Services 2018-10-26T09:20:30-05:00

Ear, Nose, and Throat Services


Allergy is a genetic trait often seen in several family members.  There is no cure for allergy, but treatment is available.  Medical therapy consists of antihistamines, decongestants, saline nasal spray, sinus rinses, topical steroid spray, antihistamine spray, and oral steroids.  Environmental measures include the use of HEPA filters, dust mite precautions, avoidance of pet dander, masks and protective goggles.  If the symptoms are disruptive enough, or severe enough, then the patient can be tested to discover their exact allergies, and a desensitization program can be designed specifically for their needs.

Desensitization consists of a weekly allergy shot, or daily sublingual drops, introducing the allergen to the body in such a way that the immune system builds up blocking antibodies over time.  Upon exposure to an allergen, the blocking antibody effectively reduces, if not eliminates, the allergic response.

Nasal polyps are outpouchings of the membrane that lines the inside of the nose.  The membrane produces mucous, which gets trapped inside the polyp, causing it to grow.  Because there is limited space inside the nasal cavity, these polyps cause obstruction in airflow and the patient finds it hard to breathe through the nose.  Removal of the polyps gives relief by re-establishing normal airflow patterns.  Some polyps are so extensive they require removal under general anesthesia,  Less severe cases can often be managed in the office under local anesthesia.

Polyps are often seen in allergic patients.  Therefore, the patient should be treated for any concomitant allergies they might have.  Nasal hygiene measures are prescribed, which include steroid nasal spray, saline spray, sinus rinses, and silver gel.  Unfortunately, even under the best circumstances, polyps can recur.

Endoscopic sinus surgery is an operation performed under general anesthesia in a hospital setting.   It is indicated for patients with complicated and/or extensive sinus disease.  During the procedure, a camera system is used to visualize the interior of the nose.  A microdebrider removes polyps and tissue blocking the sinuses, which then reestablishes normal sinus function.

Most insurance plans cover this operation when certain criteria are met.  Our office will take care of the precertification process and can usually give you a ballpark figure of your out of pocket expenses.

For patients who do not qualify for balloon sinuplasty in the office, endoscopic sinus surgery is the best alternative.

Balloon sinuplasty is an in office surgical procedure to treat chronic or chronic recurrent sinusitis.  Patients with these conditions suffer from frequent sinus infections, for which they have to take high powered antibiotics.  They lose time off work and school. Their quality of life suffers due to headaches, fever, muscle aches, fatigue, fog brain, dizziness, ear pressure, sinus pressure, sore throat, constant cough, and drainage.  Many patients have had teeth pulled thinking that would relieve their dental pain, when actually it is pain coming from their sinuses.  In chronic sinusitis patients, some, if not all, of these symptoms never go away.  It becomes a debilitating disease.

Balloon sinuplasty is performed under local and topical anesthesia.  The patient avoids the risk and expense of general anesthesia in the operating room.  Premedication drugs are given to help the patient relax and be comfortable.  Once the nose is numb, a tiny balloon is introduced into each sinus opening and then inflated to remove any blockage present.

Afterward, the patient usually has minimal to no discomfort.  A small amount of bleeding may occur over the following 24 hours.  Most patients can go right back to work within a day or two.

Patients report greatly improved breathing, much less sinus pressure, fewer to no sinus infections. Most have said the procedure has changed their life.

A major cause of nasal airway obstruction is a deviated septum.  The septum is the structure that divides the nose into a right side and a left side.  When the septum is straight, the breathing is equal on both sides.  When the septum is bent (deviated) it decreases airflow through one side compared to the other.  Sometimes the obstruction seems to switch sides.  This is especially noticeable when lying down.

The cause of a deviated septum can be due to an injury, either recent or in the past.  Injuries occur from traffic accidents, fist fights, sports injuries and falls.  Often, there is no obvious explanation, but rather just the result of nature.

Septoplasty is the term for surgery to correct the defect.  It is most often performed under general anesthesia as an outpatient.  Most insurance companies cover the procedure, but this office will always do a precertification process to ensure coverage. Recovery is usually uncomplicated.  Bleeding and discomfort can be expected for a day or two, but are typically minimal.

Medical Aesthetics


There are three different neurotoxins available.  We use Botox in this office.  It is reliable with a high safety profile.  Botox relaxes the muscles of facial expression that cause frown lines, crows feet, and forehead wrinkles.  Botox typically takes three to five days to take effect,  but may take up to two weeks.  On average it lasts three to four months.

