X-rays on children must be read very carefully. Subtle fractures can be missed easily due to the presence of epiphyseal plates (growth plates).
Clicking following an injury may represent an early "trigger thumb". This happens when the tendon swells and clicks within the sheath.
These issues may spontaneously resolve. Children are very resilient. They can bounce back from many injuries, but close follow up is important

Jason Hess, MD, FACS

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Juvederm Ultra Plus is slightly more viscous than its predecessors. It is thicker, and takes slightly longer to reabsorb.
The difference is subtle, but it will last slightly longer than other fillers. Conversely, it must be used with caution by the provider. Small lumps or bumps require a more vigorous massage to maintain an even fill.
Good luck!!

Jason Hess, MD, FACS

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Unfortunately, there is no way to really remove a scar altogether. there are was to improve a scar, but no method of simply erasing it.
The best method to my knowledge is scar revision. Unfortunately, with scar revision, results are often worse before they are better. A scar revision involved meticulous excision of the scar. Then, it is meticulously repaired, generally in layers. A multi-layered repair removes tension from the surface of the skin, and may yield a thinner, lighter scar, but it may take nine months to achieve optimal results. Optimal results are achieved through surgery, and with meticulous committed after-care including silicone gel or silicone strips following surgery.
Good luck!!

Jason Hess, MD, FACS

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Shin splints generally follow running or vigorous exercise. Shin splints are manifestations of fasciitis. Fascia surrounds muscles. Fascia becomes inflamed with rigorous exercise.
It is difficult to know whether you are experiencing this. It would help to know when these issues occur.
Do they only occur on long walks? Does it occur every day? Is the pain in the joint or the anterior tibial regions?

Jason Hess, MD, FACS

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Probably not an issue.
Obviously keep the area clean.
Sometimes doctors ask their patients to take "sitz baths" following surgery.
This will help to keep an area clean following surgery as it heals.
It would be wise to contact the physician.
Good Luck

Jason Hess, MD, FACS

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From your age, it appears as though you have experienced these symptoms for more than half of your life.
You may be experiencing some vascular phenomenon. Vessels dilate with histamine release and other factors.
Urticaria is also caused by histamine release. This is a difficult syndrome to evaluate without witnessing it. Also, it may be helpful to keep notes of exactly when these symptoms occur and what causes them. Then, when you see a doctor, you can present more information and arrive at a diagnosis.
Good luck

Jason Hess, MD, FACS

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You may be experiencing a seizure disorder. It could also be related to electrolytes, but this would be extremely unusual.
I would begin with a visit to your primary doctor. Primary doctors are great generalists. They can sort out problems and refer to the appropriate specialist, if needed. Additionally, a neurologist may help. There could be a cerebral vascular issue, but this is also very unlikely

Jason Hess, MD, FACS

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Eating disorders, when they truly exist, are potentially fatal in the long run. But these are psychiatric ailments and are treatable.
Surgical weight loss is not a cure for eating disorders.
However, when obesity is an issue, surgical weight loss may be the answer. Sometimes sleeve gastrectomy or Roux and Y gastric bypass will help with weight loss. These surgeries are designed to help patients with a high BMI and comorbidities from obesity. Comorbidities are health conditions that are enhanced or caused by obesity including diabetes, hypertension, arthritis, etc.
At 24, you are young and may be able to lose weight through diet and exercise. This is, by far, the healthiest means of weight loss.
I would begin with a visit to your family doctor. These doctors can help to sort out issues.
Good luck!

Jason Hess, MD, FACS

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Chin implant and rhinoplasty are often performed together.
These surgeries help to improve projection and profile. Doctors sometimes refer to a cephalometric analysis to complete this goal.
Cephalometrics are measurements of facial projections that help to determine what "normal" means with respect to nose and chin projection.
https://en.wikipedia.org/wiki/Cephalometric_analysis
What is too small or too big is sometimes not certain, so measurements sometimes help.
Also, it is important to understand dental occlusion. Upper teeth and lower teeth should meet in a "normal bite". A normal bite usually includes a few millimeters of overbite of the front teeth.
The reason these assessments are important is they help to decide whether a reasonably sized chin implant is appropriate or whether another surgery may deliver a more optimal result.
I would recommend seeing at least 2 plastic surgeons to assess your nose.
This may improve your overall profile. I am not a fan of fillers for chin or nasal improvement because they are temporary. However, Radiesse lasts over 1 year and may help you and your physician to decide whether more projection will improve your appearance. Later, you can transition to an implant revision if desired. Some patients who believe they would be improved by a chin implant really need a mandibular advancement or other orthognathic surgery. Orthognathic (maxillary / mandibular surgery) like all surgery, should be carefully considered, but is sometimes an option.
Good luck!!

Jason Hess, MD, FACS

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Your complaint may be addressed with a good history and physical examination. Imaging may be required. If pain is associated with your symptoms, surgery may be an option. However, if it is painless, it may be prudent to avoid surgery. As a general rule, my philosophy is: "If it ain't broke, don't fix it". Additionally, as physicians, we should adhere to the Hippocratic Oath; "First do no harm." I would seek a consultation with at least one cardiothoracic surgeon. Good luck!!

Jason Hess, MD, FACS

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It sounds as though you have had a ventral hernia repair?
Surgery of the abdomen is expected by be quite painful. In particular, repair of hernias generally requires sutures in the fascia.
The fascia is highly innervated. This means that surgery of the abdominal wall generally results in a lengthy recovery. Pain may be expected for weeks after surgery, but each patient is different. I generally begin post operative abdominal pain treatment with vicodin, percocet, or tylenol III. These are opioids combined with tylenol. However, opoid pain medications are widely known to cause constipation.
Thus, it is wise to gradually minimize the use of opioid pain medications and to transition to non-narcotic pain relievers such as ibuprofen. This is assuming you have no contraindication to the use of ibuprofen such as an allergy, GERD, or ulcer.
Good luck

Jason Hess, MD, FACS

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A turbinectomy can be recommended based purely upon a good history and physical examination. However, most plastic surgeons and ENT doctors prefer to assimilate as much information as is possible prior to surgery. A CT is a good adjunct to evaluate airway potency (this means to check the narrowing or opening of the nasal airways in addition to the curvature of the nasal septum). A "recent" CT may or may not be necessary. An older exam may also work if it has been done. IT is generally rare for a physician to "demand" a procedure. If you do not trust your physician's judgement, consider a second opinion. It may seem costly or inconvenient, but nasal surgery is complex. The more information that you can acquire, the better. If you have seen a prior ENT or have undertaken a prior nasal surgery, these records should be provided to your current or future provider.
Good luck!!

