Ear Surgery (Otoplasty) Questions and Answers

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Question:

I have 2 questions: 1. My daughter who is nearly 7 years old, has inherited Class III, skeletal malocclusion. Two out of three orthos we've consulted recommend starting treatment right now. Treatment would consist of expanding the upper arch and the use of a chin cup with anterior traction to upper teeth. We've read studies that indicate that in the short-term results from this treatment are very effective but that long-term, growth of the lower jaw can resume, in adolescence. What is the success rate for permanent treatment of class III at an early age? Can early treatment lead to greater problems later on to correct additional growth at a later age? Do you recommend treatment at this age? 2. My other daughter who is nearly 9 has excessive overcrowding. Two orthos we've consulted recommend we wait until more adult teeth come out. One ortho recommends the extraction of 7 baby teeth and the use of a space maintainer to allow more room for the adult teeth. Do the baby teeth not already act as a space maintainer, therefore making this apparatus unnecessary? Is there a chance that her jaw will develop normally allowing room for all her adult teeth? What do you recommend? Any info. you can provide would be greatly appreciated, as we are a little confused given the differences of opinion. Thank You

Answer:

1) Class III malocclusions are very difficult to correct. If the discrepancy between the upper and lower jaw is too great, jaw surgery in combination with orthodontics is required to achieve a correction. Consequently, children in the 7 to 9 year range who demonstrate class III growth are frequently treated to re-direct this unfavorable growth. I treat each patient individually addressing their specific circumstances. Sometimes I do begin treatment at 7 years of age. 2) While I can't diagnose a patient without seeing him/her, generally the space for the permanent teeth in front of the first permanent molars has been determined as soon as these molars erupt. There are appliances available to expand the dental arches to some extent. Although all orthodontists have similar goals for the patient, the method of achieving those goals can vary from orthodontist to orthodontist. Sometimes there can be a significant variance in the treatment plan.

Question:

I am 16 and have the dreams of becomming an Air Force pilot. I have been reading up on the qualifications and found out that pilots can have no history of corrective eye surgey. I was wondering if there are other ways to correct vision. I don't think that my eyes are that bad, I used to have perfect vision then one day I found that I could not read the black board from the back of the classroom. Please tell me that I have a chance of my eyes getting better without surgery.

Answer:

Dear Stefanie, It is most unusual for myopia to get better rather than worse. If you are far-sighted, this may improve. Sincerely, Alexandra Chebil M.D.

Question:

My Aunt, 88 years old, has retina degeneration. Recently a doctor gave a speech about a new "air" surgery treatment that some of her friends attended. She now thinks that she'll be able to see well enough to drive a car again. What can I find out about this new process? Is this something that she should be so excited about?

Answer:

I am not sure that I know what you are talking about. Could you get more information. The specific name of the procedure would be helpful.

Question:

Dear sir, I am considering having lasik surgery done to clear up my astigmatism. I read that if I have a certain type of vision problem, that often when a person gets older and starts to lose his vision do to age, the two problems being the oposite of each other balance themselves out. If I have this certain type of vision problem and have lasik surgery done, then when I get older and start to lose my vision due to age, the two problems will not balance each other out because I would have already eliminated one of the problems. Therefore I will be left with a vision problem due to old age and once again continue to have to use glasses. The story I read did not explain exactly which vision problem it was that balances itself with age so I can check if it is the problem I have. Is all this true? Can you explain a little more in detail how this balancing process works and if i'm better off waiting ? I'm 31 years old now. Thank you very much. Tobias Maes

Answer:

If astigmatism is your main problem, and if you need glasses for most or all tasks at distance and near, then you are not losing much. Presbyopia affects everyone ~40 y/o and gets worse with age. You will have to deal with it wether you have LASIK or not. People with low amounts of myopia (with little or no astigmatism) can take their glasses off to read. Those people need to understand that having their distance vision corrected means they will need glasses for reading. The best way to decide is to think about when you would prefer to wear glasses.

Question:

I wore braces on my teeth for three years. After removing the braces I am still not satisfied with my teeth structure, and food gets stuck in the roof of my mouth when eating. I have a lot of gum over my upper teeth and this causes my mouth to protrude thus giving me a very ugly profile. I am forty years of age. Am I too old to have maxillofacial surgery? What do you recommend?

