Ear Surgery (Otoplasty) Questions and Answers

Question:

hi, i'm a 31 yr. old female and had liposuction twice on my abdomen, i'm 5'3 and 110 pd. 80%of my body fat seem to be in my stomach, my first lipo i wasn't satisfied because the moment i ate food i got fat bulges coming out on my sides and lower ab, so my doc. redid it, it seems to me that he took out pretty much all the fat out, but my waist is still fatty feeling, it seems like i have fat rolls, but i think that maybe it could be excess skin,when i tighten my abs it goes pretty flat but my skin feels and looks like an old lady's skin, kind of like "chicken skin" very loose but the rest of my body my skin is very tight, but the first time he did my lipo my skin was firm, do you think that maybe he took out too much fat?.. do you recommend a tummy tuck for this, i don't want to do lipo again, and if you do recommend a tummy tuck how is the scar situation for this and also what if i decide to get pregnant will that put me back to square one or worse with stretch marks, please help..thanks

Answer:

Dear Rachel, The skin can only contract so much after liposuction surgery. If there was too much fat removed and your skin could not contract fully after its removal, you have excess skin. You do not say when the second liposuction was performed but, given that it was several months ago, you likely have skin excess. The only way of dealing with this is by some sort of tummy tuck, with a larger scar being necessary for the more skin that needs to be removed. If you are going to have children I would suggest that you wait until after pregnancy or else you will likely need to have the procedure repeated in the future.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Dr. Amy, you have been so helpful to me thus far and I cannot tell you how much I appreciate all your help. I would love to share all this info with my husband but he doesn't want to talk about it at all, so this really helps me. I am being as strong as I can be for him and abiding by his wishes by not discussing it, the children on the other hand are worried, especially my youngest son who has Obsessive compulsive disorder, he is very worried and I keep reassuring him that daddy will be fine. you said that the .8 and level 4 don't go together, what exactly do you mean? and as far as the scale are there 2 different ones and why? according to the first scale you explained, brian (my husband) would be stage 2? but according to the second he is stage 1 right? Just making sure I am understanding. Yes the melanoma is on the upper center of his back, between his shoulder blades, if that helps at all. he has several more he needs to get removed in 2 months, and I am not sure what they would do if any of those showed up melanoma? could he have it in more then one mole? I guess what makes it all so difficult is we took care of his grandmother just last year who died in our home from lung cancer and it is still so clear in our heads how she suffered so badly especially the last week and I think we are all seeing that so fresh in our minds. this is when I try to be the strong one and reassure everyone that brian is young, healthy, and in an early stage, where grammy was 80, sick and at stage 3 when they found it. big difference. thanks so much for all your help but if you can explain about why the melanoma on his back is .8 and level 4 and why this doesnt fit? thanks and God Bless. amy

Answer:

The best thing you can do is to reassure everyone and leave your husband alone. This is the way he is dealing with it- you are dealing with it by trying to understand, but he wants to forget, so give him some space. I wouldn't involve your children much at all, only to tell them concrete things like Dad is having surgery but he'll be fine. Then be strong! He is not a stage 2. This is the only thing that matters ultimately, that the cancer hasn't spread. Breathe a huge sigh of relief when the lymph node is negative. Write me back when you have the surgical results. PS Glad I could help.

Amy Taub, M.D.
Lincolnshire, IL

Question:

Dear Dr., I had Lasek surgery less than a year ago. I would like to know if Lasek surgery can cause cataracts? I am 55 years old. Any information or direction would be greatly appreciated. Thank you.

Answer 1:

LASEK or PRK itself is not a known cause of cataracts as the laser does not penetrat through the cornea. Topical cortico-steroids that are used in refractive procedures can in some cases cause cataracts after prolonged use (many months or years), which is not usually the case with refractive surgery.

Answer 2:

LASIK, LASEK, and PRK do not cause cataracts. Andrew Caster, MD

Question:

I have some questions that I would really appreciate a response to. First, I had breast implants done approximately 16 years ago (silicon) I was 25 years old at the time. I now am faced with "capsular contraction" (I believe that is what it is called, hardening and discomfort of the breasts). I would like to know what the success rate is for successfully replacing the implants and not having the problem reoccur. Is it possible to have the upper and lower eye lids lifted at the same time as this replacement surgery? Also, one question that I am very embarrassed about since I have never heard of this problem before, is there any surgery that would alter the appearance of "extremely" long vaginal lips, I take the word "extremely" from an obstetrition who must have felt that since I was in labor that I would not be sensitive to his remark "she has extremely large vaginal lips". Please answer this question, it has made me very self concious even though my husband says its great!

Answer:

Dear Donna, The capsular contracture is a difficult problem and recurrence is common (at least 50% from published studies. It is reduced by the use of textured implants and also by placing the implants under the muscle (a less natural position but one which better "hides" the implant. Eyelid surgery can very safely be performed at the time of explantation, removal of the capsules and replacement surgery. The vaginal lips question is very common. Often women are uneven on the two sides and require evening of the lips. The labia minora (proper term) reduction is commonly performed in my practice (about once or twice per month) with excellent results. Make certain that they are not over reduced, your husband won't appreciate it.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

On july 10th I had moh's surgery under my left eye, it was quite extensive and I've been left w/ a diagonal scar under my left eye beginning 1/4 of an inch under my tear duct and going towards my left ear. The scar is approximately 2 inches in length and I am having dermabrasion on the 19 of Sept. I would like to know what to expect, will I be in any discomfort, will it swell, and how long does it generally take to heal. Thank you for your time. I have visited a website on dermabraision and did get some information but I guess I feel I just need a little more positive thoughts. Thanks again.