Jason Hess, MD, FACS

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It sounds as though you must have had cardiothoracic surgery?
Drainage tubes are common following surgeries that leave a potential empty space beneath the skin or in another body cavity.
Our bodies do not "like" empty spaces.
Seromas or hematoma may accumulate.
Drains prevent seromas. However, scarring or adhesions may result following nearly any surgery.
This scarring may lead to pain or other issues. Additional, damaged nerves may create a scar or neuroma.
These neuromas may result in intermittent pain. It is rarely permanent. The pain is not necessarily normal, but it is not unusual. You could consider re-visiting your physician. Physical therapy may help with symptoms, but it is far out from surgery to be effective.
I hope this helps.

Jason Hess, MD, FACS

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The skin margins look red and separated. What has really happened with the incision is a wound dehiscence.
This means that the surgical excision site opened. The yellow material that is present is known as fibrinous exudate. http://www.advancedtissue.com/exploring-different-types-wound-exudate/
People often mistake this material for pus, but it is not pus.
Thankfully, this wound will heal without further surgery.
It can be treated simply with wet to dry dressings.
The dressing is dampened with saline and the wound can be covered with this dressing once daily. Or it can simply be left open. It may take 3 weeks to heal. It may leave an unfavorable scar.
However, do not be discouraged. It will heal with time. And an unfavorable scar can be revised. Good luck!

Jason Hess, MD, FACS

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I hope that your symptoms have recovered. One week following surgery is likely too early to be completely symptom-free. An over the counter antacid may help.
If symptoms persist, I would recommend communicating with your doctor. There are very potent non-prescription antacids today including prilosec. But, the likelihood is that your symptoms will resolve with "tincture of time".
Good luck!!

Jason Hess, MD, FACS

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I would keep in close contact with your physician. There are many expected symptoms following surgery. These include pain and "tightness" in the surgical area. Swelling and some redness are also common in the immediate post-operative period. However, difficulty breathing is not normal following hernia surgery. Is it possible that you had some difficulty breathing before surgery?
Best of luck!

Jason Hess, MD, FACS

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You may have diastasis recti (separation of the abdominal muscles) or a recurrent ventral hernia.
The good news is that both of these issues are repairable.
Sometimes, a very large intervention is required. Sometimes, Something smaller like an implantable mesh may be required. A reconstructive surgery called a component separation technique may be the best option.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205369/
If you have not yet had a CT scan, this would help you physician to define the anatomy of you muscle and fascia. The fascia (a layer overlying the muscle may be partially released to help to repair the problem if it is indeed a hernia. Good luck!

Jason Hess, MD, FACS

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Congrats on your surgery. It sounds as though you have bounced back quickly given the fact that you are in the gym. I do not perform gastric surgery. However, this surgery can be done under epidural anesthesia.
Epidural anesthesia is sometimes followed by headaches; these traditionally resolve on their own. However, I suspect that your surgery was done under traditional general anesthesia. You may have some minor electrolyte or other issues, but these will most likely resolve without any other issues.
Good luck!

Jason Hess, MD, FACS

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Pain is normal following surgery. Every surgery is different and every patient is different. In general, I tell my patients that the first 3 days following surgery are generally the worst. However, some patients complain of minimal pain following surgery. Others take a bit longer to recover. I hope this helps

Jason Hess, MD, FACS

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Two weeks following a procedure is far too early to consider this a long term result. I would recommend keeping in close contact with your physician.
He should be able to help you to maintain the appropriate topical ointment on the wound if necessary. Scars require approximately 6-9 months to evolve. If the final scar is unacceptable, it is relatively easy to improve. This would require scar excision and revision, but it is far too early to consider this options. "Mother Nature and Father Time" are the best options for now. Good luck!!

Jason Hess, MD, FACS

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In general, a scar such as yours may be improved with scar revision. This generally entails removing a scar with a scalpel and repairing the skin edges. It may be prudent include a picture here or to include dimension of the scar. The difference from a revision and the initial trauma is that the wound can be repaired in layers meticulously, and the edges of the skin can be carefully re approximated. Scar tissue has no sebum or sweat glands. It is simply unstable fibrin and skin components. Skin contains many small sweat and oil glands to help preserve its texture, tone, and moisture. It may be wise to meet with a physician for scar revision.
Good luck!!

Jason Hess, MD, FACS

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I appears as though the cut healed into a small scar. Scars continue to evolve for up to 9 months following an injury.
Thus scars can be painful, red, and tender for months following a scar. In large injuries, nerves may be injured and nerves themselves may scar into painful neuromas. This does not appear to be the case with your injury as it usually occurs with larger injuries. My best recommendation for your injury is to simply give it time.
Sometimes topical silicone gel or strips help in the immediate period of scar development, but I do not think they would help much now.
I hope this helps!

Jason Hess, MD, FACS

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I generally use submuscular high profile implants. Submuscular approach ensures preservation of the natural contour. "Teardrop" or form-stable implants are now manufactured by mentor, sientra, and allergan. These implants do indeed provide upper pole and additional lower pole fullness. If your physician has experience in these implants, they may provide a favorable, natural look when placed precisely in meticulously dissected retropectoral pocket. However, if there is any rotation of the implant or if it implanted even slightly off-center, it will be obvious in your outcome. Round implants are more forgiving in there results. I hope this helps!!

Jason Hess, MD, FACS

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This sounds like a hemmorhoid. This lumps often occur in patients who have been constipated frequently or in women who have had children or are pregnant. There is no substitute for a physical exam by an experienced doctor. With a good history and physical, a diagnosis could be made likely with no further testing. At the age of a 19 year old male, the likelihood of this being a serious medical issue is small, but I will still recommend having this lump examined. Good luck!

Jason Hess, MD, FACS

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The four cardinal signs of inflammation—redness (Latin rubor), heat (calor), swelling (tumor), and pain (dolor)—were described in the 1st century ad by the Roman medical writer Aulus Cornelius Celsus. A small amount of swelling follows nearly any invasive procedure. Antiinflammatories help with this. These include NSAIDs (Non steroidal anti inflammatories). Aspirin, ibuprofen, and other over the counter medications work for minor inflammation. Ice is a non-invasive anti inflammatory that can help within the 1st 24 hours following a procedure.
Arnica is a homeopathic anti inflammatory. A modest amount of swelling following nearly any procedure or injury is almost unavoidable.
Tincture of time will almost always help.
It is important to keep in touch with your physician. Different doctors have different protocols to manage swelling. Some would not recommend over the counter anti-inflammatories.
I hope this helps

Jason Hess, MD, FACS

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I would keep an open line of communication between you and your orthopedist and/or podiatrist. Edema is a sign of inflammation. Inflammation is part of healing, but sometimes anti-inflammatories such as NSAIDs or Tylenol may help to moderate the effects of inflammation. However, these medications are contraindicated in some patients and certain health conditions.
I hope this helps!!

