Allergy treatment involves a combination of modalities including medication, environmental controls and immunotherapy and Sublingual Immunotherapy (SLIT). Immunotherapy, commonly known as allergy shots, is a program that increases immunity to certain allergens that trigger allergy symptoms. While increasing immunity, it decreases your sensitivity to the substances that trigger your allergy symptoms when you are exposed to them. Immunotherapy by sublingual drops, commonly referred to as “allergy drops” is an individually tailored alternative program designed to desensitize you to those substances to which you are allergic. Your allergy tests results are used to create a mixture of substances to which you are allergic. Sterile extracts are prepared from allergy-producing substances such as pollens, molds, house dust, and animal danders according to thing to which you are allergic. These biological substances are then taken under the tongue in increasingly stronger doses until your maximum or maintenance dose has been achieved. Allergen immunotherapy involves administering increasing amounts of an allergen to a patient over several months. Immunotherapy has been shown to be effective in preventing the development of new allergies and, in children, preventing the progression of allergic disease from allergic rhinitis to asthma. Allergen immunotherapy can lead to the long-lasting relief of allergy symptoms after treatment is concluded.
Immunotherapy is only recommended for allergic rhinitis, asthma, conjunctivitis, and insect allergy. It is not a recommended treatment for food allergies. The decision to start immunotherapy is one made between patient and doctor. That decision should be based on the length and severity of seasons, how effective medications and environmental controls are, and the desire to avoid long term medication usage.
Allergen immunotherapy works like a vaccine. Your body responds to the injected amounts of a particular allergen, given in gradually increasing doses, by developing a tolerance to the allergen. As a result of your body’s response to these immune changes, immunotherapy causes decreased, minimal or no allergy response when you are exposed to the allergen included in your allergy vaccine.
There are two phases to immunotherapy: a buildup phase and a maintenance phase. The buildup phase of treatment involves receiving injections with increasing amounts of the allergens that are customized for each patient based on individual skin testing results. Patients generally receive injections during this phase between one to two times a week, though more rapid buildup schedules may be used. The duration of this phase varies, but, generally, is between three and six months.
The maintenance phase begins when the effective therapeutic dose is reached. The effective maintenance dose will vary from patient to patient. It depends on the level of allergen sensitivity and the response to the immunotherapy buildup phase. Maintenance immunotherapy intervals generally range from two to four weeks.
The benefits of immunotherapy, in terms of reduced allergy symptoms, begin during the buildup phase but may take as long as a year on the maintenance dose. Improvement with immunotherapy is expected to be progressive during the treatment period. Effectiveness of immunotherapy seems to be related to the length of treatment and the dose of the allergen.
If immunotherapy is successful, maintenance therapy is generally continued for three to five years. Some patients will experience lasting remission while others may relapse after discontinuing therapy.
Allergy immunotherapy is a proven effective treatment for allergic rhinitis, allergic asthma, and insect allergies. Immunotherapy can lead to lasting remission of allergy symptoms. To schedule a consultation with one of our physicians, please call 770.740.1860.
Botox Cosmetic, botulinum toxin, has revolutionized the market of products to reduce wrinkles, particularly of the forehead. In April of 2002, the U.S. Food and Drug Administration approved Botox for the temporary improvement in the appearance of moderate to severe lines of the forehead in adult men and women. Botox derived from botulinum toxin has been used successfully for over 15 years for the treatment of various conditions.
Patients that benefit most from Botox are those who have wrinkles between their eyebrows who tend to appear tired, upset, or display a permanent scowl. Wrinkles between the eyebrows are caused by contracting muscles in the forehead, the corrugator and procerus muscles. A small amount of Botox is injected under the skin to paralyze the muscles in the face that pull the skin and cause wrinkles. The results we see at our Alpharetta botox clinic is a smoother, improved appearance between the eyebrows. The Botox we use at our Alpharetta botox clinic also can weaken the muscles in the forehead and around the eyes which means it’s a great option for reducing the appearance of crows feet. The procedure at our Alpharetta botox clinic is minimally invasive, quick, and may have results that last up to four months.
Dr. Jeffrey Gallups and Dr. Mark Beaty are both double board certified in otolaryngology and facial plastic surgery in Georgia. They have personally treated thousands of patients at our Alpharetta botox clinic with Botox with great results. The cost of the Botox is individually determined by the Georgia plastic surgeon based on the patient’s individual needs.
