Ear Surgery (Otoplasty) Questions and Answers

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.

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.

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.

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 1:

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?

Answer 2:

See your surgeon.

Question:

I had RK surgery done in February of 1993. Now my vision is starting to change. I know it will not correct my vision for reading, but my distance vision is getting worse. Is there anything that can be done or do i have to start wearing glasses again?

Answer:

LASIK can be performed on patients who had RK in the past. Andrew Caster, MD

Robert Joseph, MD
Danville, KY

Question:

I am interested in having liposuction to my stomach. I have read that good skin elasticity makes you a good candidates, but what determines that? What is the cost for this surgery? Thank you in advance for your prompt response.

Answer:

Dear Danita, Skin elasticity is all important in the liposuction procedure since you do not want to have a large amount of excess skin present after the procedure. Sometime if the skin is in excess and not very elastic, tummy tucks, thigh, buttock, etc. lifts need to be performed. The cost for abdominal liposuction is determined by the amount of fat needing removal and the operative time. Usually you would be thinking of spending from $3000 to $6000 for this procedure.

Question:

One of my breasts is larger than the other, is there a way to even them out with out cosmetic surgery such as excercises?

Answer:

Dear Shannon, No that is not possible. Usually uneven breasts require either reduction of the larger one, enlargement of the smaller one, or some form of reshaping on each. There are also a number of breast deformities such as tuberous breasts which require special treatment. I know that the prospect of surgery is not great but I would suggest that you visit with a qualified plastic surgeon to discuss the options. This type of surgery often yields the most pleased patients we have.

Question:

I am a 31yo male with pectus carinatum. I have been to two thoracic surgeons for evaluation. One recommended a surgery that would leave a "V" shaped scar on my chest that follows my inferior rib cage; and the expected hospital stay would be 4 days. The 2nd doc said I would have a short vertical scar over my sternum, with a 1 day hospital stay. Neither one does many of these surgeries (2-4 per year). Both recommended removing my xiphoid process, and the extra cartilage around the xiphoid. 1. Is one procedure better than the other? 2. Would a plastic surgeon have more experience in repairing pectus carinatum?

Answer:

Dear Mike, Both plastic and thoracic surgeons routinely perform this procedure but the number of cases nation-wide is not huge. I would suggest that you visit with the plastic and thoracic surgical departments in a large tertiary center such as the Mayo Clinic, Cleveland Clinic, etc. to find those with the most experience. Also, pediatric specialists may have slightly more experience since the severe cases are often done at earlier ages. It sounds as though the second procedure is placement of an implant. This is an easier method but will not help if you have any functional problems with breathing, your heart, etc. There are also problems of extrusion, infection, etc. with using foreign materials. The first procedure sound like one where your own bone is being altered to reshape your chest. I personally think that this is always a better way of going for all but the smallest of defects. Hope this helps.

Question:

I have worn gas permeamble contact lens for 20 years. For how long should I not wear them before surgery?

Answer:

The general rule is: one month without gas-perm lenses for each decade of use. Andrew Caster, MD Beverly Hills, California

Robert Joseph, MD
Danville, KY

Question:

I'm 31 y.o. For few years I couldn't concieve, because my husband had many problems of sexual dysfunction + only 0.1 ml semen volume + < 5% functional sperm cells. My doctor put me on clomid and we tried one cycle of IUI, which didn't work. Following the clomid I developed a polyp in the uterus. Now my doctor wants to do hysteroscopy to remove it + diagnostic laparoscopy in general anasthesia. My questions are: 1. Is it possible to go on with the IUI without removing the polyp? I'm a little scared of the surgery. 2. Does it make sense to go through the laparoscopy, in spite of the fact we have enough reasons to explain the infertility (the male factor)? 3. Later on, is it really necesaary to use the clomid, when no ovulation problem was diagnosed, and it may cause additional damage as another polyp? Thank you.

Answer 1:

Dear Ronit The polyp needs to be removed. The paraoscopy is plus/minus. However, you are wasting your time with clomid and IUIs. It seems to me (with the info on your husband's semen analysis) that you need to have IVF with ICSI since his sperm is so weak. Why don't you discuss this with your doctor (is he a board certified reproductive endocrinologist?). I can only go with the info you gave us, so I cannot make a comment on whether your doctor is doing the right thing for you. Good luck

Scott Urban, MD, DMD, PC
West Jordan, UT

Answer 2:

Hi Ronit, You need to IMMEDIATELY see a Board Certified Reproductive Endocrinologist. If your partner's sperm is truly as bad as you make it sound to be, it really seems to me like you've been wasting your time with a doctor who is not a true infertility specialist. Since you're located in our tri-state area, you're welcome to come here for an opinion by a qualified RE - otherwise, you should see an RE in CT ASAP! Hope this helps! Dr. Roseff, Director W.E. C.A.R.E. in NJ Visit us at http://www.reproendo.com

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

Next Step

• Learn about Ear Surgery (Otoplasty) in the Articles Section
• Ready for a consultation? See qualified Facial Plastic Surgery doctors in your area

Advertisement

• Doctors in Your Area | 
• Research Your Procedure | 
• Finance Your Procedure | 
• Recommend Your Doctor | 
• Doctors Only

• Home | 
• Site Map | 
• Site Search | 
• Help | 
• About Us | 
• Feedback | 
• Advertise With Us

• Add a LocateADoc.com Doctor Search to Your Web Site | 
• Conditions of Use | 
• Privacy Notice