Jason Hess, MD, FACS

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First, I would check with your insurance provider to find a good referral in your area. Additionally, I would recommend checking with your friends and family members to find if they have any recommendation for an orthopedist who has treated them well.
Additionally, primary physicians are a great source for referrals.
They see patients both before and after surgery, so they are aware of patient experiences and patient outcomes with relationship to providers. When you find a good physician, it would be beneficlal to review the imaging.
This way, you may know what is being corrected and what the best expected outcome will be. It is best to visit the risks, benefits, and alternatives to surgery prior to embarking upon treatment. Good Luck!

Jason Hess, MD, FACS

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Sorry to hear you are unhappy with your rhinoplasty results.
Rhinoplasty is widely considered to be one of the more difficult of plastic surgical procedures. However, optimal results can be achieved. It simply requires planning, an experienced surgeon, and an open line of communication between you and your doctor. Some things can clearly be achieved with plastic surgery. Some cannot. It is difficult to know what outcome you have sustained, but I would guess you have a collapse of the external or internal nasal valve. This means that you may have lost stability in the opening of your nasal airway.
If you forcefully inspire and sustain a collapse of one or both nostrils, this would indicate stenosis or narrowing of the nasal airway. This problem can be easily evaluated on a physical exam. It can be repaired with a graft, possibly from your ear cartilage. I hope this helps. Contact me if I can be more helpful

Jason Hess, MD, FACS

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I prefer to perform rhinoplasty under general anesthesia. I find this surgery to be time consuming and potentially painful.
However, every surgeon exercises techniques with which they have had the most success.
Facial plastic surgery is often performed under oral or IV sedation. I have had colleagues perform various surgeries in this manner. Additionally, facelift surgery is often performed in this manner.
However, rhinoplasty sometimes requires osteotomies, which are broken bones. This can provoke anxiety. There are benefits and risks to every surgical approach. Thus it is important to disccuss these concerns with your doctor.
Good Luck!!

Jason Hess, MD, FACS

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I would keep in close contact with good communication between you and your surgeon. The general consensus is that rhinoplasty surgery is challenging. In general, cartilage is cartilage. The properties differ only modestly depending upon the donor site. The reason that rib cartilage may be sought is that plenty of this cartilage is available. Rib cartilage is often used when other donor sites have been exhausted or when large amounts of cartilage are needed. Additionally, rib cartilage is thick and robust. However, there is pain and scarring associated with harvest of rib cartilage.
I generally choose cartilage from the conchal bowl of the ear when the septal cartilage has been previously harvested. However, the conchal cartilage is often curved, and is not as desirable when long, straight, stiff cartilage is needed. This conchal cartilage is ideal for an alar batten graft to bolster the valve of the nostril open.
Give the repair time. I hope it will resolve without further intervention

Jason Hess, MD, FACS

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I ask my patient to wear internal nasal splints (Doyle splints) for 3 days following surgery. I also ask that they wear an external nasal splint for approximately 10 days following surgery.
They are then free to exercise in non-contact situations. This means no soccer, softball, etc. Treadmill and lower body exercise is generally permissible at 1-2 weeks following surgery, but every surgeon is different. I hope this helps!

Jason Hess, MD, FACS

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I have seen buttock augmentation patients who have had the procedure done both legally and "illegally". Implants are generally used for the legitimate procedure. Injections are generally used when the augmentation is performed by non-physicians. Free silicone injections risk encapsulation, granulation, infection, and/extrusion.
You may be currently asymptomatic, but it would be a good idea to have a board certified plastic surgeon evaluate your results. Good luck!

Jason Hess, MD, FACS

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This is a good question. When people are diagnosed with an ailment, it is typical to experience emotions from denial, anger, hopelessness, acceptance, and others. People often lose faith in traditional medicine and sometimes even seek homeopathic remedies. Cystic fibrosis is not my area, but I did study molecular genetics in college and pondered genetic therapy for other diseases. This is a very difficult question to answer. There are countless laboratories and scientists studying therapeutic options for cystic fibrosis throughout the world.

https://www.cff.org/Our-Research/Our-Research-Approach/

One of the reasons that restriction enzymes are not used to repair human genes is that these enzymes must be introduced into cells that live in the patient. As you may know, the enzymes would be required to affect only the cells and genes that are responsible for the disease. One specific difficulty is the delivery of the enzyme specifically into the affected cells. This can sometimes be done using a "viral vector". This means that a cold virus, for instance, can be genetically engineered to deliver genetic material into cells. However, genetic engineering and selective "in vivo" cell infection are theoretically possible. However genetic errors lead to mutations. And a genetic mutation is what led to cystic fibrosis.
There have, indeed been attempts at gene therapy with cystic fibrosis. However, it appears that improvement has thus far been modest. To learn more about this, I would recommend a PubMed website search. This is far more potent than a Google search for medical issues.
I found this article. It details a gene therapy study that demonstrated modest improvement in CF patients:

Repeated nebulisation of non-viral CFTR gene therapy in
patients with cystic fi brosis: a randomised, double-blind,
placebo-controlled, phase 2b trial

Jason Hess, MD, FACS

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I allow post-surgical breast augmentation to begin lower body exercise within a week or two following surgery. This recommendation is generally tailored for each individual patient. It may require 4-6 weeks following surgery for return to vigorous upper body exercise. This is particularly true with subpectoral implants. In this type of surgery, the implant is placed beneath the muscle. At age 18, patients rebound from surgery quickly. At age 58, you may be very healthy and active, but recovery may take a bit longer.
Good luck!

Jason Hess, MD, FACS

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Sometimes, sulfa drugs give a disulfuram-like reaction. This means that if you are taking Bactrim, Augmentin, or ampicillin, for example, you may have an adverse reaction to your medications including redness, nausea, or vomiting. However, this reaction should not be present when antibiotics are ceased. It is not wise to mix pain medications with alcohol. However, with good judgement, you should be able to have drinks after meds have been stopped. Good luck!

Jason Hess, MD, FACS

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Absolute symmetry following any surgery is very difficult to achieve. We strive for perfection, but this is rarely achieved. You may have an internal valve collapse. This means that you may have insufficient cartilage support of your nostril. When you inspire air, the suction created may produce a collapse of your nostril.
If you block one nostril and forcefully inspire, it should help to determine whether you have collapse of the other nostril. I hope this helps!

