Ear Surgery (Otoplasty) Questions and Answers

Question:

I am a 21yr old male with breasts. they used to be hard but now they are just fat. Do i need surgery or can training reduce these? thanks

Answer:

Dear Luis, Certain medications, among them steroids, can make the breast more fatty in the male. Ultrasonic-assisted liposuction is an excellent means of reducing the size and contouring the male chest.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

HOLA: PLEASE I WOULD LIKE TO RECEIVE SOME FEEDBACK. ONE WEEK AGO I SAW A DR. AN EYE SURGEON ON LASIK. HE IS A MEXICAN DOCTOR IN REYNOSA, MX. MY FATHER KNOW THIS DOCTOR FOR OVER 25 YEARS. HE DID SOME TEST AND TOLD ME i'AM A CADIDATE FOR LASIK SURGERY. MY RX R.E -1.00 (SPHERE),-4.OO CYLINDER /103 AXIS LEFT EYE -1.25/ -3.25, 75AXIS ................. CONTACT LESNSE RX -1.00,-3.50 ,100 OS -1.50, -3.00 -.80 ..................... HE DID THE CORNEAL THICKNESS TEST. ON THE OD EYE CENTER 533 MICRO AND THE OS 525 MICRO. THE EXCIMER LASER AVAILABLE IS NIC EC 5000. WELL MY QUESTION IS THIS EQUIPMENT CURRENT OR IS BETTER TO DO IT IN HOUSTON WHERE THE COST 2.5 TIMES MORE? I'M AFRAID TO POST SURGERY EFFECTS LIKE SOME PEOPLE HAS (HALOS,GHOST) Please give some advice, my father trust in this doctor. I'm a 32 years male. gracias

Answer:

Dear Alex, You provided some important information, but not all information that will help me better answer your question. You have a lot of astigmatism. Was corneal topography done? If so, what kind of topographer was used? It is very important to make sure that you don't have a condition called keratoconus, which is a contraindication for lasik. Keratoconus means that the cornea is shaped more like a cone instead of like a ball. It is possible that you have so much astigmatism because of this condition. If you do not have keratoconus, than the next question is, what is your pupil size? When we treat patients with astigmatism, the treatment area can be smaller than when we treat only nearsightedness. With the Nidek laser, usually this can be accounted for by altering the treatment zone. In the US, we can NOT do this with the Nidek laser at this time. In Mexico, your surgeon may be able to change the treatment size, but you will need to ask him yourself. Buena suerte con su decision! David B. Cano, M.D. www.canovision.com

Question:

I am 19 years old boy with gynecostomastia, and I have had it for 4 years. When will it go?

Answer:

Dear Prince, If you've had gynecomastia for over four years, it will probably not go away without surgery. I would recommend that you see a plastic surgeon,and also a family physican to test your blood levels of testosterone ( whch will probalby be normal). The surgery is straight forward and very successful. Josh Korman, M.D.

Question:

Sir, I'm a 19 year old male, with a physical difformaty,(I believe it is anyway). I have very enlarged puffy nipples that stick way out and its hurting my self esteem and self image tremendously. What can I do about this. Thank you for your time.

Answer 1:

Dear Jeff, You have what is called gynecomastia and is very easily treatable with surgery. It involves making a small incision on the lower half of your nipple and with a combination of liposuction and some excision of tissue can give you excellent results. I would recommend that you see a plastic surgeon in you area. Good luck Josh Korman, M.D.

Answer 2:

Dear Jeff, If it is just your nipples that are enlarged, you should look into nipple reduction surgery. This is straightforward and should be able to be performed by any well-trained plastic surgeon.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had a doctor correct my breast augment due to capsular contraction in Oct 2000. I originally had them under the muscle, but this time wanted them above the muscle so that they would actually move! The doctor convinced me to redue them under the muscle, so I gave in. He said I would be happier after this surgery, but I'm not. It's been 9mo since the surgery, and my breasts are a cup smaller than I wanted, and sit on my chest like rocks. I did ask the doctor about redoing them over the muscle, and he quickly changed the topic and stated that he didn't think I should mess with them. What are most surgens obligations to a patient when the results of breast augment are not what was expected. I feel like I was ripped off now, and mislead.

Answer:

Dear Kathy, In all liklihood, had the implants been placed above the muscle, your results would have been the same or worse. Capsular contracture tends to be more severe and more evident when implants are above the muscle. I try to place over 80% of new implants above the muscle for aesthetic reasons but, should severe contraction occur, the best place for the implant is beneath the muscle. Surgeons have little control over capsular contracture. You should have textured and not smooth implants in place as this will help. I wish that we could foresee the future and tell patients before the surgery that this will occur but we cannot.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have a third nipple and would like to know how safe it would be to get it removed, and how much it would cost.