The shape of your nasal cavity could be the cause of chronic sinusitis. The nasal septum is the wall dividing the nasal cavity into halves; it is composed of a central supporting skeleton covered on each side by mucous membrane. The front portion of this natural partition is a firm but bendable structure made mostly of cartilage and is covered by skin that has a substantial supply of blood vessels. The ideal nasal septum is exactly midline, separating the left and right sides of the nose into passageways of equal size.
Estimates are that 80 percent of all nasal septums are off-center, a condition that is generally not noticed. A “deviated septum” occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
Septoplasty is the preferred surgical treatment to correct a deviated septum. This procedure is not generally performed on minors, because the cartilaginous septum grows until around age 18. Septal deviations commonly occur due to nasal trauma.
A deviated septum may cause one or more of the following:
- Blockage of one or both nostrils
- Nasal congestion, sometimes one-sided
- Frequent nosebleeds
- Frequent sinus infections
- At times, facial pain, headaches, postnasal drip
- Noisy breathing during sleep
(in infants and young children)
In some cases, a person with a mildly deviated septum has symptoms only when he or she also has a “cold” (an upper respiratory tract infection). In these individuals, the respiratory infection triggers nasal inflammation that temporarily amplifies any mild airflow problems related to the deviated septum. Once the “cold” resolves, and the nasal inflammation subsides, symptoms of a deviated septum often resolve, too.
Diagnosis Of A Deviated Septum: Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or combinations thereof. A trained specialist in diagnosing and treating ear, nose, and throat disorders can determine the cause of your chronic sinusitis and nasal obstruction.
Your First Visit: After discussing your symptoms, the primary care physician or specialist will inquire if you have ever incurred severe trauma to your nose and if you have had previous nasal surgery. Next, an examination of the general appearance of your nose will occur, including the position of your nasal septum. This will entail the use of a bright light and a nasal speculum (an instrument that gently spreads open your nostril) to inspect the inside surface of each nostril.
Surgery may be the recommended treatment if the deviated septum is causing troublesome nosebleeds or recurrent sinus infections. Additional testing may be required in some circumstances.
Septoplasty: Septoplasty is a surgical procedure performed entirely through the nostrils, accordingly, no bruising or external signs occur. The surgery might be combined with a rhinoplasty, in which case the external appearance of the nose is altered and swelling/bruising of the face is evident. Septoplasty may also be combined with sinus surgery.
The time required for the operation averages about one to one and a half hours, depending on the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. After the surgery, nasal packing is inserted to prevent excessive postoperative bleeding. During the surgery, badly deviated portions of the septum may be removed entirely, or they may be readjusted and reinserted into the nose.
If a deviated nasal septum is the sole cause for your chronic sinusitis, relief from this severe disorder will be achieved.
Millions of Americans have disorders of balance they describe as dizziness. What can be difficult for both a patient and his or her doctor is that dizziness is what is called “a subjective term.” (That means a word like dizziness can be used by people to describe different sensations they are experiencing, but it is hard for anyone but the person experiencing the symptoms to understand or measure the nature or severity of the sensations.) Another difficulty is that people tend to use different terms to describe the same kind of problem. “Balance problems,” “dizziness,” “imbalance,” and “disorders of balance” are all used interchangeably.
What is dizziness?
For some people, dizziness is a feeling of unsteadiness or a spinning sensation. Others may experience extreme balance disorders that affect many aspects of their lives. Dizziness may be a fleeting sensation or the prolonged and intense symptom of a wide range of health problems that can affect a person’s independence, ability to work, and quality of life. Experts believe that more than 40 percent of Americans will experience dizziness that is serious enough to go to a doctor. Even dizziness that seems minor, if undiagnosed, may be a signal of underlying disorders.
Balance problems are among the most common reasons that older adults seek help from a doctor. Many people are surprised to learn that the source of their imbalance may be in their inner ears. Balance (or vestibular) problems are reported in about 9 percent of the population who are 65 years of age or older. Fall-related injuries such as breaking (or fracturing) a hip are a leading cause of death and disability in older individuals. Many of these hip fractures are related to balance disorders. Although this fact sheet is about adults, children who complain about or describe balance problems should be seen by a doctor.
