Ear Surgery (Otoplasty) Questions and Answers

Question:

My lasik surgery took me from -7.00 correction to -.50 in one eye and -1.75 in the other. I am wearing soft lenses to get to full 20/20 vision now (surgery was 9 weeks ago), and am looking forward to "enhancement" surgery at the end of the year. What are the chances I'll be correctable this time to full 20/20 or better? Having worn hard lenses for 30 years, I'm used to seeing "great!"

Answer:

Most rigid contact lens wearers do not see as well after laser vision correction as they saw in there rigid lenses. Some surgeons no keep there patients out of rigid contacts for about 1 month for every ten years of hard contact lens wear before they get the final refraction for laser vision correction surgery. This is because of corneal warpage from the hard contacts. An enhancement is possible so long as your cornea is not to thin and you do not have signs of corneal ectasia.

Marc Kayem, MD
West Hollywood, CA

Question:

I had a breast reduction about 6 years ago and now they are back. Insurance paid for it the first time and I just wondered can you have the surgery again and will insurance pay for it twice?

Answer:

Dear Emily, Each insurance company is different but if you have symptoms from your breasts being too large, again, the surgery should be covered.

Question:

are any plastic surgeons in the raleigh durham area using glue for face lifts

Answer:

Dear Jody, Tisseal or tissue glue has been FDA approved for a few months and has led to fewer hematomas in facelift surgery. I have used it extensively in Canada and Switzerland prior to its FDA approval. Sutures (stitches) are still necessary in performing the procedure. I don't know anyone in your area using it routinely.

Question:

I have very thin legs and have tried everything (weightlifting) to make them bigger. Is there any kind of implants for the legs?

Answer:

Dear Josie, There are implants for the calves but this procedure is fraught with problems and complications. There are no implants available for the upper legs (thighs). I would suggest that you contact Dr. Lloyd Carlsen in Canada as he is the world leader in leg implant surgery. I believe that he is in Montreal.

Question:

wonting to no about breast reduction,I have a stint and wonting to no the risk I take moneket 10MG for heartnorvasc2.5mg for blood preasure zoloft 50mglopid 600mg to lower blood lipids and estrace 2mg and asprin 1 a day

Answer:

Dear Sandra, I am not sure what type of stent you are talking about but you are certainly on a number of heart medications. I would suggest that you visit an internist and have a thorough physical examination prior to visiting with you local plastic surgeon. You will have to stop the aspirin and may have to substitute another medication for a short time prior to your surgery.

Question:

My son is seeing five small black dots in his vision. He is 24 years old and has seen an optometrist, they didn't find anything wrong, but did refer him to an Ophthalmologist. Isn't he too young for glacoma? Should I be as worried as I am or just concerned to get answers? Can surgery correct the dots or remove them? Can you provide me with any information and maybe some comfort? Thanks much for your time. Terrie

Answer:

The small dots that he sees may be vitreous floaters that can be benign. Many people see these and have no significant eye problems. He should see a good pediatric ophthalmologist to rule out any retinal pathology or other eye diseases. As long as he does not have flashes or visual, I would not be alarmed. Daaaavid Ca

Marc Kayem, MD
West Hollywood, CA

Question:

I am a 36 yr old,three children, that has had gallbladder surg. which resulted in a incisional hernia which was repaired twice with failure , finally the third time was repaired again with mesh. After this surgery i have what looks like a fat roll but have never had that before. Could it be scar tissue? I also have had four bikini cuts due to ovarian cysts surg. I have done many things to try to flatten my tummy again with no satisfaction, If i had a tummy tuck how much recovery time will that take and would insurance cover the hernia scar tissue issue? What would be the right way to approach my insurance about this before consultation or involve the doctor i choose? Thank you for you time- Robin

Answer:

Dear Robin, You certainly have had a number of problems in your abdominal area. I would suggest that you visit with a plastic surgeon who can determine if there is significant herniation and if your risk vs benefit is in favour of performing a modified abdominoplasty procedure. A true abdominoplasty is likely out of the question with the amount of surgery that you have had and the scarring that is present. He/she should be able to approach your insurance company to determine what will be covered by your policy prior to the surgery.

Question:

I have had a rhinoplasty, and I am unsatisfied with the results. My nostrils are uneven, and the bridge of nose is also uneven(one side is flatter than the other). I am considering having a revision rhinoplasty. But I am afraid my nose might look worse. What would you suggest?

Answer:

Dear Desiree, Unfortunately, rhinoplastic surgery is one of the procedures where there are often touch-ups and secondary procedures required in order for you to get the results that you desire. I would suggest that you visit with the surgeon who originally performed the surgery in order to see if he/she would perform the necessary revisions at a reduced cost (if you are comfortable with that surgeon).

