Miami Herald (Sunday)

I just had hip surgery but now I have pain in my back. Why and what should I do?

- BY HARLAN SELESNICK, M.D. Special to the Miami Herald

replacemen­t surgery. Most patients are up walking with a walker the day of surgery and have great pain relief and improved ambulation within a few weeks.

It is likely you had an abnormal gait and limb length difference prior to surgery that you had gotten used to. The surgeon probably corrected any significan­t limb length difference and allowed you to walk more normally.

Your lower back and other lower extremity joints may have some trouble adjusting to these changes. Your lower back pain could also be caused by arthritis or a lumbar disc problem.

I suggest you get checked by your hip surgeon or a spine specialist to determine the cause of your lower back pain. Hopefully, a return to physical therapy and a core strengthen­ing program may be all you need to get better.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthea­lth.net

Q. I had my nose done and over the years it seems to have gotten thinner and thinner. What are my options to fix this problem?

A. If you do not have any problem breathing, then it’s strictly a cosmetic issue. If you do have a problem breathing, then it is a reconstruc­tive issue as well.

First, I will address the cosmetic issue. Over the years, after rhinoplast­y, your nose may appear to get smaller and thinner because the thickness of your skin changes with time. As some of the underlying fatty tissue of your skin gets depleted with age and sun exposure, the skin gets thinner.

This issue can be corrected non-surgically with injectable fillers. The procedure is very easy, although care needs to be used when injecting fillers into the nose as there are complicati­ons that can arise. If this procedure is done with an experience­d injector who understand­s the nasal anatomy, it can be done very safely.

If, however, you do not wish to have this problem on a constant basis, surgery can be performed to make your nose appear more in balance with your face.

It could be that your surgeon either took too much cartilage and bone, or with the aging of the skin, your nose appears smaller.

These procedures are too complicate­d to discuss in detail in this column.

My recommenda­tion is that you find a very experience­d facial plastic or plastic surgeon who has extensive reconstruc­tive experience to make your nose appear thicker and more in balance with your face.

Should you have a problem breathing, you might need to open up the valve area and or fix the septal area of your nose to breathe better.

Because we have fillers that last well over one year, there are many solutions to your problem that are non-surgical and should be considered before surgery is entertaine­d.

 ?? Miami ?? Over the years, after rhinoplast­y, your nose may appear to get smaller and thinner because the thickness of your skin changes with time.
Miami Over the years, after rhinoplast­y, your nose may appear to get smaller and thinner because the thickness of your skin changes with time.
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Miami

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