Ear Surgery (Otoplasty) Questions and Answers

Question:

my vision is -10.25 in my right eye and -10.50 in my left. Is there any chance I would be able to get laser surgery?

Answer:

Dear Laura, You need to be evaluated, but if your corneas have enough thickness and you have no other pathology in your eye, then you may well be a candidate for laser vision correction with your high correction. Your pupil size may play a role in your ability for being treated though. David Cano, M.D. www.canovision.com w. palm be

Marc Kayem, MD
West Hollywood, CA

Question:

I need to find a doctor in the topeka area that performs labial reduction surgery.

Answer:

Dear Virginia, This surgery seems to be becoming more and more common. I performed two just in the past month. Any competent plastic surgeon should be able to perform the procedure for you. It is relatively simple with only local anesthetic being needed and a rather rapid healing time.

Question:

Hi, I am looking for some information on "cyclic esotropia" I was wondering if you may be able to help. My mother is suffering from it. It has caused her problems with vision over the last year. Every 24 hours her left eye crosses causing double vision. I have spoken to a couple of doctors who told me that this is a very rare syndrome and it may be corrected by surgery. However non of them have had any practical experience with it or ever performed surgery for it. I am looking for a specialist around the world who has experience dealing with this condition. Someone with practical knowledge who can offer suggestions on the best way to deal with it. I would appreciate it if you could help me get some information about the best way to cure or correct this condition. Can you direct me to a source of information or person that can help us. Thank you from your help, Hope to hear from you soon, -Erez Ben-Or erezbo@ozemail.com.au

Answer:

Dear Erez, You need to have your mother see a pediatric ophthalmologist. I know that this sounds strange, but pediatric ophthalmologists also specialize in strabismus, or as you say in oz, squint, which is the type of problem your mother has. Recognizing from your e-mail address that you are Down Under, I recommend that your mother see Dr. Lionel Kowal in Melbourne, Australia, at the Royal Victorian Eye and Ear Hospital. Good Luck, David B. Cano, M.D. www.canovision.com

Marc Kayem, MD
West Hollywood, CA

Question:

I am a 41 year old female that has worn corrective lenses (both glasses and contacts, but primarily contacts) for nearsightedness since the 10th grade. I have been evaluated for LASIK and have been told that I am a good candidate (vision is -3.5 in my right eye and -4.5 in my left). I have been told that monovision is a good idea to keep from having to wear reading glasses after the surgery. However, I have no idea which eye should be corrected for monovision and which one should be corrected first. I am left-eye dominant and would prefer to only get one eye done at a time.

Answer:

Dear Kim, Traditionally surgeons have picked the dominant eye to be corrected for distance. However, recent publications in our field have shown that there appears to be no patient preference for correcting either your dominant or non-dominant eye for distance. I suggest that you try monovision first with your contact lenses to see if you tolerate it. Wear your full correction in your dominant eye and your reading correction in your non-dominant eye. If you don't tolerate this, than you can try the opposite. If you still don't tolerate this, than monovision is not for you. Hope this helps. David B. Cano, M.D. www.canovision.com

Marc Kayem, MD
West Hollywood, CA

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.

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

Marc Kayem, MD
West Hollywood, CA

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.

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.

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.

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

Bernard Pacella, Jr., M.D.
New York, NY

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