Balance disorders may also lead to other problems including fatigue, difficulty walking, or disinterest in everyday and leisure activities. If you or your child, parent, friend, or co-worker has a balance problem–take it seriously. Talk to the doctor about what happens when you feel dizzy or lose your balance. Be as careful as possible to describe your experience of dizziness specifically.
Describe your symptoms for your doctor
Ask yourself the following questions. If you answer “yes” to any of these questions, you should discuss the symptom with your doctor.
- Do I feel unsteady?
- Do I feel as if the room is “spinning” around me?
- Do I feel as if I’m moving when I know I’m standing or sitting still?
- Do I lose my balance and fall?
- Do I feel as if I’m falling?
- Do I feel as if I might faint? (sometimes people call this “lightheaded”)
- Does my vision become blurred?
- Do I ever feel disoriented? (lose my sense of time, place, identity)
- What should I do?
Balance disorders are serious. The most important thing you can do if you think you have a balance disorder is to see a doctor. Your doctor may refer you to an otolaryngologist, the doctor who specializes in the ear, nose, and throat. An otolaryngologist will try to find out why you have balance problems and may discuss treatment options.
To schedule an appointment with the Ear, Nose, and Throat Institute, please call 770.740.1860.
Facts for Parents
- What is Otitis Media?
- Are there different types of otitis media?
- How does otitis media happen?
- What’s happening inside the ear when my child has an ear infection?
- Can otitis media affect my child’s hearing?
- How do I know if my child has otitis media?
- What will a doctor do?
- How can I be sure I am giving the medicine correctly?
- Will my child need surgery?
- What about children in daycare, pre-school, or school?
- What else can I do for my child?
What is Otitis Media?
Otitis media is an ear infection. Three out of four children experience otitis media by the time they are 3 years old. In fact, ear infections are the most common illnesses in babies and young children.
Are there different types of otitis media?
Yes. There are two main types. The first type is called acute otitis media (AOM). This means that parts of the ear are infected and swollen. It also means that fluid and mucus are trapped inside the ear. AOM can be painful.
The second type is called otitis media with effusion (fluid), orOME. This means fluid and mucus stay trapped in the ear after the infection is over. OME makes it harder for the ear to fight new infections. This fluid can also affect your child’s hearing.
How does otitis media happen?
Otitis media usually happens when viruses and/or bacteria get inside the ear and cause an infection. It often happens as a result of another illness, such as a cold. If your child gets sick, it might affect his or her ears.
It is harder for children to fight illness than it is for adults, so children develop ear infections more often. Some researchers believe that other factors, such as being around cigarette smoke, can contribute to ear infections.
What’s happening inside the ear when my child has an ear infection?
When the ears are infected the eustachian tubes become inflamed and swollen. The adenoids can also become infected.
- The eustachian tubes are inside the ear. They keep air pressure stable in the ear. These tubes also help supply the ears with fresh air.
- The adenoids are located near the eustachian tubes. Adenoids are clumps of cells that fight infections.
Swollen and inflamed eustachian tubes often get clogged with fluid and mucus from a cold. If the fluids plug the openings of the eustachian tubes, air and fluid get trapped inside the ear. These tubes are smaller and straighter in children than they are in adults. This makes it harder for fluid to drain out of the ear and is one reason that children get more ear infections than adults. The infections are usually painful.
Adenoids are located in the throat, near the eustachian tubes. Adenoids can become infected and swollen. They can also block the openings of the eustachian tubes, trapping air and fluid. Just like the eustachian tubes, the adenoids are different in children than in adults. In children, the adenoids are larger, so they can more easily block the opening of the eustachian tube.
Can otitis media affect my child’s hearing?
Yes. An ear infection can cause temporary hearing problems. Temporary speech and language problems can happen, too. If left untreated, these problems can become more serious.
An ear infection affects important parts in the ear that help us hear. Sounds around us are collected by the outer ear. Then sound travels to the middle ear, which has three tiny bones and is filled with air. After that, sound moves on to the inner ear. The inner ear is where sounds are turned into electrical signals and sent to the brain. An ear infection affects the whole ear, but especially the middle and inner ear. Hearing is affected because sound cannot get through an ear that is filled with fluid.
How do I know if my child has otitis media?
