Q.  I have a 4 year old son whose ears stick out too far.  What is the appropriate age to consider fixing his ears?

A.  You should let a board certified plastic surgeon evaluate your son’s ears.  There are measurements that are considered normal for the ears, and his ear measurements can be compared with what is considered normal.  Once your son’s variation from normal has been determined, a discussion between the surgeon and you will review the pros and cons of correcting prominent ears.  In general, fixing a child’s ears should be considered at around 5 to 6 years of age, at the earliest.  A child’s ears have reached 90% of adult size by about 5-6 years old.  If your child has very prominent ears, he may at some point experience teasing by other children.  This is more common in older children however.  The surgery to correct prominent ears is an outpatient procedure that takes about 2-3 hours to complete.  A bandage will have to be worn for about 4-5 days after surgery, followed by a soft, elastic band around the head to hold the ears close to the head.  This band is worn for about 3 weeks.  Because of the need to wear this band, a child should be mature enough to understand what is being done and be willing to cooperate with the post-operative care.  A child who has ear surgery often will need to be out of contact sports for about 3 months following the surgery.

Q.  I am contemplating having a breast augmentation.  I had a consultation with a plastic surgeon who talked about implant sizes, but she talked about how many cc’s the implant would be.  This does not mean much to me as I don’t know what a cc is.  I would like to see what I will look like after the augmentation.  Is it possible to simulate what my breasts will look like after surgery so that I can choose the correct implant size?

A.  Determining the correct size implant for a patient is a very important task.  Selection of an implant should be based on multiple measurements of your breasts.  These measurements are used to determine a range of implant sizes that will fit naturally within the dimensions of your breasts.  For many years in my practice I used manual measurements to determine which implant sizes fit a patient, then have the patient try on implant sizers based on the breast measurements to see what she might look like in clothes.  This technique gives the patient a pretty good estimation of what she, and everyone else, will see after the surgery in clothing.

Until recently, we did not have the capability to allow a patient to get an estimation of what she will look like without clothes.  A new 3-D computerized camera system has been developed that will perform a virtual breast augmentation on a patient, using the 3-D photo of the patient’s breasts.  The computer performs all of the measurements that previously were performed manually, and then recommends a range of implant sizes that will fit the patient.  The recommended implants sizes are then chosen, and the virtual augmentation is performed in about 2 minutes on the computer screen.  The system allows you to try on saline or silicone implants by any of the manufactures in the U.S.  The implant size can be changed with just a click of the mouse, thus allowing a patient to see what she would look like a little bigger or a little smaller.  This new system allows a fairly accurate prediction of what the breasts will look like after surgery.  The results are not perfect, of course, but the system has be proven to be very close to what a patient can expect.  Since the photo is 3-D, it can be rotated into multiple positions to see the top, the bottom, from the side, and a straight on view.  Soon, the system will also allow us to email your pictures to you (password protected), via the cloud, where you will be able to review your 3-D pictures in the comfort of your home.

So the answer to your question is yes, you can now see what you will look like both in and out of clothing before a breast augmentation, which hopefully will help you and your surgeon determine what size implant is right for you.

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William Byron Barber II, M.D. has been practicing plastic surgery in Greensboro for 20 years and is certified by the American Board of Plastic Surgery.  He is Chief of Plastic Surgery for Moses Cone Health System, and is an active member of numerous local, regional and national plastic surgery associations.

Visit his website at: www.BarberPlasticSurgery.com or e-mail him at: AskDrBarber@BarberPlasticSurgery.com