Ear Surgery (Otoplasty) Questions and Answers

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Question:

I was in a car accident and fractured my spine (a T3 fracture). I had surgery on it and later my x-rays showed that the top part of my spine shifted forward, so my spine is now offset. I'm not in any pain. So I'm wondering if there are any limitations to having a spine that is not completely together.

Answer:

Spinal Surgery almost always changes the allignment or quality of movement of the spine. When rods and screws or plates are used, the alteration is greater. Often the patient will experince trouble at the level above or below the area of surgery in the years following the surgery. In your case the repair was very necessary. However the lack of proper allignment will cause muscles tendons and ligaments to deal with forces that are in excess of what is optimal. To get an idea of what is normal or ideal go to www.idealspine.com. There you can read about the impact of these problems. Thanks for your question Dr. Jim

Question:

This question is for my mother not me, she is an elderly woman, who has had cataract surgery, the operation was a sucess. There is only oneproblem, now the light really bothers her, they say she is light sensitive, she has had 6 pair of glasses made in the last year. she can see fine untill she is in the light, then it pretty much blinds her .Do you know what causes this and what can be done to correct it

Answer:

She should go back and see her Ophthalmologist, to be sure that no Keratitis is present from dry eye.

Question:

I didn't see an ortho MD as a choice, but being you care for the human frame, I will ask nevertheless. Almost 4 months ago I was hit by another jet ski traveling about 30-40mph straight at me from the side. I was hit in the R knee area and received a comminuted fx of the R proximal fibular head, a damaged peroneal nerve (causing severe dysthesia: severe pain, numbness, tingling, and burning all the way down to my toes). There was minimal displacement of the fibular neck (5mm)posterolaterally. Despite the slight deformity, the fx was not reduced. Upon injury there was immediate hemarthrosis and swelling of the knee joint, and not nearly as bad in the L knee. I was taken by ambulance to a trauma center b/c I had a concussion, but the concussion part is not my point. I was referred to an ortho MD who would not take me in until 5 days later. Being I had insurance no one likes (trust me on this), I was short-shifted, etc. I had a knee immobilizer from the ER, FYI. I could not bear weight on my R leg, God forbid I do that,& might as well shoot me if I tried to bend it even slightly. I've had 3 kids, mind you, so I KNOW pain! So, the MD chkd for ligament dmg ant/post, but not laterals b/c it would cause too much pain. I had a posterior sag in the PCL, and I don't know about the ACL. 6 weeks later I went back to get MCL/LCL chkd. Overall, the MD said there was still a sag, and he said if there was still pain and instability in 6 more wks, he might order an MRI. He didn't really answer me regarding ALL ligaments. This is what I told him: I cannot go up stairs without pain. I have to hold on to something (rail) when going downstairs because, not only does it hurt and burn, but my R leg is weak, and my knee feels unstable as if it is going to dislocate, and it pops when I bend it too far. I cannot squat down all the way b/c it hurts, nor can I run, ride my bike, twist my leg, ride in a car or sit for long because my knee burns,or hike anymore. Being I am a nurse (and now have excellent insurance taking effect after my hospitals orientation in March)my job is WALKING ALL day long, 12 hrs/day. Walking for prolonged periods hurts my knee. Since my L leg is compensating for the weakness in my R, the L is now hurting again. The MD assured me after my 6 wk chk and new XRay that I can continue to be as active as I wish b/c I would not further injure myself. So now what? Doesn't this sound a little weird that he isn't treating me? No physical therapy, surgery, or MRIs? I'm afraid this will affect my career that I worked so hard for, and my life. What is your opinion? The other nurses I have spoken with who know this MD say he is great, but doesn't like the insurance I have until my new one takes effect. insurance.

Answer:

Hi Kim, I was wondering if you were an MD or a Nurse due to the terminology you were using. First let me say that knees aren't my specialty, but I do have a good bit of knowledge in the area. I used to work closely with orthos in the fitting of rehab knee bracing years ago. Your knee sounds like it needs some attention. How you are going to get it, I can't say. I can tell you that sometimes there are cases that get ignored because they aren't "surgical" cases. In my opinion you need some PT at the LEAST. The fact that you have "bad insurance" shouldn't keep you from getting some rehab. The knee needs to be strengthened. The ligaments will not heal properly unless stressed along the lines of function. I'd either ask my current MD to write a script for some rehab or get a new MD. Thanks for being a part of the most underpaid and under appreciated professions.....nurses are awesome gifts from God. Wishing you a speedy recovery, Dr. Heinz

Question:

I have a cyst(hard) in my right cheek, over my sinus cavity and need to have it surgically removed. It is about the size of a quarter, but feels like it goes deeper than that. Should I have an ear, nose and throat surgeon do the surgery or an experienced plastic surgeon do it? I have seen an eye doctor (since it is located under my eye also) and he was going to do it, but my insurance will not let an ear, nose and throat surgeon assist him during the procedure. Plus, they will have to cut the outer corner of my eye, then pull down the skin to remove it. This sounds like it would be awful! They said the worst that will happen is I would have some bruising around the outside of my eye. Please give me your input on this and who I might go see to take care of this. It makes me feel terrible to have something like this on my face and I really want it taken out, but I am scared to have surgery on my face. Input, PLEASE!!!!Thank you so much..............

