Ear Surgery (Otoplasty) Questions and Answers

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Question:

I have an 8 year old son who 5 years ago had surgery for a thyroglossal duct cyst. The cyst was removed and the lab tests confirmed that it was a benign fluid filled cyst. However, after 5 years it appears as thought there is something else going on with the cyst. My son has a very bad cold that may or may not be related. The scar under his chin is red and there is some swelling in the area that was once the cyst. My question is this: Is it possible for the cyst to recurr? If so, can it reoccur very quickly and fill with fluid quickly? Or, is it possible that this is a soft tissue infection in the area of the old incision related to the bad cold? thanks for any advice you can give me. Sincerely Geoff Mills PS I couldn't find the speciality of ear, nose and throat listed.

Answer:

Dear Mr Mills, I am sorry to hear of your son's affliction, hiwever, you should really direct your question to either a General Surgeon or a Head and Neck ENT surgeon. Good luck.

Question:

I have dark spots on my knees that I am trying to get rid of. I've tried several fade creams (some prescribed) that don't work. Can I have some kind of laser surgery to remove the spots. ALso, I am trying to get rid of a "dark neck" and dark under arms. PLEASE HELP!

Answer:

Dear Laverne, There are a number of lasers that are able to remove pigment from the skin. The ones that work best are Q-switched ruby and alexandrite lasers. Call your local dermatologist or plastic surgeon and see if these are available in your area.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hi Doc I am 29 and my husband is 37. We have been trying to have a baby for over 3years and we have had some bad luck. I got pregnant and had an etopic pregnancy and lost my right ovory and part of mt uterus. I then after 6 months went to see an RE who did some tests and a hysto. He told me that if I had an lap. that he thought we would have no problems. About 4 months after the Hysto. I got pregnant and carried for 4 months and then lost the baby. No one is sure why. Ever since we have been trying and seeing an RE and I have had surgery and under gone IUI which was a real problem. I overstimulated and was sick from the first day I started taking the shots to about three weeks after I stopped. I did go to see another RE and got his oppinion and he feels at 29 I should not be taking fertility drugs and that we should have no problems. I am so confused and would like a more clearcut answer because we would like to consider adoption as an option but with the confusion I do not know which Dr. to beleive. Please Help???

Answer:

Hi, What's the status of your remaining tube? Also, SOMEONE has to be able to say why you lost the baby at 4 months! Please e-mail me (doc@reproendo.com) with the fist/last name, city/state of office location of the RE's you've seen. I want to check their credentials. Thanks! Dr. Roseff Visit us at www.reproendo.com

Question:

Hello, I am 28 years and have never had any children. I have always had very large breasts (32 DD)but not had many problems with them. Recently they have grown to 34 D--DD. I had to discontinue using birth control pills as they were becoming excessively large and painful (34DDD). Now they also sag slightly. I have gained 10 pounds in the last three years, but I am still considered extremely light for my size (5'10") Most people wouldn't know that I have large breasts because I have adjusted my posture to hide them. Unfortunately, I was recently involved in a car accident and injured my neck. While recovering from the trauma, I placed increased strain on my upper back. Radiographs have shown osteophyte formation along several of my thoracic vertebrae. I am concerned that the excess weight of my cleavage is harming my back permanently. I have been seeing a chiropractor, physical therapist, and working on ergonomics, but am still having problems with my posture as well as severe back aches. I would like to have a breast reduction, but have a few concerns: 1. length of recovery, 2. extent of scars 3. cost 4. feasibility--is this really a size that should be reduced. 5. would insurance even consider paying for this procedure??? Thank you your time

Answer:

Dear Tonia, In your case I would certainly encourage you to seek breast reduction surgery. The recovery time will be about two weeks and the discomfort is rather minimal. Depending upon your insurance, a large portion of the procedure (which costs about $6000 or so) should be covered due to the physical problems that your large breasts are causing you. The scarring in your case would be around the areola (the dark area around the nipple), down the center portion of the breast and along the crease under the breast to a variable extent. I would suggest that you visit with a plastic surgeon in your area for input and to determine exactly the breast size that you would like following the procedure.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have deep acne scarring on my face. I had laser surgery 3 years ago, and it didn't improve. What could I do to help my face become smoother?

Answer:

Dear Kristina, I am surprised that you got no improvement, however, that procedure, like all others is very operator dependent. You may require pre-excision of deep pits followed by another resurfacing procedure. Make certain that you visit with someone who is either board-certified in laser surgery or who has great experience and does many similar cases to yours. Ask to speak with past patients to make certain that the results are as described to you. I would also suggest that you plan on taking 3 weeks off from whatever you do since a deep resurfacing will take about that long to heal and still be red for another several weeks thereafter.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

The orthodontist refuses to continue with braces until my daughter has either orthognatic (sp?) surgery on her upper jaw or a partial glossectomy to reduce her tongue size. The surgeon insists on the jaw surgery while my daughter has chosen (only because there have not been alternatives offered) the tongue surgery. I feel like I am backed into a corner. She is 16 and small boned. She has an open bite and cross bite on the left side. Her front teeth are fractionally off center. She was in braces for four years. The first two years seemed to be effective. Unfortunately, we moved before treatment was complete. The second orthodontist, whom I assumed was to continue the treatement, insisted on re-doing everything. Each month he "re-tied" according to his records. We moved again and the third orthodontist (same org as the second) was to complete the treatment. He took off the braces after six months saying four years was long enough. He put her in a retainer. We moved back to our first home and immediately returned to her first orthodontist. He was quite concerned because, after excpanding her palate, one side had partially collapsed creating a crossbite and, she still had an anterior open bite. He said to think about it but we would likely have to start over. He wanted to extract upper and lower bicuspids. The new ortho (who is oushing for the surgery options) says her tongue will likely just push the teeth out again despite the extractions and braces. I hate that she has already gone through so much. It has already cost a lot more than I can afford as a single mom. I don't know what to do or who to contact. In the meantime, I have paid out even more to this orthodontist who claims he can do it once and do it right BUT with the surgery. It never should have come to this and I am extrememly concerned as well as confused. CAn someone help or advise? Thank you Jamey

Answer:

I am confused also! I cant recommend the glossectomy when orthognathics or distraction osteogenesis will do the job. Texas is filled with top notch oral surgeons. get another opinion.