Jason Hess, MD, FACS

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Breast asymmetry is more common than symmetry. Approximately 70% of women have some degree of asymmetry. Severe asymmetry is less common. Areolar size depends on breast size, development, lactation, and other factors.
It would be unusual for your breasts to become more symmetric with time. Surgical options are available. But, as with all surgery, there are risks and benefits.
A lift and small reduction may be an option for the breast that sags a bit more. The areolar size may also be reduced. If you are considering treatment options, it would be wise obtain a few opinions from qualified plastic surgeons. Post-surgical scars can be well-refined. But there are no scar-free surgeries. Thus, you may consider your current breast aesthetics versus a more symmetric breast with a scar. Good luck!

Jason Hess, MD, FACS

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Judging from the picture, this looks like your brow?
If so, the suture line appears to run "with the grain" of the skin. This means that it follows Langer's lines. Langer's lines are lines of relaxed skin tension. This means the skin laceration follows the wrinkles or lines of the skin. When a skin laceration or excision occurs parallel to these lines, it generally heals with less scarring than if it were "against the grain". I would recommend having the sutures removed 7-12 days following repair. At six weeks following the procedure, you an use silicone strips or silicone gel nightly to improve scarring. When silicone strips or gel is used appropriately, you may not require a "revision". Silicone strips are available over the counter at most pharmacies.
Good luck!

Jason Hess, MD, FACS

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The type of dressing, in general, depends upon the preferences of the provider, and the nature of the surgery.
Occasionally, patients may have a sensitivity to adhesive. Additionally, latex allergies are very common.
If your physician is okay with a non-adherent dressing, I would recommend Telfa. This is the same material that is on the inside of a Bandaid, without the adhesive. Telfa protects a wound and absorbs any secretions, but it does not stick to a wound. There is a dressing (wet to dry dressing) where a physician intends for the gauze to stick to a wound. When the gauze absorbs secretions and drys, it with debride the wound. This helps to remove any unwanted material from a wound. It does not sound as though this is what your physician is hoping to perform. I hope this helps.

Jason Hess, MD, FACS

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One of the most important factors in achieving a good surgical outcome is to select the appropriate candidates.
This means, that if you do have stenosis of the external or internal nasal valve, surgery can and should correct the issue. However, surgery involves one human working on another human. Thus, errors, miscalculation, and/or other issues can occur. Additionally, even when surgery is performed perfectly, healing issues can vary the outcome. I would suggest keeping close follow up with your physician. Most physicians are committed to achieving good long-term outcomes with their patients. Occasionally a revision is necessary, but this should only be embarked upon if other measures fail.. Revision is usually not performed in nasal surgery for at least 6-12 months following the initial procedure.

Jason Hess, MD, FACS

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the shape of the scalp is determined, in part, by inracranial volume, growth, and sutures within the scalp.
These scalp sutures stay open during early early childhood growth. This allows the scalp (cranial vault) to expand and to form a normal shape. If one or several of these sutures fuse prematurely, a skull with an abnormal shape may result.
This is determined, in part, by genetic influences. In early childhood, the skull is also shaped by child positioning.
At 17, head shape cannot be altered without surgery. I hope this helps

Jason Hess, MD, FACS

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The edges of the scar demonstrate what are called "dog ears." "Dog Ears" are raised skin edges following scar revision. Time will likely improve the scar. I generally recommend the use of Scar Away silicone strips for improvement in scars at six weeks following the procedure. This will help to soften the scar and improve pigmentation. Good luck!

Jason Hess, MD, FACS

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Nasal valve surgery is not as invasive as an entire rhinoplasty. With rhinoplasty, swelling will continue for up to 6 months. With nasal valve surgery, swelling should resolve within 2 months (estimate).
At this time, hopefully you will appreciate improvement in symmetry at this time.
Surgery of the nose is challenging. Even a few millimeters causes a difference in symmetry.
Sensation will most likely return to normal. Numbness most often resolves. I hope this helps!

Jason Hess, MD, FACS

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Embrace can help. The "active ingredient" is silicone. Silicone has been used for decades for scar therapy.
It has been used in burn units to treat burns of the face and extremities, and there are countless studies supporting it's efficacy. I do believe in reducing the tension on wounds following surgery. This may be achieved when your surgeon repairs a wound in layers. I generally treat wounds with steri strips following surgery for 6 weeks. Then we use silicone strips for up to 12 weeks. These methods do not necessarily need to be in the form of "Embrace". But "Embrace" can be used. You are simply paying more for a brand, in my opinion. Silicone strips manufactured by "Scar Away" - Ethicon, Curad, and others. Hope this helps.

Jason Hess, MD, FACS

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A septorhinoplasty can require anywhere from 1.5 to 6 hours. Insurance will only cover the septoplasty portion for breathing issues. Shaving down the cartilage and/or lifting the tip a bit can certainly be achieved at the same time as a septoplasty procedure, however, insurance will not cover this. Insurance was generous with coverage in the past; However, they are strict with coverage currently. Rhinoplasty (the cosmetic portions of procedure) can sometimes require hours to achieve perfection. Generally, patients expect perfection on their face. Perfection requires time, and OR time requires anesthesia and operating room personnel. Even if your plastic surgeon performed the cosmetic portion free of charge, your insurance company would not pay for the anesthesia or OR time, which are recorded in your medical record. I hope this helps!

Jason Hess, MD, FACS

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The scar is very visible in the photo, but the nasolabial folds are visible as well. This, I believe, is in part due to the lighting. The depression, as you know, is exaggerated in certain lighting, and not others. This is why some pictures of the same person look better or worse, more wrinkled or less depending, in part, upon the lighting. Based upon what I can see, a dermal filler such as Juvederm or Restylane may help.
However, these are temporary solutions. Undermining and fat transfer may be a more permanent solution.
I would be curious to know whether the wound was repaired in layers at the time of scar revision.
When a wound is repaired in layers, the tension is maintained deep to the skin.
The scar will then remain narrow, rather than widened. However, this scar is in a difficult location. If it were on my own face, I would attempt a small amount of juvederm first. This is subtle and reversible if the result does not meet your expectations. Good Luck!!

