Ear Surgery (Otoplasty) Questions and Answers

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Question:

How can I remove scarring (rashes) under the breast from having too large breast (size 42 T approx. 50 inches); second question, is there a publication that list top plastic surgeons by speciality. I scar very easily.

Answer:

Dear Kimberley, It sounds as though you would benefit from breast reduction surgery. One of the insurance clauses to have coverage is the improvement in your problem (called intertrigo). You should be able to have at least part of the procedure covered by your insurance. There is no listing of plastic surgeons by the procedures that they perform or want to perform. Those plastic surgeons who are most interested in performing cosmetic rather than reconstructive procedures are usually members of ASAPS (American Society of Aethetic Plastic Surgeons). I would suggest that you simply ask the few surgeons in your area that you visit with how many breast reduction procedures they perform each month. If the answer is more than a few, you have an experienced breast reduction surgeon. I recall from my training that we performed at least 4 to 10 reductions per week during our training.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I was wondering what part daily stress would play in "obtaining" a panic disorder and is a panic disorder a precursor of post-traumatic stress disorder? If so, I've had 2! very stressful disorders (Vietnam and brain surgery resulting in the EXTREMELY stressful grand mal seizures that were a residual effect! Since my SOUND decision making ever since the surgery has been severely affected, I feel that it's, probably, due to some damage that has occurred to my frontal lobes for the "successful" surgery occurred deep within them and they're responsible for one making sound decisions! I'm very interested in the frontal lobes of the brain and the brain is the MOST delicate and sensitive organ of the body! What I have to deal with is very close to mental incompetence, I feel, and rightly so, and will feel that way until mental incompetence is PROVEN to me to be something else!

Answer:

Dear Mr. Dettrey, June 13, 2001 You certainly sound like you’ve had enough trauma to cause posttraumatic stress disorder, but someone would have to examine you in person to make a diagnosis. Though people with posttraumatic stress disorder often have panic attacks, panic attacks themselves are not a precursor of posttraumatic stress. The brain surgery also could produce a lot of strange effects, including panic. I suggest that you try to find a psychologist in your area who is trained in testing and diagnosing neurological problems. Check with LocateADoc in your area. Also,The National Register of Health Service Providers in Psychology, which you can find in the reference section of your public library, will give you a list of psychologists in your vicinity, and a description of the training of each and their specialties. If you can’t find what you need there, call a local psychologist and ask for a referral. Good luck, Eric Loeb, Ed.D.

Question:

How much (ballpark figure) would a reconfiguration of the tip of my nose cost? Also, who gives free consultations?

Answer:

Dear Lisa, I am sorry to be so vague but there are many possible things to do to the tip of a nose to make it look more attractive. Also, the look that you wish for must be considered and strived for by the surgery. It is impossible for me to tell what you would need to reach this desired end. A simply tip rhinoplasty can cost as little as $2000. With regard to the free consultation, this is often not in your best interest since the more experienced surgeons often charge a $50 to $100 consultation fee. This allows only interested people to seek consultation and for us not to have our offices overun with people who are only interested in information and not surgery. I offer a reimbursement of the consultation fee for any procedure that I perform - which I think is a fair approach to this problem. I would suggest that you also seek out two or three consultations prior to deciding upon your surgeon and the procedure that you desire to have done.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I'm 25 female,my height is 4.10 and my breast are 32 inches I want to enlarge them upto 36 inches is that possible by cosmatic surgery.I've used heomopathic medicines,but could only increased them upto 2 inches [32].how much will it cost?Will I be normal forever[just like having natural breasts].Will I've normal sex[breast sucking etc? Any side effects?

Answer:

Dear Kiran, The increase in breast size from breast augmentation is in cup size and not circumference (this is measured below the breast in determining bra size). Certainly your breast size will be increased with augmentation surgery, however, your breasts will not be normal. It will not be like having natural breasts. Sensation is usually preserved although this cannot be guaranteed and, also, the ability to breast feed is usually maintained. Your breasts will feel and look different to you as well as to others. The cost is normally $4000 to $6000. There are very few side effects but I strongly suggest that you visit with a qualified plastic surgeon so that not only the good points about breast augmentation but also the bad can be fully discussed with you.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Iam a 54 year old male considering lasik correction. Currently Iam taking unaretic for hypertension(under control) and lipitor for high LDL count, as well as Enbrel 25mg twice weekly for control of limited Reiters syndrome(psoriatic arthritis). Need I have any concerns taking into account my medical history regarding the lasik surgery? Pleas advise.

