Ear Surgery (Otoplasty) Questions and Answers

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Question:

Is there any product that you recomend to use to prep the face before having it lazered? Also, following the surgery?

Answer:

Dear Janet, Your physician should review this with you. I use a combination of a bleaching cream (containing hydroquinone) and Retin-A for two to three weeks prior to facial resurfacing and then, after a new top layer of skin has grown back, I use the bleaching cream again for as long as the skin is red. I use a special Silon face mask for the first 3 to 5 days after resurfacing to help the healing and essentially make the procedure painless.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hello, Is it possible to have a cataract return to the same eye that 2 years ago had cataract and artificial lens replacement surgery? This eye has very rapidly(within the last 6 months ) become cloudy again. Thank You

Answer:

Sometimes, the membrane behind the artificial lens can become cloudy, causing blurry vision. This can be easily treated witha laser. Andrew Caster, MD

Question:

i had a breast implant about 2 yrs ago and i was wondering how they enlarge them more if you want them larger.

Answer:

Dear Laurien, The current implants are removed, a larger pocket is created and new, larger implants are placed. This is usually less painful and easier on you than the original surgery. Most of us remove any capsule present at the time of the surgery. Drains are seldom used. The cost is similar to that of the original surgey.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

my doctor told me i have spondyloithesis please explain & what happens if not treated thank you

Answer:

Hi Emily...Here's what Medline says about it... Spondylolisthesis Definition Forward slippage of a lumbar vertebra on the vertebra below it. Causes and risks The spine is divided into 5 anatomical sections: cervical (neck), thoracic (thorax or rib cage), lumbar (the lower back from bottom of the thoracic spine to the top of pelvis), sacral (pelvis) and coccygeal (tail). Spondylolisthesis is a condition in which a vertebra slips forward on the vertebra below it. In children this normally occurs between the fifth lumbar vertebra and the first sacral vertebra and is often due to a congenital malformation of that region of the spine. In adults, the most common cause is degenerative disease (like arthritis) and the slip usually occurs between the fourth and fifth lumbar vertebrae. Other causes of spondylolisthesis include stress fractures (caused by repetitive hyper-extension of the back, commonly seen in gymnasts), and traumatic fractures. Spondylolisthesis may occasionally be associated with bone diseases. Spondylolisthesis may vary from mild to severe. It is associated with and can produce increased lordosis (abnormal anterior convexity of the spine or swayback). Symptoms may include lower back pain and pain in the thighs and buttocks, stiffness, muscle tightness, and tenderness in the slipped area. Neurologic damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down the legs. Prevention People with marked lordosis should avoid back hyperextension (leaning way back), weight lifting, and contact sports. Lower back pain, although common in preadolescent and adolescent children, should be evaluated especially in the presence of marked lordosis. Symptoms marked lordosis lower back pain localized tenderness over the spine just above the pelvis pain in thighs pain in buttocks tight hamstrings stiffness in back Signs and tests X-ray of the spine (demonstrates misalignment of lumbar vertebra, and possible fracture) straight leg raise may uncomfortable or painful NOTE: Spondylolisthesis can be asymptomatic. Treatment Treatment varies depending on the severity of the spondylolisthesis. Most patients require only strengthening and stretching exercises combined with activity modification (avoiding hyperextension of the back and contact sports). Some practitioners also use a rigid brace. For cases with severe pain not responding to therapy or if the slip is severe or there are neurologic changes, the slipping vertebra will be surgically fused. This surgery has a higher incidence of nerve injury than do most other spinal fusion surgeries. Use of a brace or body cast may be part of treatment after surgical correction of the defect. Prognosis Conservative therapy for mild spondylolisthesis is successful in about 80% of cases. When necessary, surgery produces satisfactory results in 85 to 90% of people with severe, painful spondylolisthesis. Complications compression and transient or permanent damage of spinal nerve roots chronic back pain Call your health care provider if your child’s back appears to curve excessively, if the child complains of back pain or stiffness, or pain in the back, thighs, and buttocks. Update Date: 5/24/2001 Hope this helps.. Julie Adinolfe RN

Question:

All my life i have had a large raised mole on my nose. It is about 6 millimetres all the way around and i hate it. It makes me feel unattractive and whats more i often worry that one day it may become cancerous. My mum says because i've had it all my life it'll probably be fine because its sort of like a birth mark, but that still doesn't solve that fact that i hate the way it looks. Whenever i meet someone new i can always tell that they are looking at it and it makes me feel selfconsious and embarrased. Because its so big would it be possible to have it removed? would i need plastic surgery? the thought of a big operation really scares me.