Jason Hess, MD, FACS

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Allergies to titanium or other metallic implants have been reported. However, these are quite rare.
I have never witness an allergy to titanium. Acute hyperallergic reactions lead to death. Given the implant was placed 6 years ago, this is clearly not the case. In fact, it is unlikely the root cause of your symptoms. However, in medicine, nearly anything is possible. The literature quotes adverse titanium reactions to be less than 1% to more than 6 %. I have placed several hundred places and screws for hand surgery operations, and none have led to allergic reactions. I have removed hardware due to pain, but not allergy. In my series, then, this would be less than 1%. The long and short answer is that you may have an allergy. But to be certain, it would be necessary to see an allergist/immunologist.
Good luck!

Jason Hess, MD, FACS

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Fever, pain that is not controlled by pain medication, excessive bleeding, shortness of breath.
Every doctor is different and every surgery has post-operative warning signs.
blood tinged drainage is normal for many days from following abdominoplasty.
However, bleeding for days is not normal following a facelift.
I would stay in close contact with your physician. Do not hesitate to call following surgery if concerned.

Jason Hess, MD, FACS

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Kienbock's Disease is a difficult disorder to treat. The natural history, when left untreated, is for this ailment to evolve into wrist arthritis.
As you may know, Kienböck's disease is a condition where the blood supply to one of the small bones in the wrist, the lunate, is interrupted.

Bonerequires a regular supply of blood. If the blood supply is disrupted, osteonecrosis, or dead bone can result.
Damage to the lunate causes a painful, stiff wrist and, over time, can lead to arthritis.

Depending upon the stage of the disease, various surgical options are mandated. Revascularization is a complex procedure; It is conceivable that revascularization failed to completely treat the problem or the symptoms. When all else fails, a proximal row carpectomy or wrist fusion will cure pain, but will obviously destroy wrist mobility.
These are invasive procedures and are avoided unless less invasive options are available.
Further imaging is necessary here including a possible CT angiogram or MRI. I hope this helps!

Jason Hess, MD, FACS

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A deep plane facelift is an alternative term for a facelift that tightens the layer beneath the skin. This is the SMAS layer or Superficial muscular aponeurotic system. Most surgeons realize that skin does not hold tension for a prolonged period. Thus it is important to suspend the facelift with deeper stronger tissue. Skin-only facelifts reduce excess skin, but results are temporary. Sub-SMAS facelifts provide longer lasting results, but surgery requires a longer period and recovery is lengthier. Additionally, the risk to nerve injury is slightly higher, but in experienced hands, complications should be rare.
Good luck!!

Jason Hess, MD, FACS

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Athletes foot is a fungus (tinea cruris) that thrives in dark damp places. So it is critical to keep the feet very very dry. When at home, remove socks and expose the feet to the air. Also, it cannot hurt to expose the feet to UV rays. Then, you can generously apply tinactin, micatin, lamisil, or other topicals. I do not think epson salt or peroxide will kill the fungus. Alcohol (topical) may help, but will not completely eradicate this problem. Good luck!

Jason Hess, MD, FACS

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Droopy eyelids may be the result of excess skin or muscle weakness, or both. Excess skin and a modest amount of fat may be excised under local anesthesia. If the levator muscle is weak or atrophic, the surgery is more difficult, but good results may still be achieved . A visual field exam may be of benefit to determine if your vision is affected by droopy lids. The talk to your surgeon about ptosis and Dermatochalasis. Dermatochalasis is caused by a loss of elasticity in the connective tissue supporting the structure of the eyelid. Ptosis is actual lid drop. Blepharoplasty is generally the best for this condition. Good luck!!

Jason Hess, MD, FACS

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The majority of the population does indeed have a deviated septum. Surgery is indicated when nasal airway obstruction or aesthetic deformity is an issue. I often harvest septal cartilage during rhinoplasty in order to use this tissue for molding the nose. However, rhinoplasty is a difficult surgery. You would be best advised to speak with your surgeon at length regarding your expected outcome and your goals. I hope this helps!

Jason Hess, MD, FACS

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Breast implants are best placed in the submuscular or partially submuscular plane. This means you will still be able to have mammograms, MRI's etc. Plastic surgeons are also generally good doctors. Most would not want to risk your health. Thus, they are as interested in a good long term outcome as you are. So you will still be able to feel lumps and bumps, but be sure to keep a close relationship with your doctor for good breast health. Good luck!!

Jason Hess, MD, FACS

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Biocorneum is best used for acute scars. This means it is best used for recent incisions. I prefer silicone scar strips to silicone gel.
I would recommend scar revision if you have a thick or wide scar. It is best to use this type of therapy only 9-12 months following scar formation. Any time before this is too early. Then use biocorneum or silicone strips afterward. Good Luck!!!

Jason Hess, MD, FACS

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Your scars are, thankfully, not severe. They could be excised and revised under local anesthesia.
This means you would not need to be asleep unless desired. Local anesthesia minimized expense and can facilitate the safe and comfortable removal or your scars.
This generally requires meticulous sharp excision and repair with very fine nylon or prolene sutures. The sutures are generally removed in 5-10 days.
And silicone scar therapy helps to minimize long term scarring. Good luck with your surgery. It should cost between 300 and 1500 dollars. Surgery depends, in part, upon surgeon location and experience.

Jason Hess, MD, FACS

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If the turbinate threaten to obstruct the airway, I believe that is is prudent to infracture them or consider a partial or complete submucous tubinectomy. This involves preserving the mucosa and essentially crushing or removing part or all of the bone. In the past, surgeons sometimes removed the turbinates. However, these tissues warm and humidity inhaled air. So it is useful to keep them.
In short, at times, less is more in rhinplasty surgery. Good luck with your surgery

Jason Hess, MD, FACS

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I am not a bariatric surgeon, however, I have performed many abdominal surgeries following massive weight loss. Massive weight loss is defined as the loss of more than 100 pounds following surgery. I would recommend breast feeding your baby following birth. The time period for this varies among women, but this will help you to lose weight. The best weight loss is that which you can achieve on your own. Furthermore, I have seen successes and failures with the lap band. Most of the bariatric surgeons that I work with are now performing sleeve gastrectomies and gastric bypasses. We wish you the best of luck in your weight loss!!

Jason Hess, MD, FACS

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I would recommend visiting with a few urologists. There are some who only work in this field. Additionally, there are an array of medications to assist with this issue today. When medications fails, a pump will nearly always work for temporary measures. Physicians are sensitive to the importance of this need. Only a visit with a physician and a good history and physical exam can help to evaluate and fix underlying issues. Good luck!!