Answer:

Dear Mr. Smith, LASIK may not be a problem for your medical conditions in general. Some conditions, such as Reiter's syndrome can have ocular manifestations. These include conjunctivitis, iritis and keratitis. If your ocular symptoms are chronic or recurring then I would avoid LASIK to be safe. David B. Cano, M.D. W. Palm Beach, Boca Raton, Ft. Laud. www.canovis

Question:

I had a breast reduction in January 2001. I went from an overflowing 40DD to a C cup. Prior to surgery I was told that some lipo is generally done given the shape of my breasts and where/how the reduction would be done. The lipo was to be done where the incision would stop beneath my arms and a small amount in the arm pit area itself. My reduction was covered by my insurance company since it was done for health reasons rather than cosmetic so the outcome causes me concern. Although the front of my breasts are noticeably smaller and are round for the most part, there does not appear to have been any lipo and there are rather squarish protrusions where my breasts previously began. Because of this shape, many bras don't fit properly and I am much more self-concious than I was before when they were too large and in the beginning stages of drooping. I am a bit overweight but was told it wasn't enough to warrant any weight loss pre-surgery so i'm concerned that they will be square even if I do lose weight. Is there anything that can be done now and if so, what procedure and what might it cost me? I am leery of returning to the doctor that did the reduction.

Answer 1:

It sounds like you could benefit from some additional liposuction. If you are not comfortable returning to the surgeon who did the first surgery, there are many excellent plastic surgeons all around. Good luck Josh Korman, M.D.

Josh Korman, M.D., F.A.C.S.
Mountain View, CA

Answer 2:

Dear Cyndi, There are different ways of performing breast reduction surgery and those of us who do a lot of this type of surgery are very aware of the "boxy breast" problem which can result from the procedure being performed without this possible result in mind. It may be that liposuction alone will help the problem or that a revision of the outer portion of the reduction is required. I would suggest that you first revisit with the surgeon who performed the procedure and discuss these options with him/her. It may be that this was considered and that the breast may just need time to drop further to achieve a nice shape.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Mu husband and I have tried and successfully conceived twice in six months. However, each time it has resulted in an ectopic pregnancy. I have had one live birth nine years ago. And, three years ago I was about 10 weeks pregnant when we discovered the fetus did not have a heartbeat, therefore, a D & C was performed. What are the chances for a normal pregnancy? Should we try implantation at this point? I am 33 and in pretty good health otherwise. I have had a history of dermoid tumors which have resulted in surgery to remove them. However, I still have my ovaries. And, both tubes were repaired and remain functional from the ectopic pregnancies. I look forward to your advice.

Answer:

Hi, It's IMPOSSIBLE to dictate treatment from afar, as it's only possible to do so after an extensive history, physical exam, lab testing, and review of all past records. However, it does sound like IVF is your best bet. If you do choose IVF, make sure you research each potential center's updated/latest success rates. For example, you can view our updated awesome rates at http://www.reproendo.com/pages/ivf_success.htm Good luck! Dr. Roseff, W.E. C.A.R.E.

Question:

Thanks for your immediate response. We have tried everything (i.e.Laser, Liquid Nitrogen, Aldara Cream, and Scraping) and nothing has worked. I am ready to go to the next level. Plastic Surgery. I want my face back. Please help!

Answer:

Dear Auntjuan, In my hands, I find that laser is the most effective treatment for these lesions. Surgery tends to cause their spread and, as you have noted, they are difficult to erradicate. I would suggest repeated treatments with either a KTP or FPTD (flashlamp pulsed tunable dye laser). Hope this is helpful to you.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am individual with AIDS and presently suffering with MELUSCUM. Because of the damage it has caused to my face, I am strongly considering plastic surgery. Would I be wasting my time and money? What is your recommendation? Thanks.

Answer:

Dear Auntjuan, Moluscum contagiosum is a viral caused skin eruption with little severe long-term effects. I would suggest that you seek treatment. You may heal a little slower but the treatment is very benign.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Dear Sir: I want to schedule rhinoplasty this summer. I also want to go scuba diving this summer. Will the rhinoplasty effect my ability to scuba dive? How long after the procedure will I be able to schedule my trip? Thank you. Malissa Shirkey malissas@cre8.co m

Answer:

Dear Malissa, The answer to that is dependent upon the type of rhinoplasty and exactly what is being done. In an augmentation rhinoplasty, using an implant, you could likely go diving within two weeks of the procedure. If a major reduction is being performed with infracture (breaking the bones of the nose), I would suggest that one month wait would be better. If a septoplasty is being performed (straightening the cartilage inside of the nose), because of the dryness involved with diving, I would suggest at least one month before diving. Increased pressure at depth would affect the surgery in a very limited manner.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

What are the actual risk factors of any given cosmetic surgery?

Answer:

Dear Danni, Risk factors generally include bleeding, infection (both uncommon)but perhaps the greatest risk is that you will not be as happy as you want to be. You should review all potential risks with a board certified plastic surgeon. Dr. Korman

Josh Korman, M.D., F.A.C.S.
Mountain View, CA

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