It is not always easy to know if your child has an ear infection. Sometimes you have to watch carefully. Your child may get an ear infection before he or she has learned how to talk. If your child is not old enough to say, “My ear hurts,” you need to look for other signals that there is a problem.
Here are a few signs your child might show you if he or she has otitis media:
- Does she tug or pull at her ears?
- Does he cry more than usual?
- Do you see fluid draining out of her ears?
- Does he have trouble sleeping?
- Can she keep her balance?
- Does he have trouble hearing?
- Does she seem not to respond to quiet sounds?
A child with an ear infection may show you any of these signs. If you see any of them, call a doctor.
What will a doctor do?
Your doctor will examine your child’s ear. The doctor can tell you for sure if your child has an ear infection. The doctor may also give your child medicine. Medicines called antibiotics are sometimes given for ear infections. It is important to know how they work. Antibiotics only work against organisms called bacteria, which can cause illness. Antibiotics are not effective against viruses, such as those associated with a cold. In order to be effective, antibiotics must be taken until they are finished. A few days after the medicine starts working, your child may stop pulling on his or her ear and appear to be feeling better. This does not mean the infection is gone. The medicine must still be taken. If not, the bacteria can come back. You need to follow the doctor’s directions exactly.
Your doctor may also give your child pain relievers, such as acetaminophen. Medicines such as antihistamines and decongestants do not help in the prevention or treatment of otitis media.
How can I be sure I am giving
the medicine correctly?
If your doctor gives you a prescription for medicine for your child, make sure you understand the directions completely before you leave his or her office. Here are a few suggestions about giving medicine to your child.
1. Read. Make sure the pharmacy has given you printed information about the medicine and clear instructions about how to give it to your child. Read the information that comes with the medicine. If you have any problems understanding the information, ask the pharmacist, your doctor, or a nurse. You should know the answers to the following questions:
- Does the medicine need to be refrigerated?
- How many times a day will I be giving my child this medicine?
- How many days will my child take this medicine?
- Should it be given with food or without food?
2. Plan. Sometimes it is hard to remember when you have given your child a dose of medicine. Before you give the first dose, make a written plan or chart to cover all of the days of the medication. Some children may require 10 to 14 days of treatment.
3. Follow Through. Be sure to give all of the medicine to your child. Make sure it is given at the right times. If your doctor asks you to bring your child back for a “recheck”, do it on schedule. Your doctor wants to know if the ears are clear of fluid and if the infection has stopped. Write down and ask the doctor any questions you have before you leave his or her office.
Will my child need surgery?
Some children with otitis media need surgery. The most common surgical treatment involves having small tubes placed inside the ear. This surgery is called a myringotomy. It is recommended when fluids from an ear infection stay in the ear for several months. At that stage, fluid may cause hearing loss and speech problems. A doctor called an otolaryngologist (ear, nose, and throat surgeon) will help you through this process if your child needs an operation. The operation will require anesthesia.
In a myringotomy, a surgeon makes a small opening in the ear drum. Then a tube is placed in the opening. The tube works to relieve pressure in the clogged ear so that the child can hear again. Fluid cannot build up in the ear if the tube is venting it with fresh air.
After a few months, the tubes will fall out on their own. In rare cases, a child may need to have a myringotomy more than once.
Another kind of surgery removes the adenoids. This is called an adenoidectomy. Removing the adenoids has been shown to help some children with otitis media who are between the ages of 4 and 8. We know less about whether this can help children under age 4.
What about children in daycare, pre-school, or school?
Even before your child has an ear infection or needs to take medicine, ask the daycare program or school about their medication policy. Sometimes you will need a note from your doctor for the staff at the school. The note can tell the people at your child’s school how and when to give your child medicine if it is needed during school hours. Some schools will not give children medicine. If this is the case at your child’s school, ask your doctor how to schedule your child’s medicine.
What else can I do for my child?
Here are a few things you can do to lower your child’s risk of getting otitis media. The best thing you can do is to pay attention to your child. Know the warning signs of ear infections, and be on the lookout if your child gets a cold. If you think your child has an ear infection, call the doctor.
Do not smoke around your child. Smoke is not good for the delicate parts inside your child’s ear.
To schedule an appointment with the Ear, Nose and Throat Institute, please call 770.740.1860.