Answer:

Dear Sarah, You mother is right and there is only a slight chance of this becoming a cancer, however, appearance is very important and I understand how you would like it removed. The procedure would not be a big one but that area is particularly difficult to remove a largish lesion from without special techniques. I would suggest that you visit with a plastic surgeon in your area to discuss the options. Unfortunately, lasers, dry ice, etc. will not permanently remove a mole and so surgery is necessary.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have a couple of questions wrapped into one. When I was younger, I had pretty severe acne which left me with many scars on my face. Some of them are purplish, and others are what look like little "pits". Although they've faded quite a bit, I still find them hard to look at in the mirror each morning. What is my best bet to get rid of them? Also, I've noticed that I've been developing more facial hair (which I find disgusting) and it's to the point that I can't handle plucking and waxing anymore. I've heard of laser hair removal-what is this exactly? Is it painful? Is there any kind of miracle treatment that will cure me of my scars AND hair? If not, which should I try to clear up first? Approximately how expensive are the treatments? Any advice is greatly appreciated.

Answer:

3 of the best choices for the acne scars would be laser resurfacing with either a carbon dioxide or an erbium yag laser, surgically removing the scars and then having a more superficial laser such as photorejuvenation, mild peels or microdermabrasion, or having treatments with the Cool Touch Laser. You need to find a laser specialist and aesthetic dermatologist. I would go to the American Society for Laser Surgery and Medicine website www.aslms.com and they have listing of their members in all geographic locations. Your hair, if dark, would best be removed by a laser as well (unfortunately a different one than we use for scars). The most expensive option is laser resuracing which would probably run more than $2500 for a full face. Most of these solutions for scarring will probably run into the $1000 range. But it would be better to consult with an experienced aesthetic dermatologist and laser surgeon to determine what it best for you. Good luck!

Question:

As a child I developed a sever underbite which required extensive surgery. Unfortunately I had to wait until I was 17 to have this done, and my childhood was miserable with teasing and tormenting. Now my 6 yr old is developing hints of an underbite. Is there anything I can do at this point to help him? Is it preventable? Or treatable before near adulthood? Please reply as soon as possible as I am very concerned for his well being in the future.

Answer 1:

the severity will determine if any procedures are warranted at his young age. Generally, nothing is indicated at this time since his growth is not complete. The lower jaw does lag behind the upper until the teenage years and there is no way to predict his growth pattern. Surgery at this time may only mean additional procedures in the future. If the only concern is cosmetic and your son has no other problems associated with the size of his mandible (ie: breathing abnormalities, tongue obstruction), the best treatment is no treatment at this time. If you are still concerned, consult an Oral & Maxillofacial surgeon in your area. I do understand your concerns and if your son does experience these terrible things that kids can do, consuling and reassurance on your part is the best starting point.

Answer 2:

There are no surgical treatments available for a 6 year old, but a Board certified Orthodontist could help you get started in the right direction.

Question:

I have moles on the face. Is it possible to have them removed and not have scars?

Answer:

Dear Kate, If they are true moles (intradermal nevi), the answer to your question is no. They have a root and unless this is removed, they will recur. If they are removed adequately by laser or surgery, a scar will result. I have found that, on the face, it is better to surgically remove the moles since the scars are better, finer, etc. when the procedure is performed surgically.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

If one nostril is lightly distorted from the other, would the process of getting it fix be plastic surgery? Or if the center piece of the top lip is completely gone because of being dry and peeling and once was there would the process of getting that fix be plastic surgery?

Answer:

Dear Takia, The correction of nostril distortion is performed by plastic surgeons.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am 35 years old and considering have breast augmentatin again. I had it once after my 2nd child in 1989. I went from an A to a C cup. The saline bags are behind the muscle. I've since had a 3rd child and my breast seem to have gotten smaller. I'd like to have a D cup. I have very large noticable blue veins in my breasts. One question, is this because of the implants? If I have another surgery to make my breasts larger will it make the veins more noticable? Is there a way to have these veins removed? At the same time as augmentation? Also, does the procedure usually cost the same to have the surgery done the 2nd time?

Answer:

Dear Kim, We often see large veins after augmentation and sclerotherapy of them works very well. This is an injection and not surgery. Regarding your breasts, it is hard to know how much droop (ptosis) there is and if a lift is needed but, often, after this long it should be considered. Usually the natural contours as well as the ability to see and feel the implants decreases as the size increases. The cost is usually more for a second procedure although just exchanging implants to a larger size costs less.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

What do you know about "neck banding"? Is botox used for this?

Answer:

Dear Deborah, Vertical neck bands are caused by a division between the large platysma muscle which supports the skin and soft tissue of the neck. The best repair for this is directly reappoximating this muscle with or without an associated removal of excess skin and resuspension of it (facelift). If surgery is not desired, the central muscle can be weakened with botox so that the bands do not stand out so definately. After performing the botox procedure a number of times, both my patients and myself do not think that it helps very much ( maybe 10 to 20% ).

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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