Question:

Doc, I am 24 yr old & finally have the $$ for braces. I was told that I need surgery as well to move my lower jaw out, since it is recessed. I was told my teeth are slanted far outward so they want to pull teeth in lieu of moving the teeth out. The dr. said without the surgery I could only hope for 50% improvement of my overbite. He said I would wear braces for under two yrs w/ surgery & 2 yrs w/out surgery. I asked how much this surgery would cost. He referred me to the oral surgeon. The oral surgeon told me he would have to see me (even though my orthodontist had lunch w/ him & took my records to discuss my case). Do you have any idea how much Im looking at? I dont want to spend the consultant fee of 250 if I cant afford the surgery. I mean is this 2000 or 5000 or over 10,000? Please help!!!

Answer:

I can't give you an answer without seeing your models, xrays, and doing an exam. Fees vary with the complexity of the surgery, and vary from region t region as well as practice to practice. Most major medical plans will cover jaw surgery if you can prove medical need.

Question:

I chose Allergy/immunology didnt find Otolaryngology. I have had a mild sore throat with 1 swollen tonsil since Feb 2001 with bad sore throats couple times a month. Drainage in the back of the throat off and on also. Feeling (off and On) drained, weak, nauseous, joint pain - knees. Tender lymph nodes. No allergies that I know of. Dr. wants to do a tonsillectomy in September. I take Omnicef 300 mg 1 pill daily for 14 days and I am on my third round. In my research I have read I should take one twice a day??? I went to a local lab to do a CBC My Neutrophil % was noted very hi 85.1 and lym % noted very lo at 11.1. Hemoglobin (12.3) and MCHC (32.0) was on the low end of normal I did this because I wanted to make sure I did not have mono. I am a female 33 yrs old - I do not smoke,drink or work around fumes. I live a stressful life -work many hours. I would like to know the cause of my ongoing problem and why the medicine has not been of any help. I would like to know what has caused this before I do the surgery. Are there any test I could do that would help me find my answers? Thank you for your time it is appreciated.

Answer:

Your case is out of my field, as I am not and ENT or Allergist. I would suggest you see your primary care physician for a complete exam. He may suggest a mono spot test to rule our Mono. The dose of omincef can be one per day in most cases.

Question:

Can you tell me more about the "tear-drop" type breast implants? And how much do they typically cost? Are they less dangerous? Thanks.

Answer:

Dear Sheila, Anatomical implants are meant to give a more contoured look to the woman when she is in upright posture. They have largely been overated and can give a strange look to the supine (lying down) chest. They are no safer and are still filled with salt water which will always have problems with looking and feeling natural. They cost more than standard implants and thus the cost of surgery is more as well.

Question:

I have been having headaches which have been diagnosed as tension/migraine combos. They have been getting progressively worse. They are here almost 24/7. If I awake w/o one, one comes on within an hour. My last migraine was an 11 day one, which just ended. I have seen a specialist who has almost given up on me & a neuro, who only advised I see a pain management doc. My MRI shows I have degenerative disc disease, but only mildly...normal for a person my age, I was told (I"m 45). My headaches get strong in my neck & wind up turning into migraines as they progress. I turn to the possibility of TMJ because most other options have been excluded. One main reason I am considering this is that I had brain surgery 8 1/2 years ago, removing my right temporal lobe & successfully ending 36 years of seizures due to epilepsy. BUT to get to my RTL, part of my upper jaw had to be removed & replaced. Chewing gum has given me headaches ever since then. I eat 2 apples every morning for breakfast & that seems to bring on the initial pain. If I can't get it under control, it spreads down my neck and up my head, turning into the tension/migraines. The tension in my neck seems to aggrivate the degenerating discs & making neck pain worse. Most of the time, no OTC meds will get my pain under control in time. I've lived on OTC meds for so long that my system is immune to them. I had a CT scan to check for tumors & the radiologist wanted to know what on earth happened to my head. I had told him about brain surgery, but failed to mention my upper jaw removal at the time. When I told him of it, he just kinda nodded & didn't mention TMJ possibilities. I was about to see an allergist & get checked for food allergies when I thought about the possibility of TMJ. Do I need to see a dentist to be checked for it? Can my regular dentist advise me yea or nay about seeing an oral surgeon? I'm searching for answers & am tired of 24/7 headaches for the past 3 years. I failed to mention that there is a very sensitive spot right above my right ear, which is extra sensitive during headaches. I have always attributed it to the jaw removal. I have not had jaw locking problems. If you can help me, PLEASE do. Thank you very much. Sorry if this is too long. Jacque

Answer:

The jaw removal may have something to do with it but I would suggest that you see your local dentist. I am going to refer you to a web site (www.drjimboyd.com) for more info on an appliance that may help you with the headaches. This device is called a NTI that is worn like a splint but has better success with treating TMJ problems and headaches. Good luck.

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