Answer:

Dear Kimberley, I take it that the cyst is a benign growth and not a cancer and that it is localized under the skin so that there will be no skin defect once it is removed. I would suggest that, at least, you get an opinion of what in involved in the removal, in terms of risks and goals from a plastic surgeon. Hopefully, there is one which will be covered by your insurance plan.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I think i am relatively underweight for my height. I'm about six feet and 145-150 lb. Also i'm relatively "skinny." I exercise six days a week for about an hour (or a little more) each of these days. I alternate between aerobic and strength workouts. My question lies in the fact that i can't seem to get rid of some "flab" that is beneath my bellybutton area and also i can seem to get rid of some flab from my chest. What am i doing wrong? what can i do to get rid of it? I am 18 years old and don't want surgery. I used to be overweight before. is that part of the problem? anyhow, also the chest area makes my nipples seems puffy. I would appreciate a response as to how to get rid of these problem areas. Thank you!

Answer:

Dear CL, In ordr to best answer your question, I wuld need to know how much weight you lost and over what period of time. If the weight loss was high over ashort period of time you have probably lost significant muscle mass. The slower the weight loss, theless muscle loss and more fat burned. In addition, your present weight is below ieal. Ideal body weight for a six foot male is 161-195. I would first start with a dietary evaluation by a dietition to assess te adequacy ofyour nutritonal profile to help your exercise be as efficient as possible. You also wan to get a body fat test. After all of this is completed and you've given yourself ampletime to allow th exercise to work, then you may want to consider a evaluation with a plastic surgeion. But I would ony use this as a last resort. Make sure thatyou are experiencing a healthy relationship with your food and exercise before taking on drastic measures. Karen Sue Beerbower MS RD

Question:

I have a twenty-four year old male in my family who has had his spleen removed due to a bad fall. How normal can his future be? What long-term effects will occur due to this surgery?

Answer:

Hi...People can live long normal lives after spleen removal...here's a link to an article which gives recommendations for avoiding infection....http://www.gaucher.org.uk/risk99.htm Hope this helps Julie Adinolfe Rn AskANurse

Question:

I have about a dozen scars on my shins due to chemical burns (from Nair Hair removal cream) and electrical burns due to bad electrolysis. All of the scars are small (about pea sized) and shallow rather than raised, and are very discolored--brownish purple while I am very fair skinned. I've tried silicone sheets to reduce the scarring, but it hasn't worked at all. I REALLY want to get rid of the discoloration, and would love to get rid of the shallowness, also, but it's the discoloration that bothers me more. What type of surgery (dermabrasion?) could help with with these scars, and what's a rough estimate of the cost? I hope you can help me. I can't go another summer in pants every day, but I can't bear to wear shorts with all of these ugly scars. Thanks for any help you can give me. Carla

Answer:

Dear Carla, The pigmentation can be readily removed with lasers although that will do little for the textural skin changes. You may wish to have the larger ones surgically removed to leave a fine scar that is level. The former should not cost too much - I charge $20 per spot per treatment with about 3 or 4 treatments required to lighten the pigmentation. The surgery costs about $200 per scar.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had a breast reduction done in July of 2000, and my scaring is unbelieveable!!When I went in to see the surgeon before my surgery date was set, he explained what would be happening and he also sent me to consult with a nurse. She also told me of the procedures and then the day of my surgery nothing happened the way it was supposed to. I ended up getting an infection and ended up in the hospital in my home town for a week. The scares are very ugly and I am very disappointed in the way that they look. My husband describes it as a "hack job." Is there anything i can do about this legally?

Answer:

Dear Jocy, Breast reduction surgery involves long scars. The scars are likely not of the best quality (thin, white lines) mostly because of the infection. Scars that become "hypertrophic", that is, thick, red or wide, can often be significantly improved with scar revision surgery. I am certain that your plastic surgeon would like to see you again in order to review the options. Unfortunately, infections and bad scarring is unpredictable and a risk of the surgery. I would suggest that you seek to improve the scars rather than legally try to receive compensation for them being unsightly.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