Surgery of the Eyelids
Every year, one hundred thousand men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, your surgeon may also recommend a browlift, facelift, or skin resurfacing to achieve the best results.
If you are wondering how blepharoplasty can change the way you look, you need to know how eyelid surgery is performed and what you can expect from this procedure. This pamphlet can address many common questions and provide you the information to begin considering blepharoplasty.
Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your Georgia blepharoplasty surgeon can answer specific questions about your specific needs.
Is Blepharoplasty for You?
As with all facial plastic surgery, good health and realistic expectations are prerequisites. Blepharoplasty removes the excess fat, muscle, and skin from both upper and lower lids. The results can be a refreshed appearance, with a younger, firmer eye area.
People with circulatory, ophthalmological, or serious medical conditions must rely on the diagnostic skills of their own personal specialists to determine whether blepharoplasty is an option to consider. Consultation with the facial plastic surgeon can help you decide whether any additional, complementary surgery would increase the success of the surgery. Your Georgia eyelid surgeon might recommend planning a simultaneous forehead lift to correct a drooping brow and smooth the forehead, or skin resurfacing to remove the fine line wrinkling in the eye area.
Making the Decision for Blepharoplasty
Whether the surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. The patient must also make the commitment to follow the pre-surgical and post-operative instructions of the surgeon.
During the pre-surgical consultation, you will be examined or asked to answer queries concerning vision, tear production, use of lenses, and your desires for surgery. Your surgeon will explain what you can expect from blepharoplasty and take a complete medical history. Factors to be weighed include age, skin type, ethnic background, and degree of vision obstruction. Furthermore, you can expect an open and honest exchange between you and your surgeon, which will establish the basis for a successful outcome.
After a mutual decision is made by both you and your surgeon, the technique indicated for your individual surgery will be discussed. The type of anesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be outlined.
Understanding the Surgery
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.
In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.
What to Expect After the Surgery
Immediately after the surgery has been completed, your Georgia eyelid surgeon may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. Your surgeon will prescribe medication for discomfort.
For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eye drops may be recommended. Your surgeon will also list activities and environments to avoid in the weeks immediately following surgery. Permanent stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.
Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, facial plastic surgery can help change how you feel about yourself.
Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve vision or surgery for eye deformity or injury may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.
Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow’s feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.
If you ever wondered how a rhytidectomy, or facelift, as it is commonly called, could improve your looks or self-confidence, you need to know how a facelift is performed and what you can expect from this procedure. This pamphlet can address many of your concerns and provide you the information you need to begin considering facelift surgery.
Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery is performed. Your surgeon can answer specific questions about your specific needs.
Is a Facelift for you?
As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of rhytidectomy is crucial and psychological stability is vital. There is no ideal in a facelift. Rather, the goal is to improve the overall facial appearance. Skin type, ethnic background, degree of skin elasticity, individual healing, basic bone structure, as well as a realistic attitude are factors that should be discussed prior to surgery. This procedure is sometimes performed on patients in their thirties, and successful surgery has been performed on patients in their eighties. A facelift cannot stop aging, nor can it turn back the clock. What it can do is help your face look its best and give you a look of health and a more youthful appearance. A side benefit is that many patients experience increased self-confidence.
Before deciding on a facelift, you should discuss with your facial plastic surgeon whether the overall effect will be more successful if additional changes are made in the chin and neck areas through other facial surgery. Many patients decide to have facial liposuction to remove excess fatty deposits in conjunction with a facelift. If several flaws need correction, more than one procedure may be necessary for the best overall result.
Making the Decision for a Facelift
Your choice of a qualified facial plastic surgeon is of paramount importance. During the preliminary consultation, the surgeon will examine the structure of your face, skin texture, color, and elasticity. Photographs will be taken so the surgeon can study your face. Individual risks will also be examined, especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, and any deficiency in blood clotting. The surgeon will take a thorough medical history, as well as assess the patient’s mental and emotional attitudes toward the surgery. Because a realistic attitude is crucial to the success of the surgery, the surgical procedure and realistic expectations will be discussed.
After the decision to proceed with a rhytidectomy is made jointly by you and your surgeon, the surgeon will describe the technique indicated, the type of anesthesia, the surgical facility, any additional surgery, the pros and cons to include possible complications, and costs of the procedure.