Jason Hess, MD, FACS

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Experience is certainly important. I would also recommend asking specifically to see results.
Some doctors have a lot of experience, yet fail to yield exceptional results. And vice versa.
I generally perform rhinoplasty under general anesthesia. This means the airway is protected. Local anesthesia and general anesthesia are the safest forms of anesthesia. "Twilight" anesthesia or sedation poses a risk of inadvertant over sedation. While this is rare, it is a risk. Rhinoplasty can be done under local, sedation, or general anesthesia. But I prefer general. An I prefer an open approach. Good luck with your decision

Jason Hess, MD, FACS

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Insurance may certainly cover a septoplasty. Unfortunately, insurance companies have historically been liberal with compensation. However, this is historical. Currently, it is difficult to even have necessary surgery approved. Cosmetic surgery is never approved. And even when part of a procedure is approved and another part is not, insurance will only cover anesthesia for the necessary part. I would save your money and find a qualified doctor. Many can offer quality results at affordable prices. When insurance pays for a deviated septum surgery, it may pay a doctor around $1000. There is not a doctor in North America than can provide a quality procedure for this price.

Jason Hess, MD, FACS

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Ibuprofen can indeed be taken with Claritin. Claritin is a non sedating antihistamine. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Over the counter cough medication may help as well, but it may be prudent to contact your doctor's office. Follow up with your doctor is as important as surgery itself. Every physician is different with regard to their post surgical preferences. I hope this helps.

Jason Hess, MD, FACS

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These are insightful questions. Revision rhinoplasty is necessary in up to 30 % of rhinoplasties. There is no real guarantee that this will not happen in your case. I would recommend simply being clear with your physician regarding your desired goals and being realistic. Some things can be achieved with plastic surgery, and some things cannot. The nose will not generally droop with time after surgery. A columellar strut will help reduce the risk of this. This strut helps to elevate the nasal tip. The first place to harvest cartilage is from within the septum. Septal cartilage is often of firm quality and hopefully straight. Rib cartilage is a good source, but it requires opening an incision on the chest. Cartilage can also be harvested from the ear. But the quality of ear cartilage is not terrific. Pieces are small and often curved. There is no best site, but each donor site should be tailored toward the patients needs. In revision rhinoplasty where large pieces are required, rib cartilage may be necessary. Good luck in your surgery

Jason Hess, MD, FACS

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If your surgeon offers free revisions, it would be prudent to determine whether the costs of anesthesia and the facility fees are covered. If these fees are "free" this is very generous.
I generally provide free follow up for 18 months and revisions are no charge; I do not charge for facility fees, and there is generally an anesthesia fee. This is fairly standard.
Lets hope for the best and be optimistic that you will not require a revision. Good luck!

Jason Hess, MD, FACS

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Both general anesthesia and sedation are quite safe today. In general, a preoperative evaluation is mandatory for all patients over 65 and is recommended for anyone with any significant health problem (hypertension, diabetes, etc.) You are correct in your concerns, but with a good anesthesiologist, risks of complications are fewer than 1%.
I like to use zofran for procedures and prescribe phenergan after surgery. Nothing can wholely eliminate nausea, but these medications can reduce nausea.
When asked about being concerned for surgery, Joan Rivers once responded, "I don't worry about surgery, just anesthesia". I would agree with these concerns. Thus, it is important to speak with your anesthesiologist prior to surgery. They will be most knowledgeable about your risks. However, in my experience, risks are minimal in young healthy patients. At your age, your risks are modest.

Jason Hess, MD, FACS

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I prefer open rhinoplasty to closed rhinoplasty. With this approach, you will have sutures, but they will be removed in about 110 days following surgery, To have 1 month for recovery is a small amount of time following surgery. You will certainly have residual swelling, and may have some bruising. You do not need a primary doctor if you are young and healthy. A chin implant is sometimes a good option depending upon your facial profile and your goals. Swelling will not be terrible following this surgery, but may be modestly visible in the time frame that you have mentioned. Good luck!!

Jason Hess, MD, FACS

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There is no hard and fast rule for a time frame to wait following birth for abdominal work. There have been reports of physicians performing abdominoplasty at the time of C-section, however, I do not recommend or perform this practice. It is generally best to wait for healing and you're body's own skin improvement following child birth. Your skin and abdomen will improve for up to approximately 1 year following child birth. You will also want to ensure that you do not intend to have more children prior to pursuing any cosmetic work. The only definitive way to improve stretch marks following child bearing is with tummy tuck surgery. Good luck!

Jason Hess, MD, FACS

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The best result depends upon your skin tone. If you have excellent tone (The skin will retract quickly when pulled), liposuction alone may be an option. Many would recommend laser lipolysis (Smartlipo or Cool lipo) to facilitate some additional skin retraction. However, the "jury is still out" with regard to whether this actually works to facilitate skin retraction. I would recommend visiting a few trusted board certified plastic surgeons. Nothing beats a good physical exam. Good Luck!

Jason Hess, MD, FACS

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I would recommend focusing on functionality. If there is no impairment in function, then the toes may not require surgery or other treatment. However, a pediatric orthopedist would be your best consultant. I am not certain what the cause of this overlapping would be. It may be a congenital issue. Good luck!

Jason Hess, MD, FACS

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Traditional liposuction has been around since the 1980's. This is tried and true technology. To supplement this, some practitioners used laser assisted lipolysis. This is called Cool lipo, or smart lipo. Liposuction has many variations in name. I would recommend seeking a board certified plastic surgeon and having a physical exam. One scenario to be avoided in your case is excessive liposuction. This is what has occurred with Tara Reid, and many other non-famous patients. It is critical to perform liposuction deeply on the abdomen. Superficial liposuction will lead to rippling and visible skin deformities. Your doctor should also use a small cannula and many passes rather than a large cannula with few passes. This will ensure good results. Good luck!!

Jason Hess, MD, FACS

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I would simply seek a qualified surgeon who you trust to commit to deliver the results that you seek.
I would seek a personal referral, possibly from a friend or family member who has had plastic surgery.
To put it simply, photoshop and 3D imaging are easy. Surgery is hard.
Rhinoplasty and revision rhinoplasty are some of the most difficult surgeries in plastic surgery. This does not mean that you cannot achieve a good result. It simply means that your doctor and his techniques are far more important than any imaging modality. You should ask to see before and after pictures. Meet with at least 2 physicians. Do not base your decision upon imaging technology. Make your decision based upon the doctor that you feel can come closest to the outcome you would like to achieve. Imaging tools can help you to view your potential outcomes, but will not likely reflect your real outcome. Good luck!!!

