Hello everyone, in today’s blog you will see that I had to make decisions about my health. Yes, I am a practicing physician, but injuries of the face are not my forte. I received very different opinions from different doctors and I had to put it all together, which was not an easy task.

I am sure that many of you have been or are in the process of making a serious decision based on the information you receive from doctors. One main point here will be you always need to get another opinion. In addition, just because a doctor is well known doesn’t mean he/she will do the best thing for you.

The CAT scan revealed that I indeed had multiple fractures of my face, the most prominent being the zygomatic arch, which is the bone between your ear and nose right under the eye. It’s the one that gives your cheekbone a nice round shape. After notifying me of my results, the ER doctor, who was very nice and competent, told me I was probably looking at surgery with plates and pins.

By the way, a word about nausea. I have always been taught that when treating patients, nausea is worse for them than pain, and from this experience I can fully attest to that. As the blood filled my sinuses, I had tremendous nausea. When the doctor offered me pain medications I refused. I told him it really hurts but if the Percocet will make me even more nauseous I will not take it, I’d rather be in pain. He gave me something for the nausea, and I began to feel human, then I took the pain medication. I can also say from personal experience that the only time this concept may not apply is in the case of a kidney stone, which involves pain and nausea, but the pain is so insanely severe, pain meds first please.

Anyway, I was discharged from the ER, CAT Scan and drugs in hand, and off I went to seek professional help. I called a plastic surgeon friend who told me nothing needed to be done right away, so that gave me reassurance that I had some time to get to the right person. You should take your time too.

I did a bit of research and made appointments to see to 2 prominent facial surgeons, each at different institutions. Teaching point: I didn’t see one then decide to see another, I went for 2 opinions from the start.

Doctor One. Asshole. Typical NY office: all of the NY’s best this and best that plaques. Alright, I seem to be in the right place. Plus he was highly recommended, so let’s see where this takes us. He seemed nice, thoroughly examined my CAT scan, and then told me what I absolutely needed, no question about it. I needed to have the bones put back in their right place with pins and plates. Because some of the broken bones were part of my upper jaw, he said that if I did not have the surgery I would never be able to eat properly again. To get to the bones, he would need to make a long incision right across the front of my face. Not a word about the resulting scar. He was so interested in doing the surgery, he called the hospital and resident right in front of me and scheduled me for Sunday. Who does surgery on Sunday? Who rushes to get the thing booked right away? Someone desperate to operate, that’s who. He already knew I was getting other opinions, so after hearing this I said I would get back to him. I did not totally dismiss his suggestion, but I left his office running. And he was the most prominent surgeon at a very fancy New York Hospital.

Doctor Two. Better, but, well you’ll see. Same thing, the good recommendation, plaque city. He was a very nice man, who seemed much more competent that doctor one. He reviewed my films and told me that I had the option of surgery or no surgery. If I had surgery he could do it from the inside of my cheek. Wow what a difference; imagine how angry I became at doctor one who had no problem at all slicing my face right open. I am still mad at him. Doctor 2 was not worried about the eating thing, getting me even madder at Doctor 1. Doctor 2 did however say that he was in favor of surgery. Why? “Because afterwards I would be more beautiful.” More beautiful? Is he kidding? Here I was 50 years old, married 24 years and he is telling me I should have the surgery to be more beautiful? I think he must have dosed off during our conversation and he forgot I was not coming in for a facelift. Then when I asked him again about a scar he did say that some time after the original surgery he would need to make a tiny incision on my face to remove a wire. Oh.

Two doctors 2 very different opinions. At least I felt safe with Doctor 2, so if I thought I should have the surgery, I was fine with him doing it.

So as it turns out I have a friend through a friend who is also a prominent facial surgeon, Steven Denenberg. He practices in Omaha, but with the internet and phones, I was able to send him my films and talk about my options. With Steve, things were starting to make sense. The key approach: think about what you have now, and how that might be changed with surgery. What did I have? A depressed face, pushed in about 2-3 millimeters, enough to see if you looked carefully, but to most people, not noticeable. What would surgery do? It would give me a risk of bleeding, infection, big or small scar, and may or may not be able to make a big difference in the way I looked. What if in the quest for perfection, the doctor raised the bone 2 mm too much? This is a real possibility because it’s hard to get it exactly right with such small distances. What if in healing it only really elevated one millimeter? Then it was kind of a waste to have the surgery in the first place.

So in the end, I did not have the surgery. When I look in the mirror, I see the dent, but I’d rather see the dent than a massive scar or some other bump or new dent from surgery that was supposed to make me better. And years later I am still eating, no one has ever noticed my slightly asymmetric face, and I have not missed out on any movie roles for being less beautiful.

Has a doctor recommended surgery to you? Do you have fibroids, endometriosis or uterine scaring? Next time I will do my best to discuss which surgeries may be necessary and which are not.

Thanks for reading, I’ll write again soon,

Dr. Licciardi