Understanding the Surgery
Our Georgia facelift surgeons begin the incision in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.
After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips, which permit surgery without shaving hair from the incision site. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia, the patient will experience little discomfort. Some surgeons prefer to use general anesthesia for facelifts. Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.
What to Expect After the Surgery
Even though most patients experience very little pain after surgery, our Georgia facelift surgeons will still prescribe medication. Some degree of swelling and bruising is unavoidable, and your surgeon may instruct you to use cold compresses to keep swelling to a minimum. If a dressing has been applied, it will be removed within one to two days. The surgeon will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery.
In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery. All sutures and staples are usually removed within five to 10 days following surgery. Surgeons generally recommend that patients avoid vigorous activity. Patients should prearrange for post-surgery support from family and friends.
Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature. In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred. Bear in mind that the aging process continues after surgery and that some relaxation of tissues will occur over the first few weeks.
Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.
What to Expect from a Hearing Aid Purchase
Since you are considering the purchase of hearing aids, it’s important for you to establish reasonable expectations from these highly sophisticated, miniature devices. Acquiring hearing aids is not merely a simple act of going to a store and purchasing a product. Rather, it is a complex process-one that evolves over time and begins with the hearing –impaired individual accepting the realization that hearing impairment has detrimental effects on interpersonal relationships and safety. The hearing impaired person’s motivation to hear well is the single most important factor in determining the success of the hearing aid fitting. It is important to realize that you will not experience the exact same benefits from your hearing aids as your neighbor does. This individuality is a critical component, and I want to emphasize that your expectations should be based on you, your type and degree of hearing loss, your past experiences, and the improvements you personally receive from amplification.
There are several “reasonable expectations” for the hearing aid consumer. However, there is only one totally unreasonable expectation-do not expect normal or perfect hearing!
- Expect others to notice your hearing loss before you do!A common complaint of hearing-impaired individuals is that other people mumble-and if they would just speak up, it would be easier to hear them! This is placing the “blame” externally, rather than accepting the reality that your ears are not as good as they used to be. Realize that it is your hearing. Take that step to have your hearing tested before you blast your loving spouse out of the den with the blaring sound of the TV set. Seek our help! We are here for you.
- Expect our Georgia audiology staff to be knowledgeable, courteous, and accommodating. Your Georgia audiologist will take a thorough case history. She is searching for information about your hearing loss, its probable cause, and whether your offspring may be affected. It is important to establish the presence of any medical condition associated with your hearing loss as this will trigger a medical referral. Comprehensive hearing and hearing aid evaluations will be conducted. These evaluations will provide information about the degree and nature of your hearing loss, as well as your ability to process and discriminate the fine sounds of speech. Comfortable listening levels will be defined, as well as a determination about how well you tolerate loud, intense speech and other sounds. These findings are very important as they allow the audiologist to pre-set some of the characteristics of the hearing aid’s circuitry. You will have time to talk with the audiologist about the different styles of hearing aids (in-the-ear, in-the-canal, completely-in-the-canal, behind-the-ear), the advantages and disadvantages of each style, and maintenance issues and costs involved. Approximately 80% of all hearing aids sold fit in the ear. After you and your audiologist determine the best style of hearing aid for your needs, an ear impression will be obtained. The ear impression is a plastic case of your ear which reveals the exact shape of your ear so the laboratory can place circuitry in a hearing aid shell that will fit your ear(s) only.
- What is the best for me?Everyone in the hearing aid industry acknowledges the fact that there is not a single “best” hearing aid. Rather, there are many excellent hearing aid brands available, and there are many different types of circuitry that may benefit you. Your audiologist uses the case history information and the evaluation results to make the best recommendation for you and your lifestyle. Expect a recommendation to purchase two hearing aids if both of your ears are hearing impaired and are “aidable.” There are many benefits to binaural (two ear) hearing, including being better able to understand speech in noise, and being better able to localize sound. Your audiologist will explain the advantages of a binaural fitting versus a monaural fitting in more detail. Nonetheless, it is very important to understand that if you have two ears with hearing loss, and you only wear a hearing aid in one ear, you will still have significant hearing problems, even under the best of circumstances. A reasonable good analogy is to consider wearing a single eye glass for a two-eye vision problem, such as being near-sighted or far-sighted–it simply will not work well for very long!