Bruising is rare, and usually limited to the injection site. Occasionally, it  is more extensive, especially for people on blood thinners. Drooping of the eyelid is an occasional side effect.  These are all unusual and temporary.

Be sure to discuss with your doctor any blood thinner you might be taking or any change in your medical condition. You should not get Botox injections if you have certain neurological conditions.

A chemical solution is applied to the skin causing exfoliation of the superficial layer of dead skin cells. The skin regenerates itself, resulting in a smoother, less wrinkled, more radiant look. The peel can be used on the face, neck, and hands.

We offer three levels of chemical peel. The Illuminize peel is the lightest peel and recommended for those who have never had a peel before. This is also referred to as the “lunchtime” peel, because there is no downtime, and the patient can go right back to work. It usually doesn’t cause any peeling, but does give a radiant glow.

The Vitalize peel is the medium depth peel. Peeling usually starts 2-3 days after the peel and lasts 2-5 days.

The Rejuvenize peel is the deepest level peel. Like the Vitalize peel, the peeling usually starts 2-3 days after the peel and lasts 2-5 days. These peels are safe for all skin types, but darker skin types should start with the Vitalize peel.

Post peel skin is more sensitive to sunlight, so sunscreen is essential. Avoid direct sun exposure for at least a week.

For best results, we recommend a series of three to six peels performed four to six weeks apart. Peels are used to treat fine lines, wrinkles, sun damage, acne and acne scarring.

As we age, we lose volume secondary to bone loss, gravity, sun damage, and smoking. This results in deepening of the nasolabial folds (lines around the mouth) and Marionette lines (jowls). These factors also cause thinning of the skin with loss of collagen and elastic fibers. This results in wrinkling of the skin, crows feet (laugh lines), frown lines, forehead creases.

Dermal fillers restore lost volume, lifting and plumping to restore a more youthful appearance. Botox smooths the forehead, crows feet and frown lines by relaxing the muscles that cause wrinkling.

Platelet rich plasma (PRP) therapy is one of the newer treatments available, and is becoming increasingly popular. Platelets contain embryonic growth factors, from where all new cells are born. We spin down your blood to harvest those platelets, so this treatment is 100% safe. PRP stimulates circulation, collagen growth, and tissue repair. With it, we can address scarrring, acne, rosacea, enlarged pores, sun damage, wrinkling, volume loss, and tired complexion. Patients LOVE the results. We recommend a series of three treatments spaced a month apart. After that, many choose to do maintenance every 3-6 months.

There are several different dermal fillers available.  Most are hyaluronic acids (for example, the Juvederm family).  Within that category are different options for different areas of the face.  A more permanent filler is BelllaFill which is great for lifting the cheeks and jowls.  The results obtained from fillers are immediate, which allows you to become an active participant in the process of evaluating the result.  In this office, we strive for a very natural, refreshed appearance.

Downtime is minimal, with swelling and bruising the main side effects.  We do offer a product to prevent bruising, if your are interested.
There is no restriction on diet or activity, although we recommend no strenuous activity for the first few days.  You should stop all Aspirin containing medications, NSAIDS (ibuprofen, Aleve, Motrin, etc) for a week prior to your procedure.  Stop all over the counter supplements as well.  You will be able to use any kind of makeup or coverup you wish immediately following the injections.

Loss of volume in the lips is very common. We use a couple of newer fillers (Vollure and Volbella) that last year the best year in town we can get together we are up to 18 months. They give a beautiful natural look to the lips without looking overdone.

There are several ways to remove unwanted hair on the face and body.  We use the Venus Versa system, a combination of Intense Pulsed Light and SmartPulse technology. The light energy targets the pigment in hair to destroy the follicle.  The cooling system makes this a virtually PAINLESS process.  Because hair grows in cycles, the best results are obtained by a series of six treatments approximately four weeks apart.  The length of the session depends on the area being treated. There is no downtime, and no restrictions afterward.  As opposed to waxing and shaving, this is a more permanent method of hair removal. Our laser is safe for all skin types, including darker skin tones.
Two weeks after balloon, patient states he is breathing much better.  His headache and cough are gone.  His severe sinus pressure and pain are gone.  He is sleeping better at night.  His recovery was a nonevent.  He is sending his brother in to see me, because he has the same issues.
JC, 6/6/18
I feel better than I have for a very long time. I am breathing so much better. I am sleeping better. I no longer have all that drainage in my throat making me snort and clear my throat. I am very happy my doctor sent me to you.

