Author Topic: Question about new procedure  (Read 9120 times)

Offline naruto08

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Question about new procedure
« on: July 07, 2012, 06:19:59 PM »
Hi Doc,

I'm trying to research a new procedure called Cartilaze, but haven't found too much information about it. Have you ever heard of it and if you have will this procedure work?


Offline DrBermant

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Re: Question about new procedure
« Reply #1 on: July 08, 2012, 11:12:03 AM »
Hi Doc,

I'm trying to research a new procedure called Cartilaze, but haven't found too much information about it. Have you ever heard of it and if you have will this procedure work?

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Sorry, I had never heard about that before. But then I used the Internet and searched the word and became disturbed what I found. My initial impression is that some marketing for a new technique is asking the public to evaluate something and pressure doctors into using a new method, kind of what you have just done. However, in my case, I am retired. I can at least give my opinion and share my experience.

In evaluating ears, it is a question of setting up Standard Ear Pictures. Check this page carefully and  then go off and look at the examples posted on their site. If I was being asked if I would use their new machine based on those pictures, I would smile and walk away. The before and after photos I saw were actually unacceptable. In my opinion, the pictures fail standards set up my Plastic Surgery Societies ethics guidelines on how before and after images should be used. Each item is in itself not an issue, but the entire collection points out to one issue: I do not trust the documentation as to the problem or what may or may not have been done.  It is not up to me to decide if such pictures are a "violation" or if so who to report them to. I just know I did not like what I saw. What I did not like included:

  • Background Changed Before After
  • Shadows Hide Contours Being Analyzed
  • One View does not show enough to understand the complex contours of an ear
  • Several examples had the appearance of looking like the Overfolded Antihelix Complication. This complication comes in different degrees. Balancing the different elements of otoplasty is part of the art of this surgery. Here is another example of Over Bent Antihelix. However, there is not enough documentation to say that for a fact was the result. One view is not enough to say one way or the other, but enough for me to feel disgusted that more details were not made available.
  • Other examples had facial features that should not have been changed with surgery altered. Check out the pictures at the bottom of the link for Standard Ear Pictures. Lens choice that distorts the before after features is a critical mistake that a reputable surgeon knowledgeable in this surgery should not be making. When I see them, I question the validity of claims of surgical improvement. If the before and after pictures have different eyes nose as a distortion of lens used, then what factor of change in ears was from surgery and what from photographic technique.
  • One example had hair covering the after surgery result. Why? Was that ear not operated on or did they need to hide the result on that side?
  • One example had what looked like a Telephone Ear Deformity, again something not desirable where the top and bottom of the ears are not in the same plane as the middle.

I then tried to see their published literature. I found most articles published in the laser literature, not the Plastic Surgery literature. Why, were the articles rejected by the journals that evaluate otoplasty ear cosmetic contributions or what? They had one article published in an Aesthetics journal. I started reading that article. I did not like the results shown, but that again is only my opinion. Again only one view was used, but some of the results looked like they might have over folded antihelix or telephone deformity complications.

I do not know if the issues are with the tool or who is wielding the tool. It is not the scalpel making the mistakes, but who is using them. Any tool that weakens cartilage so it can then be molded might have value if the results last and the path taken was as good or better than what we have. From what I saw in my earlier years I might have confronted the salesman pushing that "proof" on me as unaceptable. I might have said, come back if you can show me something better. Instead we have someone posting about if this procedure works through the power of the Internet. I particularly liked the link on their site for investors. Is that possibly a clue? But the marketing game worked! Someone is asking! I do not think they were expecting someone to write a review of what they saw.

Once a new method got beyond my initial examination, I would then want to know more about how using their laser would change Otoplasty Complications. What changes in risks of bruising, scarring, sensation, and other factors I did not see carefully documented. Does the cartilage injury process also injure the nerves to make them numb or hypersensitive? What does their cartilage injury process do for stiffness of the ear: something we still do not have tools to test or document, but still a factor. I liked my ears after surgery to be supple, flexible. Ears injured too much are stiff and unnatural feeling. But how does that get evaluated or proven. I might want to feel some ears operated with that method if things got that far. I would also want to see Otoplasty Bruising Swelling After Surgery what was the path patients took using that method? I saw some photos in some netting and dressings, but not labeled sequence to analyze time after surgery and other factors. I also would like to know more about their special mold after surgery: Otoplasty Dressings After Surgery are part of the art of this sculpture. They factor not just into the results, but of what a patient must go through to have the procedure done. I did not see enough on any of these details on what I evaluated.

I may be retired and people can no longer come to me to have surgery. However, how I documented my patients' problems, their results, path they took, what they experiences can all be used as templates to measure someone's claims to skill, new methods, or problems. It is like going to a museum. I can't get that artist to paint my portrait, but I can sure admire what I see and learn from their methods and techniques.

When evaluating a new technique, you are welcome to check out our resources How to Pick an Otoplasty Surgeon and apply it to a site claiming to have a new answer and method? It is not just the picture issue. Who is doing the laser work? What training? What societies do the surgeons belong to? There are many items listed in our resource. I am sure over time it will grow and evolve.