- Expect our staff of assess your hearing difficulties in several environments and define individual goals for you. These goals may include hearing your spouse better in the car, hearing your friends better on the phone, or any others that relate to you and your hearing difficulties. These assessments are not like the hearing evaluation given by the audiologist. These are tools that allow us to measure your self-perception of how your hearing loss affects your activities of daily living and how amplification can improve you quality of life.
- Expect to be offered a 30 day trial period. Although not always required by law, many audiologists offer a trial period of 30 days for you to adapt to amplification. You may be asked to pay a non-refundable fee during this time. Ask about this trial period, and if not offered, seek a second opinion. Use this 30 day trial period to test the hearing aids in the environments that are typical of your lifestyle-not only at home, but also at your friends’ and relatives’ homes, your favorite restaurant, shopping center, grocery store, or place of worship.
- Expect the hearing aids to cost more than you think they should. There are three categories of hearing aid technology-analog, digitally programmable, and digital. Analog technology has been around for many years. Aids utilizing this technology are also called “conventional” hearing aids and they are the least expensive. Digital hearing aids use digital signal processing-the newest form of technology on the market. Digital hearing aids are indeed complete computers, similar to the PC on your desktop, but they are the size of a pencil eraser! These aids cost approximately $2500 per aid, similar to your PC. Digitally programmable hearing aids will cost somewhere between the conventional price and the digital price. You many benefit from any of the three types of technology. Speak with your audiologist about the types of circuitry and which would be best for you.
- Expect an initial orientation session with your audiologist in which you will learn how to handle and care for your new aids. You should invite your spouse or significant other to attend this first critical session in getting oriented to your new aids. During this session, you will be taught how to operate the hearing aids, how to clean them, and how to change the batteries. You will receive written information about your aids. Please note, batteries are particularly important. Please be sure to store them and use them exactly as your audiologist advises. Please be sure to keep all batteries away from pets and children. It may be difficult for you to remember all the things the audiologist tells you during this first session, so don’t leave the office without your instructional brochure. It will be very valuable to you, particularly during the first weeks of owning your new hearing aids.
- Expect a period of adjustment. Once you get your new hearing aids, expect an adjustment period of several days to many weeks to get used to the daily care and maintenance of the hearing aids. You’ll need time to learn how to: insert and remove the hearing aids from your ear, learn to adjust the volume control, learn how to clean them, learn how to open and close the battery door, learn to change the battery. As you can see, there is a lot to learn, and people learn at different speeds. I recommend that you go slowly, learn one thing at a time, practice, and stay in contact with your hearing healthcare professional.
- Expect your voice to sound different. For many reasons, your voice will sound strange to you at first-like being in a barrel. This is a normal early perception and it is often called the “occlusion effect”. If you don’t adjust to this after a few days, discuss this with your audiologist. Many times, this feeling can be alleviated through changes in the hearing aid. Your audiologist deals with this issue regularly, and they will be able to solve this with you over a short period of time.
- Expect a good, comfortable fit. Initially, it will take a while to get used to having the hearing aids in your ears. You may experience a little soreness or irritation at first, but after a few days or a week or so, you should be able to wear the aids for several hours per day without any pain or discomfort. I always find it reassuring when patients tell me they often forget that they are wearing their aids. Remember-even though the audiologist will make your ear impressions so your hearing aids will be custom fit, many things can happen in the manufacturing process and any discomfort should be reported to your audiologist immediately. If your aids are not comfortable, you will not get the maximum benefit from them, and you should not wear them. Report all discomfort or irritations to your hearing healthcare professional, and do not wear the hearing aids until she advises you as to how to best address the problem.
- Expect multiple follow-up appointments. The greatest advantage of digital hearing aid technology is the flexibility in programming the sound quality, as well as many other electro-acoustic characteristics of your hearing aids. These hearing aids are highly sophisticated instruments with many features. The computer software that is used to program your hearing aids allows the audiologist to make a multitude of adjustments while the aids are in your ears. You can actually hear many of the changes as the audiologist is adjusting different features or characteristics. Other features will only be noticeable in other environments. So, be sure to tell your audiologist as much as you can about your listening experiences in many environments.
Congratulations on taking your first step towards better hearing! Our goal is to help you in this process and we look forward to seeing you again.