board certified plastic surgeon giving the positions of shots taken for a rhinoplasty.It had: 1.Full frontal with the head directly at the camera. 2.Left and Right direct Lateral(side views with the ear pointing straight towards the camera). 3.Left and Right oblique views(side views with the tip of the nose lined up with the edge of the cheek). 4.Chin up view(from front view with chin tilted up until the tip of nose lines up between the eyebrows). When my cousin compared this to the photographed shots taken by his surgeon he became worried. His surgeon took 3 of the shots the same but did not take left and right oblique views. Did the plastic surgeon mess up? My cousin had his nose broken by the plastic surgeon to straighten it and had his tip raised just a little bit because it was droopy. The surgeon awkwardly asked for x-rays when nothing was broken.My cousins plastic surgeon is from Mexico. He is from "EL Consejo Mexicano de Cirugia Plastica, Estetica y Reconstructiva",I think is the main board for plastic surgeons in Mexico which I think might be like the American Board of Plastic Surgery in the U.S. The answer to this question is important to me because I am also thinking about getting a rhinoplasty and will learn from his experience whether good or bad. Sorry that the question is so long.Thanks

Answer:

The shots taken before surgery should be appropriate for the procedure. If there is no work being done on the nasal tip, oblique views or the head tilted back view may be omitted. The photographs bear little reflection on the surgery. There are many excellent surgeons trained in Mexico. The surgeon should be a member of the ASPRS (American Society of Plastic and Reconstructive Surgeons) or a member of ASAPS (the American Society of Aesthetic Plastic Surgeons) even if trained elsewhere. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

For a rhinoplasty, are the photographs taken before your operation used by the doctor to operate you? or just the X-rays?

Answer:

X-rays are almost never used in rhinoplasty except to prove that there was a broken bone in the nose post-traumatically. The photographs are used to plan the surgery and are often referred to in the surgery to get just the result that you want.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had surgery on my nose yesterday to remove a small spot of basal cell skin cancer.Now my left nostril is raised and flared slightly.There is a good amount of tension because of the missing skin. Will my skin stretch and go back to normal, Or will I need an additional procedure? Any information is greatly appreciated. thank you

Answer:

Good question, usually the skin will stretch. Youj should ask the surgeon what to expect. He did your surgery and he will know what better to tell you

Question:

I have been told I have Cauda Equine Syndrome, and surg. has been advised.Need more info. on risks etc. thank you in advance

Answer:

Dear Beverly, After 14 years of experience I must say i am not an expert in this syndrome. I have never had any one walk in with this condition since many times it is severe. i am able to diagnose the condition but unfortunately there is not much i can tell you except any surgery pertaining to the central nervous system is serious and i am sure there are risks. good luck and i wish i could help you more.

Question:

I was diagnosed a couple of days ago with cystocele, rectocele, and prolapsed uterus. (you can actually see it protruding out of my vagina. I am 28 years old. I also have interstitial cystitis and fibromyalgia. I was told that I needed to have my bladder and rectum repaired and my uterus removed. Can you please explain what exactly will be done? Also, what is the name of the surgery?

Answer:

Assuming that you have completed child bearing, you will have a vaginal hysterectomy, anterior and posterior repair. The uterus will be removed through the vagina. The anterior and posteror walls of the vagina will be repaired to prevent the bladder and rectum from protrding into the vagia.

Question:

Hello, Do you know of a plastic surgin that specializes in ears, I had my ears tucked back a few years ago and the shape of one of them is not right, I hade it operated on once more but still no better. I would really like to know if anyone specializes in this area. Thank you.

Answer:

Well, my training was in Ear, NOse, and Throat and then Plastic Surgery. If the procedure you are referring to is an otoplasty. I have performed a great many. It is one of my favorite operations! As to who can perform the corrections for you, you could always fly to Florida and see me! Why don't you email me some pictures of you to my website and then I can get a good look at what you have and give you an answer whether further surgery can help. MAke sure that you take pictures straight on of your face, like my website pictures and from the sides so that I can see the ears straight on. My e-mail address is drb@drberman.com. Good luck! JRBerman

Question:

Hello. I have unfortunately been given a bent nose, and I was wondering the procedure to fix it, where I can get it done (I live in Australia) and how much it will cost. Thank you, Brittany

Answer:

Dear Brittany, You do not mention how old you are abut, after puberty, a "bent nose" can be fixed with a rhinoplasty (nose job) which will straighten the nose externally. If the structures supporting the nose are also bent (often the case) a rhinoseptoplasty may need to be performed. Visit with a plastic surgeon in your lovely country of Australia - there are a great many excellent plastic surgeons there in order to obtain all of the details of the surgery. Rhinoplasties generally cost from $2000 to $10,000 depending upon what is needs be done. Insurance may cover some of this cost if this was obtained through injury or if you have breathing difficulties. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have had TMD for the past 9 years and have tried several tx. including drugs, antiflamators, pain pills, muscle relaxers, accupuncture, tens unit, splint and ice and heat. I recently had an arthrigram which indicated markedly displaced discs on both sides and severly limited translation. It is recommended that I have soft tissue repair surgery that will move my TMJ joints back into their normal postion and cartlidge will be added from my ear. My question is what is the sucsess rate of this type of surgery and what is the post operative proceedure. Also should I get a second opionion. I am in sever pain most of the time and often unable to work full time. i also have fibromyalgia and I believe nerve damage in my face muscles although this has not been confirmed

Answer:

If you have been diagnosed with fibromyalgia by a Rheumatologist, succesful treatment of the fibromyalgia may also bring a relief to the TMJ symptoms. Repositioning of the disk can help recover alot of function but if this has been a chronic problem, physical therapy after surgery may be warranted to help regain some range of motion. A second opinion can be helpful.

Question:

I have been diagnosed with DJD left TMJ. I have had surgery to correct but now the right side is popping and clicking. I don't seem to be able to find a way to chew that I can control or eliminate the popping. The closest I come is placing the food in my mouth then placing my hands on both sides of my jaw and chewing then repeating until my meal is finished. Any suggestions?

Answer:

My first recommendation would be to follow-up with the surgeon that treated the other joint to re-eval both sides. These symptoms may be early changes that could be managed conservatively ie: soft non-chewing diet, physical therapy, bite splints etc.

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