I am breathing so much better now! I can’t believe all the stuff that came out of my sinuses. I wish someone had recommended this a lot sooner.

MS, 3/5/18
My breathing is so much better! My sense of taste improved. My sense of smell is better. My asthma is better.
BH, 5/17/17

The balloon was fantastic.  It REALLY helped!

JJ, 3/1/18

I am feeling great! I was having horrible headaches every day. I haven’t had one headache since the balloon procedure. I am so happy!

MJ, 6/17/17

I am really happy. I am breathing much easier. That lump in my throat is gone. My sinus pressure is all gone. Everything is draining well. I had no discomfort whatsoever during the procedure or afterward. I never took any of the medication. I really appreciate what you did for me.

MW, 3/13/18

The balloon did wonders for me.

JF, Three years after Balloon Sinuplasty

My nose is PERFECT. My breathing is so EASY! My wife no longer complains about my snoring.

JJ, One year after Balloon Sinuplasty

I am so much better. I have had no bronchitis. My breathing is great! There is much less drainage.

PD, 1/17

I had a cough for four months. I have had no sinus pain. I’ve had no cough since I walked out of here. It’s a miracle. I am telling all my friends.

RG, 8/16

I am breathing a lot better. My ear stopped draining and my hearing improved. The headache and pressure are gone.

EA, 3/17

I am breathing so much better. The pressure is gone. The irrigations are working better. The ear pain is GONE. The tight feeling in my nose is gone.

MF, 3/17

My sense of smell has improved. Everything seems fresher. There is much less sinus pressure.

AR, 2/17

I love it! My breathing is better. My cough is gone. I am sleeping better.

MZ, 5/17

I am breathing better than I ever have.

RK, 5/17

The balloon did wonders for me. I am breathing so much better. I gave away my CPAP machine.

JP, 2/17

I am much better. I have had far fewer sinus infections.

KS, 2/17

My headaches are gone!!! The pressure is gone. I am very happy. Thank you for helping me.

BS, 2/17

That balloon sinuplasty really changed my life. It really did. Thank you.

MM, 11/16

I’ve had much fewer headaches and a lot less gunk.

SH, 2/17

The pressure is gone. My sense of smell is back.

ST, 1/17

I can’t believe how much air I get through my nose! I haven’t had a headache since the procedure.

LW, 11/16

Before the procedure, I had an ENG, CT, MRI and neurologist consult to evaluate my dizziness. That was all normal. I haven’t had any dizziness since the balloon.


My breathing is so much better. I didn’t realize how different it has been. And my vision is better.

SC, 9/16

My breathing is a LOT better. No snoring!

SM, 9/16

I’ve had no headache! No trouble breathing! I am VERY happy!

JL, 10/16

I can actually breathe through the left side of my nose, and I haven’t been able to for years. My nose has never really worked right, until now.

RK, 1/17

I am breathing a lot better. I no longer have to use my CPAP (for sleep apnea). My brother is thinking about doing it.

Wife: “It has changed his life.”

JP, 8/10/16

I want to thank you so much for saving my life. Before I came to you I was so sick for so long. I couldn’t think straight. I almost ended my life I was so desperate. They just kept throwing more meds at me which just made me feel worse. The sinus infections were so bad, I thought my head was going to explode. That surgery you did was a Godsend. It changed my life. My husband will tell you the same thing. This is the first time I’ve been sick since then, and I wouldn’t even call this sick.

BH, 12/20/17
My breathing is so much better now. My sinus pressure is basically gone. It used to last for months. I can feel a drastic difference.
AV, 4/10/18

The balloon worked GREAT! My sinuses are all cleared up. It worked a lot better than surgery

LH, 4/4/18

I haven’t had a sinus headaches since the procedure!

LJ, 3/28/18

My breathing is much better! My headache is gone. (The balloon) really helped a bunch. My airflow is much better.

EY, 3/28/18

My sinus pressure is gone. My head feels lighter. I have a lot more energy. I feel like doing something now.

MH, 5/16/18
I have a patient who has been sick for a year and a half, missing work all the time because of daily fever, severe fatigue, and a pounding headache. She couldn’t think straight. Couldn’t focus on her job. She had to go on short term disability while her insurance company drug their feet, denying coverage for the treatment she needed.

After MUCH effort and appeals, she was able to undergo inoffice balloon sinuplasty. I saw her today for her postop appointment. Her HEADACHE IS GONE! She is breathing better and sleeping better. She is back to work, and very happy.

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