Jason Hess, MD, FACS

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Liposuction is best for patients who are otherwise healthy and is best used to address small areas. The "love handles" or areas of the lateral flanks are well suited for liposuction. The best way to determine if anyone needs this type of work is to see a good history and physical exam. Most doctors who perform this type of surgery offer free or inexpensive consultations. Liposuction will only address fat that you can pinch. The more you can pinch, the more that can be suctioned. From the measurements you provided, it sound like you are already thin; So liposuction may or may not provide the results you seek; It really depends on how you abdomen looks to your doctor.

Jason Hess, MD, FACS

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Most lipomas are simply lipomas. However, it is impossible to confirm the diagnosis of a mass without removing it. When it is removed, pathologists study the tissue microscopically to be certain it is benign. Rarely, these lumps demonstrate some malignant potential. This is not intended to incite alarm. Lipomas, by definition, are benign. However, only formal pathology can make this diagnosis following excision.

Jason Hess, MD, FACS

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There are many skilled plastic surgeons out there, and the cost of surgery is often independent of the product. This means that some physicians charge a lot, but do not deliver quality. Also, some charge less, and deliver beautiful results. If you have a friend or family member who has had plastic surgery or works in the hospital, this is a great source for a referral.
I would continue to shop around. Your choice in surgeons should not be a quick decision and should not be based solely on cost alone. The price also depends upon the region where you live. Malpractice premiums are higher in New York, so surgery costs more. In states with lower premiums, surgery costs less. Good luck!

Jason Hess, MD, FACS

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This scar represents a troubling situation. Unfortunately, some scars continue to worsen for up to 6 months following an injury. I generally tell my patients that they cannot judge a scar for approximately 9 months to a year following surgery. It takes this amount of time for a scar to mature. I cannot judge the quality of your scar without seeing it. However, I can say that I have had experience with 5 FU. Kenalog is a corticosteroid that is very commonly used with hypertrophic scars. 5FU is uncommonly used. This means that few people have experience with it. It involves an injection of diluted 5FU beneath the skin. We researched this material and used it while I was in residency. In our series of 4 cases, it did not appear to improve the scar, and in 1 case, it caused a wound to open entirely. I hope this helps

Jason Hess, MD, FACS

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A lymph node biopsy may be indicated, but many factors should be considered. These include recent ailments, length of time the nodule has been swollen, other health issues you may have, and any other health issues in your family (among other factors). Tehre is no way to be certain whether the nodule is benign or a lesion of concern without a biopsy, but a swollen nodule or lymph node alone does not always mandate a biopsy. Given your history of Hashimotos thyroiditis, it may be prudent to attain a biopsy to rule out anything worrisome. Good luck!

Jason Hess, MD, FACS

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It is difficult to assess these issues without a good physical exam. However, based upon your description, you may have implant distortion due to bilateral capsular contracture.
This situation occurs when scar tissue occurs around the implants and may distort their shape. Additionally, your implants may simply be situated high on the chest, beneath the muscle, and your normal breasts have sagged below the implant. This is sometimes called a double bubble.
It is unusual for implants to last for 30 years without rupture; However, I have seen implants intact after this period. Options are several:

Implant removal and possible capsulectomy (removal of the scar tissue surrounding the implant as well as the implant)

Removal of implant and replacement with smaller implant in addition to mastopexy (breast lift)

Your options should be tailored to your goals. It is important to decide whether you would still prefer to have implants. I would recommend visiting at least 2 board certified plastic surgeons to help decide your best surgical options. Good luck!

Jason Hess, MD, FACS

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A leaking silicone implant may not be easily diagnosed depending upon the age of the implant. If the implant has been placed in the last 9 years approximately, it is a likely a cohesive gel implant. This means that if rupture occurs, the gel generally remains within the implant. A good physical exam may detect a rupture. An MRI can detect rupture with a high degree of certainty. Possible rupture is a relative urgency, not an emergency. Thus, I would return to your plastic surgeon if possible. If fever or other symptoms develop, more urgent treatment may be necessary.

Jason Hess, MD, FACS

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I would certainly consider delaying surgery. Plastic surgery is generally elective. This means there is no urgency.
Safety is always the first, second, and third priority in plastic surgery.
We often envision beautiful results in plastic surgery. However, there is some risk involved. Good plastic surgeons really are always concerned about risk and will advise you that hormone changes may affect clotting. And clotting from surgery can be very dangerous, potentially leading to DVT (deep venous thrombosis) or PE (Pulmonary Embolism).

Jason Hess, MD, FACS

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The best treatment for gynecomastia depends upon the severity of the problem. The more excess skin and fat that your breasts present, the more invasive the approach to surgery.
If the problem is simply manifested by excess fatty tissue, liposuction can be performed through the armpit of via the fold beneath the breast.
However, if you have excess skin, breast tissue, and fatty tissue, you may require a male breast reduction surgery. This may be achieved using a circumareolar incision or another type of breast incision. I hope this helps

Jason Hess, MD, FACS

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The term "anti-aging" product covers a very broad spectrum of material. However, it is never to young to take care of your skin. At the very least, sun block should be an every day habit, particularly if you reside in a sunny climate. Topical retinoids (Retin-A) or its derivatives may be helpful in some situations. A balanced diet and exercise regimen are always helpful. To my knowledge, there are no potential negative effects of topical products. Good luck

Jason Hess, MD, FACS

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I prefer juvederm simply because I have used it often and have not had any adverse experience with it. To my knowledge, there is not one that is better than the others. Radiesse is also a filler that deserve consideration. This is a thick viscous material that persists for a longer period that the other fillers.
It is very effective at reducing very coarse furrows because it is more viscous (thicker) than the other fillers.

Jason Hess, MD, FACS

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I only use monocryl sutures in the dermis. Some physicians use PDS, but I have occasionally seen these sutures extruding from the skin. They may form open wounds in the scar line.
Redness following surgery is usually not an allergy to the sutures, but rather part of the healing process. Inflammation is part of healing. Inflammation includes more blood flow to an area. It will cause a scar to be reddened. However, scar mature and color almost always fades. It takes a minimum of 6 months and up to 18 months for scars to improve.
Sometimes silicone scar sheets will help to improve the outcome. If the outcome is poor after several months, I would recommend scar revision. This involves excision of the scar and meticulous, layered tension-free repair when possible.

Jason Hess, MD, FACS

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Pressure and silicone scar therapy are the only clinically proven methods to improve scar maturation. There is no laser or IPL or other known therapy that will absolutely alleviate scars.
I have not used Embrace, but use silicone scar sheets routinely in all tummy tuck patients.