Answer:

Dear Dianna, It is a safe and relatively minor surgery performed with local anesthetic. In my practice, the charge is $350 but prices will vary across the country and with different surgeons.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hi..I am 22 years old..And we are trying to get pregrant for 3yrs..Now we are taking treatments with our infertility specialist.Actually ..i have taken HSG test.But the test result is abnormal.So my doctor wants to go further procedure.He decide to do laproscopy.But..Is that neccessary for us right now.Why can i take hysteroscopy.Is laproscopy cause any side effects?Do u know..any other suggestion without surgery?Thanks JayanthiMurugan!!

Answer:

Hi, I would need to review your HSG films in order to properly answer your question. If they're recommending surgery based on those findings, my review of your records would be the ONLY way I could possibly determine if I agree regarding the need for surgery (and whether you need hysteroscopy or laparoscopy). Since I'm not far at all from Edison (I'm in West Orange), you may want to obtain a second opinion consultation here by me (a Board Certified RE). If you are interested in this, please write back and let me know. Good luck, whatever you decide! Dr. Roseff, Director W.E. C.A.R.E. Visit us at www.reproendo.com

Question:

REF: Excimer Laser What experience should an ophtalmology have with this procedure regarding the number of surgeries done? What price am I looking for both eyes? What are the positives ? What are the negatives of this procedure. No other disease process is involved.

Answer:

Dear Bill, You should find an ophthalmologist that has formal corneal and refractive fellowship training and is board certified. He should be involved in your care from your initial evaluation for surgery, and your post-operative care along with the actual surgery. He should have certification and experience with the lasers that he is using. High volume does not mean high quality! Price should not be your concern, because this is a once in a lifetime procedure and you only want the best for you. In general it is about $2000 an eye by a good surgeon. If you are a good candidate there are a lot of positives for having the surgery including reducing your dependence on glasses and contact lenses. As far as the negatives - there are many that you need to be aware of if you are not a good candidate and a good surgeon and his/her staff will usually educate you about these at your initial evaluation, which is usually complimentary. Your eyes should be healthy without other diseases like dry eyes, infections, cataracts, glaucoma, retina problems, etc. David B. Cano, M.D. W. Palm Beach, FL www.Canovision.com

Question:

Hello, I had LASIK performed on my right eye in Nov. 1998, with an enhancement done in June 1999. I posted a question to this website 11/99 regarding the dry eye that followed the surgery, and was advised to try TheraTears four times a day. I tried the TheraTears (in the single use container) several times a day during the day, and found that I got more relief in the morning if I used an eye ointment (Refresh PM or Lacrilube) before bedtime. TheraTears has been highly recommended, but it has not done much to improve the condition of my cornea. At my last checkup (5/01), the cornea still picks up dye and is still missing some cells. I have found that decreasing my intake of caffeine has made a big difference in the dryness, but I still find that the eye is dry. I am also have IDDM, and have improved control of my blood sugar in the past two years. Is there anything else that I can try to combat this chronic dry eye? Since the surgery, I have had regular checkups every 6 months, and I have a punctal plug in both upper and lower lids.

Answer:

Dear Lisa, There are many treatments for dry eyes besides artificial tears and punctal occlusion. It really would not be appropriate to discuss to this in a forum such as this. You require a formal evaluation by a corneal and external disease specialist. Dr. Geoff Tabin is nearby at the Univ. of Vermont in Burlington. You may want to make an appointment to see him for a better evaluation of your specific problem. David Cano, M.D. W. Palm Beach, FL canovi

Question:

I am 22 and I have extremely small breast I wear a 32 size bra but my cup size is smaller than an A. But training bras are to small around. I am the same size I was when I was 12. I have tried herbal forms but none have worked. I have also tried herbal estrogen and that also has not worked. I can't afford implants. I would like to know if there is anything I can take or do. I also would like to gain a few pounds but that also hasn't worked.

Answer 1:

There is no known way to increase breast size other than surgery. Unfortunately, if getting breast enlargement is what you want, you may have to save up money and have the procedure done when you can afford it.

Answer 2:

Dear Faye, There is no way other than breast augmentation surgery that is proven. There is a new suction device which may stimulate blood flow and marginally increse your bust size but my understanding is that this works best to make large breasts even larger. I wish that there was an easier way but, for now, implant surgery is the only sure way of increasing your bust size.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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