Ear Surgery (Otoplasty) Questions and Answers

Question:

I have had neck pain and stiffness for two years now. It is just a chronic pain that I have every single day. I have had two MRIs (the first one two years ago and the last one in August. The first one showed that I had a mild reverse-lordosis of the upper cervical spine. The cervical cord is of normal size and signal intensity. The C5-C6 interspace shows moderate posterior bony ridging with questionable small posterior central disc protrusion producing mild narrowing of the spinal canl, but no definite cord compression. there is no significant narrowing of the neural foramina. The C6-C7 interspace shows mild posterior bony ridging without significant compression of the spinal sac. The second MRI indicated that there was no change from the first one. I do sit at a computer all day which I'm sure doesn't help. The pain and stiffness goes down into my chest sometimes. I do not have any problems with pain shooting down my arms though. My doctors say that I do not need surgery (this opinion is from my neurologist, rheumatologist and family doctor). I have had physical theraphy which helps while I'm doing the theraphy. My questions is, what now? What can I do about this pain? This is really having an affect on my life. Should I get an opinion from a surgeon? Any advice you can give me would be greatly appreciated.

Answer:

I am not sure going to an orthopedic surgeon is for you. Since your doctors have already said that surgery is not what you need. It sounds like you may want to consider going to a chiropractor. It is positive that physical therapy helps. Although it is temporary this is usually a good sign that chiropractic may help long term. I can't be sure because i have not examined you but this is your next step. You may be pleasantly surprised. Try and get a positive referral if you can. Good luck.

Question:

I am very serious about this. I am searching for a doctor who can remove about 2 inches from the penis tighten the scrotum by removing excess skin. I also am searching for a doctor who will write a script for chemcial castration. There is NO criminal history associated with this. Thanks.

Answer:

I suggest that you visit with some of the plastic surgeons in your area. There are specific centers of gender reassignment surgery who are well versed with the procedures that you describe and the medications you desire. They would know where they refer in your area. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Is it possible for a guy to grow breasts? I seem to have gained a lot in that area over the last year. It doesnt seem to be all fat either. What could cause this?

Answer:

Dear Terry, The condition that you describe is gynecomastia. I would suggest that you visit with a general practitioner or endocrinologist and make certain that there are no drugs or hormonal contributions. Then, I would suggest that you visit with a plastic surgeon who performs internal ultrasonic liposuction. This procedure has been a blessing for many of my patients who I would have otherwise had to perform breast reduction surgery on with concomitant scarring. This has been a godsend for male patients. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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:

I am considering breast augmentation and wanted to know if there is a doctor in the Atlanta GA area that has heard of and performs a procedure called Trans -Auxillery...where the implant is placed under the pectoral muscle in the chest. This is the procedure I am interested in having and wanted a listing of doctors in the area that have perfected and perform this technique. Any assistance/informationis greatly appreciated. Thank you in advance.

Answer:

Breast Augmentation can be performed a variety of different ways. One of them is the trans-axillary approach that you discuss. It may not be the optimal operative approach for you. It would be a good idea to find a good qualified Plastic Surgeon and discuss the operation that you want and the approach that you want. He/she may agree or disagree with you. Unfortunately, I do not know many plastic surgeons in that region. Check out the plasticsurgery.org website and select one that is in your area. Good luck. Maybe you would want to travel to Boca Raton Florida and have the operation performed by me! Good luck to you! JRBerman drb@drberman.com

Question:

I have put money away in my flexible spending account at work that must be used by year end. Since it is not known if the FDA will aprove the upgraded software required to treat my presciption, my only option is to go to a center in Canada. I understand that the software has been available in Canada for some time. What is your opinion? I don't want to lose the money in my account. I was originally told I was a canidate for the surgery based on the initial screening. After the full evaluation, I was told I would have to wait for the expanded software. I am running out of time. ;

Answer:

I had a patient like you that was treated by Dr. Barry Soloway in New York City. You may want to try him and let your doctor comanage your care.

Question:

Hi!I have a little problem thats ruining my sex life. My nipples don't have the little ball part in the middle-they're just straight across. The one on the right side doesn't even stick out-it goes inward. Anyways I was just wondering if that was normal,and if there was anything that could be done about it and if plastic surgery was an option how much do you think it would cost to get it corrected. Thank you So much. Im glad there's someone I can talk to.... *Richelle*

Answer:

Dear Richelle, You have inverted nipples. This is a fairly common problem. It can interfere with sexual pleasure as well as breast feeding. Any competent plastic surgeon should be able to help you with your problem. If your nipples were previously normal and only recently became inverted, you should see someone immediately, it can be an early sign of breast cancer. I trust that this is not the case and that it has been a long-standing problem. The correction will require a surgery (or sometimes two), it can be tricky to get the nipples to evert and to do so maintaining sensitivity. Again, I would suggest that you visit a qualified plastic surgeon in your area. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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 read about several doctors offering penis enlargement, is this something safe that provides very good results? Are there any side effects? How long is the procedure, and what does it entitle?

Answer:

There are many of us who offer this sexual enhancement surgery. There are basically two types of procedures. The first is the lengthening procedure where tiny ligaments are cut which allow the non-erect penis to hang further away from the body. This usually will allow for an elongation of from one to 5 centimeters depending upon the anatomy of the area. The second type of surgery is enlargement of the penis in diameter. For this, most of us use fat injections. This is the only part of the procedure which can and often does require touch-up procedures after since the fat take is variable. We often also perform procedures such as liposuction of the lower abdomen in conjuction with the procedure for further apparent lengthening. There are risks with each of the procedures described. The most common is that of the fat not taking completely and disappearing. Other risks such as infection or bleeding rarely happen. Loss of sensation can occur but is usually transient. The procedures each take about one to two hours although times have been shortenend with the use of lasers for the first procedure. Hope this helps. E-mail me and I can forward a brochure on to you detailing more about the procedures.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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.

Question:

I was diagnoised with a gallstone about a year ago and surgery to remove my gallbladder was recommended. I would like to have a tummytuck done at the same time.I was told that my insurance might pay for stomach muscle repair.I have lost alot of weight over the last ten years and the skin of my stomach hangs down about four inches in a fold. In the summer I get sweaty and sort of raw there.I also have alot of lower back pain if I stand in oneplace for awhile,like doing dishes. Would insurance help pay on anything other than muscle repair? Also the place where my gallbladder is feels sore inside alot lately. Can these surgeries be done on as an outpatient? I have not consulted a plastic surgeon yet.

Answer:

Most insurance companies will not pay for a tummy tuck. I have never been able to get an insurance company pay for a tummy tuck. Good luck JRBerman

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