Question:

I am 44 years old and had to have a hyst. a year ago in January. Everything was removed (ovaries, tubes, etc.) The surgeon put me on Premarin 2.5 daily and I was supposed to go to a doctor a checkup after the year was us which was this Jan. I have not gone yet because I want to go to a female because when I first had my surgery I was so worried about taking so much Premarin a day and the three (male) doctors just looked at me like I was crazy and said that there was no reason not to take that much. Noone would tell me what to expect after the surgery. I feel like I am having a nervous breakdown and do not want to go back to them and tell them that because they will say it is my nerves and try to put me on Paxil or Zoloft when I know it all started after the hyster. One doctor told me I needed this much estrogen to keep me moist for sex and that is real important in a marriage. Well who wants to have sex with a person who is crying one minute and mean the next. Also, I have gained 25 pounds since my surgery, is that normal. Could it be the hormones where maybe I need some other kind. Is there some sort of test to check my hormones to see if I need this kind or this much of this kind? Please help me before my children and husband leave me. (Just kidding).Thank You,Kathy Killebrew200 East HardingGreenwood MS 38930662-455-3115

Answer:

THe usual dose for premarin is 0.625 mg; that should be adequate for contiued sexual function. some younger women need more after having the ovaries out because of severe hot flushes. I would recommend having a second opinion.

Question:

Hi, I'm a 14 year old female with no serious diseases or health issues. But there is one thing that I'm concerned about. My one inner labia (I believe it's called) is a lot larger the the other. It extends past my outter labia, and i was just wondering if this was something to be concerned about, or if there was something that I could do about it, considering that it makes me self conscience. Thank you.

Answer:

It is nothing to worry about. When you have your first gynecologic exam, ask your Dr about it. THere is a wide range in labial size. Plastic surgery could be used to correct this problem if it really is a problem.

Question:

Thank you for your response to my first question. We are aware of the second type of surgery to re-break the bone and put in a plate and screws to correct it, however, out of the two doctors consulted, they both had very different methods. One was to completely pull the face off making a half moon incision in the skull, from ear to ear, to gain direct access to the bone. The second was to make three incisions, going in through the mouth, under the eye and in the hairline to gain access to the bone. At this point, there are no scars from the original accident (except for the one from the original surgery in the hairline) and we're worried either one of the surgeries above would cause permanent scarring. That's why I was thinking an implant would be less traumatic. The second concern is that the jaw muscle has not completely recovered from being "stabbed" by the bone when it was initially broken. My brother has limited movement of his jaw and even though he's tried to "work out" the scar tissue, it doesn't seem to be improving toward 100%. After reviewing new x-rays 2 months after the surgery, the bone is still in somewhat of a "v" position. The doctor said he improved it over 80%. We give it 20% at best by look of the CT scans. Could it still be pressing on the muscles below and causing pain and immobility?

Answer:

The strongest muscles of the jaw insert on the zygoma and this is what is causing your pain. Also, the temporalis muscle, another strong jaw elevator passes under the arch and this may also be altered due to the fracture. The coronal approach (large incision through an incision in the hair) is usually the best for secondary revision and the scar, although present is within the hair and usually very thin. The second approach with the other two incisions is quite standard as well and may be necessary to obtain good fixation. The scars in the mouth and under the eye are really very minimal. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

How long does liposuction take? Can one do legs, buttocks, and thighs at one time? What is the recovery time after surgery? thank you.

Answer:

Dear Laura, Liposuction generally takes about one hour per paired area done (like outer thighs or abdomen). The areas that you mention are safely done at one time as long as the volume removed is not too great and you are in good general health. Recovery is also based on amount removed. Usually about two weeks should be allowed for full recovery but one week is all needed for most patients.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had facial plastic surgery in 1996 with disasterous results. My doctor without my consent or knowledge liposucked my entire face and neck out. I looked dreadful; anorexic and skeleton like. Why is this mutilating procedure being taught in some of our best med schools? My doc was a med student at Loma Linda Medical School. I have had some lipostructure done in N.Y. with some success. What was done to me was criminal! J.W.

Answer:

Dear Joanne, I could not agree more. The fatty layer of the face is a sign of youth and not aging and most of us are going to very conservative fat removal if any at all. Liposuction of the face is very rarely performed by cosmetic surgeons who perform a great deal of facial plastic surgery. The place where your doctor was a medical student is much less important than where and what type of residency and fellowship training was performed. Many ENT and dermatologists perform plastic surgery and many of them do so well. Even plastic surgeons, should have extra training in cosmetic surgery prior to performing procedures - most plastic surgical residency training is reconstructive. I hope that your fat grafts take well although that is a very "iffy" procedure. There should be some soft-tissue fillers here soon that will offer some long-term help to your problem.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have had bi-latteral tmj surgery seven years ago and have not been back to a dentist since. About two and a half years ago I was in a car accident and since I have been having problems with my TMJ. Mostly I am unable to open my mouth more then 1/2". I have tried the expansion techneque used before but the pain it cause has been unbelieveable. What can I do to solve this problem.

Answer:

Is this a joke? You had surgery seven years ago and haven't been back to the dentist since;then had a car accident 36 months ago,and have problems which have gone unevaluated and untreated. What do YOU think you need to do?

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