Ear Surgery (Otoplasty) Questions and Answers

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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:

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

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.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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

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

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

Question:

Are the methods for breast enlargement other than surgery(i.e., creams, other methods) worthy of my time? Meaning--do they work? If so, what do you recommend?

Answer:

Dear Jennifer, They do not work. I have had literally hundreds of patients who have tried all of these and none have found any effect other than to lighten the billfold. Sorry that the answer is not that easy.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

My brother had a tripod fracture or broken zygomatic Arch (cheekbone). We went through the first surgery of trying to "pop" the bone back in place. this was unsucessful. Is there a way to put in an implant to correct the apprearance of the cheekbone? What type of material would be used and what would be a ballpark figure on the surgery?

Answer:

Dear Melisa, The popping out procedure, when it doesn't work, is usually followed by actually re-breaking the bone (if necessary) and repositioning it forward using tiny plates and screws. A good craniofacial surgery should be able to help you in this regard. An implant is rarely necessary.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Iam a 54 year old male. Currently I wear acuvue 2 soft lens BC8.3, DIA14.0, -7.00. Iam considering lasik surgery and have recieved a few recomendations. One says the surgery could be done with the Visx star 2 laser, while another recommends the new Bosch & Lomb laser. Iam confused and question which laser will give me the best results taking into consideration my current eye sight. Please advise.

Answer:

We have researched this. Our findings are based on clinical outcomes. We chose the VISX S3.

Question:

During childbirth 2 years ago I had a 4 degree tear which was improperly stitched. I now have a fistula between my vagina and rectum, which causes stool to come out of my vagina. I have had a reconstructive surgery in my vagina (which didn't work), the second surgery was to stitch the fistula (which also didn't work). I need to know if there is anything out there that will fix this, that maybe the doctors in this area might not be familiar with.

Answer:

In California, I would contact Dr. Gordon Gunn or Dr. Charles Ballard. Both are pelvic surgery specialists and will be able to give you your best shot at cure. Dr. Gunn is in private practice in Fulleron (714) 447-4800; Dr. Ballard in on the faculty at USC School of Medicine and can be reached at (323)226-3416. Good luck.

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