From what I saw so far, I am not impressed at all. It may be a valuable method, but they did not show me enough to convince me to have used the method if I was still offering surgery. The shame is we all are eager to find new better solutions. I like the concept to molding an ear instead of surgery if the method can show itself to be better. What I am concerned is an expensive new tool to be sold to those without the skills to know how to use them to make a better new ear. Something like that famous story Kornbluth, Cyril M.: The Little Black Bag which Amazon says is available inside of The Best of C.M. Kornbluth (Unexpurgated Edition) (Halcyon Classics).


Edit: Sorry, Amazon said The Little Black Bag was inside this book. I do not think it is. I am still looking to find this great short story to read again.

Here is a summary Literature Annotations: Kornbluth, Cyril M., The Little Black Bag if you are not aware of this story, a favorite of mine from many years ago. But then yet again, it may be wonderful and awesome. But then I would be expecting to read about it in the Plastic Surgery Otoplasty literature or demonstrated with precision with Standard Otoplasty pictures and videos of patients' experiences.

So will it work? I do not know, they have not proven it to me.

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery
« Last Edit: July 08, 2012, 12:22:40 PM by DrBermant »
Michael Bermant, MD
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Offline DrBermant

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Re: Question about new procedure
« Reply #2 on: July 08, 2012, 12:35:01 PM »
Ah found:

http://books.google.com/books?id=yPVbDv5DqkoC&lpg=PA338&dq=kornbluth%20the%20little%20black%20bag&pg=PA338#v=onepage&q&f=false

from Google Books. will now be able to read again. Wrong! It was only a preview with missing pages. Too bad.

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery
« Last Edit: July 08, 2012, 01:28:41 PM by DrBermant »
Michael Bermant, MD
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Offline DrBermant

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Re: Question about new procedure
« Reply #3 on: July 08, 2012, 01:53:04 PM »
It was hard enough, but here it is, and only $0.99 for 8 short stories!

Eight Worlds of C.M. Kornbluth





C.M. Kornbluth was one of the Futurians (with such luminaries as Isaac Asimov, Frederik Pohl, Donald A. Wollheim, etc.) and produced a remarkable body of work until his untimely death at age 35. This volume collects 8 of his classic short stories -- the best of his best solo work -- plus an introduction and bibliography by Bud Webster.

Included are:

"The Cosmic Expense Account"
"The Adventurer"
"The Altar at Midnight"
"The Marching Morons"
"The Little Black Bag"
"Theory of Rocketry"
"Make Mine Mars"
"Time Bum"

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery







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Offline naruto08

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Re: Question about new procedure
« Reply #4 on: July 08, 2012, 09:55:11 PM »
Hi Doc,

Thanks for the in-depth review. As I was doing my research I was also skeptical, with the limited sources that were on the internet. It seems the only permanent and safe solution is to have the surgery performed on the ears. I'm having a really tough time finding a good doctor to go to, as I live in the Los Angeles area. Are there any sites that you could recommend that would point me in the right direction as to finding a good surgeon? Again, thanks for your reply and in-depth review and many thanks for the book recommendation =).

Will

Offline DrBermant

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Re: Question about new procedure
« Reply #5 on: July 08, 2012, 11:02:08 PM »
Hi Doc,

Thanks for the in-depth review. As I was doing my research I was also skeptical, with the limited sources that were on the internet. It seems the only permanent and safe solution is to have the surgery performed on the ears. I'm having a really tough time finding a good doctor to go to, as I live in the Los Angeles area. Are there any sites that you could recommend that would point me in the right direction as to finding a good surgeon? Again, thanks for your reply and in-depth review and many thanks for the book recommendation =).

Will

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

That is why I wrote the resource How to Pick an Otoplasty Surgeon. Use it instead of evaluating technique, what it was intended for: surgeon selection. Have you read the many components of that extended tool? I know of none that approaches the thoroughness of what I have written to date on How to Pick A Plastic Surgeon. New elements are planned for other aspects.

My combined Otoplasty Encyclopedia with integrated forums is one of the most extensive learning tools about this sculpture on the Internet. Actually I saw many patients from California and around the world who preferred my techniques and quite a few who were unhappy after surgery done by local doctors.

Quote
Are there any sites that you could recommend that would point me in the right direction as to finding a good surgeon?

I find it frustrating that despite what time I took to write the original pages and answer questions like yours in detail, enough is never enough for some. My resources have been evolving over the almost 16 years I have been building them.   You and others are welcome to suggest improvements in our pages. Contribute to our pool of experiences, explain what has been found and why it was rejected or liked. Share the good or bad surgical experiences, consultations, or learning experiences. That is the purpose of this site, making it easier to look beyond advertising hype and analyze what someone is offering. We are eager to engage with those looking to contribute and build.

Hope this helps,

Michael Bermant, MD
Learn More About Otoplasty Ear Surgery
Michael Bermant, MD
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