This is for Dr. Amy Taub, Reading about the melanoma Brian has. I want to know why all cover pages on melanoma say if caught early usually cured. My wonderful 37 yr olds son died June 14, 2001 after a 4 1/2 yr battle with melanoma. When mole removed .7 and no other treatment performed. Sample sent to PA and said came back clear. 1 1/2 years later to lymph nodes. Surgery and full year of interferon. No new signs until 2 yrs later rushed to hospital and found brain tumor. His mole was same as Brians but lower on the back. I believe the dye is new and wasn't available at the time of my sons mole removal but why is treatment done at mole removal. When my son told the admitting at St. Lukes in Milw. his story, she said if you knew how may times I heard that, said she thinks she would demand some other treatment at time of removal. I'm still searching for answers. He tried everything. Went to Burzynski Clinic in TX, called Bethesda, MD, saw a specialists in Chicago but all that was when it was spreading rapidly. Wish I knew if he had went to another Dr. first if it would have helped. Sorry this is long and maybe will never even get a reply. If I can get any answers, it will help me and the young couple will be in my prayers. My son left twin boys 12 yrs old. Thanks, Donna Smith

Answer:

Dear Donna, Please accept my condolences at your terrible loss. When you say no treatment, does this mean that the melanoma was never re-excised? Usually for .7 the mole would at least have been re-excised with a margin of normal skin and an excision that was fairly deep, ie all the way to the top of the muscles. Unfortunately, medical treatments are based on statistics and weighing the pluses and minuses. The statistics are that with a .7 deep melanoma, the odds were very positively in your son's favor (I'd have to know all the facts to run an "exact" odds estimate, but assume it was more than 80% chance of cure). But this doesn't help the folks like your son who was one of the unlucky ones. Let's say we had 10 men your son's age who had melanoma like his. 8 or 9 of them would probably be cured by re-excisional surgery alone. 1 or 2 would wind up having a metastatic lesion (as your son did) later. Do you think the other 8 or 9 should have to take interferon for a year with all the attendant side effects and the interference with daily life? From your perspective you might say yes, but from the other 8 or 9's view it would be no. So, typically, we go with the odds when they are as one-sided as this. With respect to the dye in the lymph node procedure, it still is not usually done for people who have thin melanomas (like your son's) unless there was something else in his history (it was ulcerated or it was deep in the skin even though it was thin, etc). Even then, it has not been clearly established that this procedure would have actually been able to save his life. You would have known that it had the potential to spread sooner, but it might not have helped. Whenever we make a diagnosis of cancer, we always try to soften the blow and look on the bright side. This is human nature. Especially when there is a thin melanoma, it is very reassuring to people that it is likely they will beat the odds. But there still are odds. Once you have a malignant tumor, there is always the chance that it could spread or has spread via cells that cannot be seen now but eventually will grow and will then be detected. See? My response was even longer than your question! May your grandsons bring you joy and give you some peace in your grief.

Question:

Hello, my best friend had a hysterectomy 3 years ago. She has what the doctors here call inter costal neuritis they say was caused by the surgery but there is nothing they can do for it. The pain is so severe sometimes that she is bedridden. She is only 51 yrs old and otherwise in good health and keeps herself fit. Have searched the internet for possible help for her but can't find anything. Could you advise/direct me to maybe someone that specializes in these type of problems? Thank you

Answer:

Hi Linda...We don't have a Neurologist on staff...I have also searched the internet for an answer for you to no avail. The literature mentions the neuritis frequently but doesn't digress...I wish I could have been more helpful. Julie Adinolfe RN AskaNurse

Question:

i want to know all about facial plastic surgery i have tribal marks on my face.i want to know the after effects.thanks.

Answer:

Dear Lisa, I am not sure if tribal marks are tattoos or scars. If they are the former, they can readily be removed with several laser treatments. If they are scars, they could likely be improved but never erased.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

What would you recommend Laser eye surgrey, RK or PRK to correct myopia. And which is more cost effective(cheap). Thanx

Answer:

Dear Russ, PRK is generally considered an outdated procedure, and seldom performed except when certain medical conditions warrant it. LASIK is quicker healing, less painful, more predictable, and does not require the use of strong steroids, making it the procedure of choice. I urge you to make your choice of surgeon based on experience and reputation, rather than cost! There were a lot of discount LASIK centers in our state, and B.C. until last year. Most of them suddenly went out of business amid a flurry of lawsuits and bankruptcies. In many cases people who paid in advance got no surgery, but lost their money. Worse, many others, including a significant number who had complications, were left without the follow-up care and enhancements they were promised. They had to scramble to find other doctors willing to care for them...and pay hefty fees for the service! There are only a few discounters left, and I expect they are likely to go the way of their predecessors. The problem is, when you cut prices so drastically, you have to cut corners. These are your eyes. LASIK is NOT like a haircut; if it is done badly, it won't grow back! You get only one chance to do it right; a low price is no bargain if you have to live with a bad result. In Washington State the average price of LASIK is currently around $1400 per eye (and rising), the price at most reputable clinics falls within about $200 of that mark. A clinic that charges a great deal less than this may be compromising on the quality of care, equipment, and staff-putting you at greater risk than necessary. Better to save up a little longer, or use financing options, and choose a well established clinic has a reputation for excellence. For more detailed LASIK information, you may wish to view our website.

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