Jason Hess, MD, FACS

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You may or may not need a septoplasty. there is a drainage tube that connects your middle ear to your throat. If this tube is occluded, you will feel a full sensation in your ear.
Sometimes, transient swelling or an allergy will affect the drainage of your middle ear. Sometimes something is anatomically wrong with this drain. This may include a septal deviation, stenosis (narrowing) of the drain valve, or a mass (unlikely). I agree with a CT and possibly eval by an ENT. Good luck

Jason Hess, MD, FACS

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Saline implants are certainly still being used. The outcome with breast augmentation depends upon the patient. I generally only recommend augmentation with saline implants for women who only desire a small augmentation.
The larger the implant, the more likely it is that visible rippling will result.
Silicone implants yield less rippling

Jason Hess, MD, FACS

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This lump is most likely a lipoma or an inclusion cyst. However, it could be any number of things. Important factors include
1. The history of the lump
2. The location
3. Associated symptoms.
I would recommend removing it. It is best to know exactly what it is

Jason Hess, MD, FACS

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I have not seen significant improvement in cellulite via any specific plastic surgical modality. Some practitioners recommend Cellulaze. But I have not been impressed with any long term outcomes. Every few years, a new option presents itself to the marketplace. Endermologie was previously popular, but was/is expensive and temporary.
I would recommend saving your money and practicing good diet and exercise for now. This may not be the answer you are looking for, but it is an honest answer

Jason Hess, MD, FACS

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Sorry to hear you are unhappy with you liposuction results. Unfortunately, this is a common finding. Liposuction, in my opinion, is marketed as a simple outpatient procedure. However, achieving satisfactory results is quite challenging. Contour irregularities in the skin are often seen following liposuction. It is important for your physician to perform liposuction in the deep plan of fat to avoid irregularities. When extensive irregularities in abdominal skin often require an abdominoplasty to tighten and smooth the skin. Nothing will help your prospective physician more than a good physical exam. This will allow your doctor to assess the quality of you skin and tissue. Good Luck!!

Jason Hess, MD, FACS

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I believe it would be difficult to find a surgeon in the U.S. to perform lower blepharoplasty surgery for under $3500. However, the price would likely depend on what you hope to achieve.
Most quality results depend upon a rearrangement of fat beneath the lower lid. This helps to fill out the "tear trough" or hollowing beneath the eye. A "skin only" blepharoplasty would be less expensive, but improvement would be less pronounced.

Jason Hess, MD, FACS

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A mucous cyst can certainly be removed with relative ease. However, dissection must be meticulous. These cysts sometimes extend to the joint. Every remnant of the cyst must be removed to minimize the risk of recurrence. Despite a meticulous dissection, there is still a risk of recurrence.
If they are not symptomatic, some practitioners and patients elect not to excise them. Others prefer to remove them and consider revision surgery if recurrence occurs. Good Luck!

Jason Hess, MD, FACS

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Lipomas are among the most common of benign soft tissue tumors. This is likely the type of tumor on the back of your neck.
A lipoma would be less common on the wrist. A ganglion tumor is part of the tendon sheath or joint capsule. This type of tumor is common on the wrist. A good plastic and reconstructive surgeon can manage both of these tumors. Your primary doctor will know the best doctors in your region. Good luck!

Jason Hess, MD, FACS

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I would recommend a rigorous diet and exercise regimen. Exercise and diet will help you to lose the fat. Excess skin is very difficult to lose without surgery.
However, even if you are considering surgical options, your outcome will be improved if you are at your peak of fitness prior to surgery.
Good luck!

Jason Hess, MD, FACS

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The best treatment options begin with a physical exam. I would recommend visiting a board certified plastic surgeon for a free consultation.
Factors to consider are the duration of time since the injury and the nature of the scar, among others. Even when nothing is done medically, scars may stay the same or become worse for up to six months. Following 6-9 months, scars improve and will lose their redness or pigmentation. Good luck!

Jason Hess, MD, FACS

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Laser hair removal is very effective at hair removal. The newest lasers are the most effective and the least painful. One of the more popular and effective lasers is the lightsheer duet.
It is important to note the multiple treatments are generally required. Those with dark hair on a light skin background have the best results. Complications can include discomfort, burns, and patchy removal. Thus, it is best to visit a well-practiced professional.
Good luck!

Jason Hess, MD, FACS

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I would recommend visiting at least 2 board certified plastic surgeons. A deep plane facelift was popularized by Dr. Oscar Ramirez. This is otherwise known as a subperiosteal facelift. It was known for complications in the hands of those who attempted to replicate his results. However, some people use the term "deep plane" to mean a sub-SMAS facelift. The Sub-SMAS technique is more difficult than a skin-only facelift, but is known for lasting results. Good luck in you selection

Jason Hess, MD, FACS

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Sorry about your injury. I would find a plastic surgeon who accepts your insurance. Some plans will cover this injury.
If not, it should cost a few hundred dollars per earlobe.
Good luck

Jason Hess, MD, FACS

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The raised edges of a straight scar often represent excess skin and minimal fat. These "dog ears" generally resolve without further surgery, but it may require 6-9 months. Unfortunately, scar revision trades one scar for another, as you know. There is really no way to remove a scar altogether, but it can generally be improved. After a scar revision, I generally recommend a silicone strip to be worn at night.
This will help a scar to be smooth and flat. This is most important to be started about 4-6 weeks after surgery. One favorable finding is that your scar is in a good location. It parallels the nasolabial fold. This makes a scar less conspicuous. My best advice would be to give the scar time to improve on its own. If this fails, you can always undergo a future scar revision if indicated.

Jason Hess, MD, FACS

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This is a good question. Bedsores (pressure ulcers) occur due to a number of problems. Moisture, thin skin, poor nutritional status, and immobility are contributors. Some paraplegic and quadriplegic patients are essentially bed-bound. In nursing homes, its generally mandated to turn patients and relieve pressure AT LEAST every 2 hours.
If you can improve any of the other factors above, this will also help

Jason Hess, MD, FACS

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Approximately 37 % of the general population has a deviated septum. Most of these people will not require surgery. Correction is indicated when the airway of one or both nasal passaged is occluded by the deviation. Snoring may or may not be related to the septal deviation. A good nasal exam should be able to determine this. I am a plastic surgeon and profit from performing surgery. However, surgery should be reserved for cases that do not respond to non-surgical measures. If your primary care doctor is a good one, he is trying to protect you from unnecessary surgery. It is impossible to give a definitive answer to the necessity of surgery without have a good history and physical. I would consult with a few surgeons prior to making a surgical decision. If you do indeed need surgery, you will here the same opinion echoed by several consultants. Good luck!!
Jason Hess, MD

Jason Hess, MD, FACS

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