Answer:

No you are not to old for maxillofacial surgery. However the more important question is will maxillofacial surgery help you. I would sugest that you discuse your concerns with your orthodontist and seek their referal to a qulified surgeon. Good Luck

Question:

I am very nearsighted, with healthy corneas. How nearsighted can one be and still be a candidate for corrective surgery ? How safe is it, and can I wear contact lenses afterward in the event my vision cannot be corrected to 20/20

Answer:

Thank you for your email. We can treat up to -12 glasses with lasik. The procedure is very safe and most people can still wear contacts after, although I usually recommend a re-treatment if you are not satisfied with your vision. Sincerely, Alexandra Chebil M.D. The Lasik Center

Question:

Will this be a permanent change to my vision? Will my vision change back or get worse? Typically what will the surgery cost for both eyes with myself being nearsighted and having an astigmatism?

Answer:

Yes, but other factors (cataracts,etc.)can influence your sight in the future. LASIK typically costs around $4500. total for both eyes.

Question:

I am thinking of having breast augmentation done. I would like to go from a small 34B/C to a 34 D cup. I run for exercise and I'm wondering what you suggest for patients who have breast augmentation and run for exercise. Will I still be able to run? Will it be hard on my body and my new breasts? Will they sag if I keep running? Thank you for your time.

Answer:

Patients who run for exercise should continue to do so after their procedure, and should wear a good supportive jog/exercize bra. You may have some discomfort when you first return to running (around 3 weeks after surgery). Your breasts may "sag" whether or not you continue to run.

Question:

My daughter needs orthodontic treatment. The orthodontist is recommending surgery to expand her top jaw and shorten her bottom jaw. Is this common? What alternatives are there to surgery? I do not notice a severe underbite when I look at her. My daugther is currently 12 1/2.

Answer:

Although I cannot diagnose a patient with seeing him/her, in general at age 12 expansion can be accomplished with a non-surgical approach. Another factor to consider is the severity of the problem and how much expansion is required. If a child of 12 has a disproportionately large lower jaw sometimes a trial non-surgical approach is recommended. Lower jaw growth usually continues until the bodily growth is complete. So if the patient has surgery at 12 years of age, he/she could outgrow his/her treatment. Talk to the orthodontist about your concerns. If you still dont feel comfortable with his/her advice, get a second opinion.

Question:

Dear Dr., My 3 year old daughter has an open bite. We have been reffered to an oral surgeon and told that surgery would be required. Are these procedures usually preformed on children of this age and if so, how does this affect future bone growth and development? Also, could you help me find more information about Le Fort I osteotomy on the web to help us better understand this procedure?

Answer:

The correction of an open bite is often done with a Lefort I osteotomy. The majority of the patients that undergo this procedure are older than 15 years old enless they have been diagnosed with a facial syndrome that requires a staged surgical correction. In these patients the final effects on overal growth and developement is unclear because of their underlying condition. For this reason I would be perfectly clear about your childs long term treatment plans as well as the primary diagnosis. Once you know this information you will be able to make a much better decision. For additional information about Lefort I osteotomies I would reccommend researching these key words on the web and at your local public library. Orthognathic surgery Craniofacial surgery Jaw corrective surgery good luck

Question:

my 7 year old daughter has one 6 year molar that did not come down-- the dentist thought it might be connected to the bone-- may need oral surgery-- any comments-- what is this procedure like?? any suggestions

Answer:

I would recommend that you seek the advice of an orthodontist before considering any surgery. Your orthodontist may be able to identify the problem if their is any and many times in conjunction with a surgeon they can help bring an impacted (in the bone) tooth into the correct position in your daughters mouth. Good Luck

Question:

I have a scar on my forehead and some wrinkles what is the best surgery i can make? I'm 39 years old and what may be cost of that kind of surgery?

Answer:

Where the wrinkles are in your forehead will determine what type of surgery is needed to correct them, and the cost, but probably you will require some type of forehead lift. Similarly with the scar. I would suggest you go to a plastic surgeon for a consultation. Hope this is helpful. Carmen Paradis M.D.

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