Answer:

Dear Margaret, I understand that you will be having dermabrasion on this scar. If the scar is narrow and not too depressed, this may help a little. In that area, dermabrasion is not the best treatment since the lower eyelid skin is very thin and fragile and does not lend itself well to mechanical abrasion. I would suggest that you visit with a plastic surgeon in order to explore the possibility of either scar revision if the scar is wide or thick and, if optimal from that viewpoint, laser resurfacing so that an adequate depth of resurfacing can be performed without danger to this very thin skin or your eye.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

In order for Breast surgery(Breast reduction) to be covered by insurance, what sort of health problems would a person go through? I suffer from rashes under my breast, Sore shoulders, back and neck pain. I am a size 42DDD. please reply .Thank you

Answer:

Dear Kimberley, That varies with the insurance company and your individual policy. Many policies have a minimum amount of tissue that must be removed in order to provide coverage. Your local plastic surgeon would be able to contact your insurance company in order to see about coverage.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am 25yrs old I gave birth to my only child in 1995, Me and my husband have not used protection for the past 6yrs and have not been able to become pregnant. I have seen a dr. who says My fallopian tubes have scar tissue in them. My question is how and why does this decrease my chances of becoming pregnant and how can we overcome this?

Answer:

Dear Virginia You need to address these questions with your doc since he/she is the one familiar with your case. But a prior infection can cause this, and your treatment may be surgery or more likely in vitro (test tube baby). Good luck Fady I. Sharara, M.D VCRM

Question:

My husband has had many atypical moles removed over the years, its been about 5 years since he has been seen by the doctor until last week. the doctor removed 3 more and called us 3 days later telling us one was malignent melanoma. He also has some on his scalp that he forgets to show the doctor, and he is supposed to have 4 more removed in december, my questions are 1.. how would we know what stage he is in, and 2. we go to the surgeon in two days, but what else will they do for him.and 3. two of our four children are very moley and one had a mole removed last year, how often should they be checked now? thanks!! amy

Answer:

First of all, you should go to a dermatologist who is thorough. You shouldn't have to ask to have his scalp looked at. His doctor should look everywhere- his scalp, between his toes and even at his scrotum. Second of all, your doctor should tell you what the depth of the melanoma is, called the Breslow depth. The dermatopathologist should measure the melanoma under the microscope. This is the most important piece of information you can get. This measurement is the most important predictor of future biological behavior of his tumor. You should ask your doctor if the mole was sent to a board certified dermatopathologist for this diagnosis. If not, seek out a second opinion. Finally, ask the surgeon whether they can do a sentinel lymph node biopsy. This involves injecting a dye at the site of the melanoma and then removing the first lymph node at the time the melanoma is re-excised. Again, if this node is negative, it is a very good sign that the melanoma has not spread. If this lymph node has melanoma, then you should consult an oncologist experienced in the treatment of melanoma. When you get all of this information back, write to me again. Your husband definitely should have surgery, which in many cases can be curative. You should take your children to a dermatologist experienced in this area for a total body examination. Although melanoma is rare in children, it does occur, and melanoma is partially an inherited disease. Finally, your husband should see an ophthalmologist for a complete eye exam as occasionally moles are present on the back of the eye. Good luck!!

Amy Taub, M.D.
Lincolnshire, IL

Question:

I have had very heavy bleeding with clots every month for some time now. I have also had an extreme bloated feeling (like something is pushing from the inside out)all of the time. The bloating is obvious because it looks like I am about 6 months pregnant(I am not) I am expereiencing low back pain. The pain is much more severe in the morning before I urinate. My husband says that he feels like he is "hitting" something when we have intercourse. I have had two miscarriages in the past five years, I know that something is wrong with me. The doctor that I have been seeing is very old,I have made an appointment with another, but I cannot get in for another month. Can you tell me what this might sound like so that I can do some research?

Answer:

Sounds like fibroids to me. Have an exam right away. They are benign but surgery is often needed to fix this problem.

Question:

I am 19 years old and I have been thinking about having a breast reduction because I've been having back problems. I wore a C cup starting at the age of 11 and through junior high school, then all during high school I wore a DD cup and my weight was 170. Now my weight is 190 and my cup size now is DDD and I've been this size for two years. My question is do you think I could be a canidate for a breast reduction? My OB said that I was too young and that My breast aren't that large for me to have serious back problems.

Answer:

Dear Amanda, Your OB is wrong. I would suggest that you visit with a qualified plastic surgeon in your area to discuss breast reduction surgery. You sound like a perfect candidate for this excellent procedure.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have never worn glasses in my life but I went to the eye doctor for the first time this year (I am 18 years old), they told me I have a weak eye and that it can't be corrected. I want to be a police officer or a military police officer and I was wondering if laser eye surgery can correct my weak eye. The eye doctor that I went to see told me that I would not pass the vision requirements to become a police officer. This ruined all my future life plans and I wanted to know if there is anything to help my weak eye so I can pass the vision requirements. How much would something like it cost also? Thank-you!!

Answer:

What you are describing is amblyopia or lazy eye that you developed as a child for various reasons. This if not caught early during your development may lead to visual loss in the affected eye. This is not correctable after about the age of 10 usually. Eye patching and glasses can be used before this time to prevent this from worening and to rehabilitate the eye. This is why early chilhood screening is so important to help prevent this type of visual loss.

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