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Sinus Surgery

We're dedicated to providing diagnosis and treatment Acute sinusitis is usually treated with medications or flushing before sinus surgery is considered. The ENT physician may find that the recurrent infections are not as responsive to treatments after some time. In these cases, surgery to enlarge the nasal passageways and drain the sinuses is considered. Before sinus surgery options are considered, the ENT physician will first ask a series of questions about clinical history. Then, a diagnostic workup will be undertaken to determine the underlying cause of the sinusitis before considering sinus surgery. Some tests include CT imaging, nasal physiology, smell testing, and blood analysis. We currently use FESS in sinus surgery. This includes functional endoscopic sinus surgery and image-guided surgery.

FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS)

Sinus surgery was first developed in the 1950’s, where an endoscope (a very thin fiberoptic tube) was entered into the passageways to clear the mucus from the major sinuses. Functional endoscopic sinus surgery has improved over the last several decades. It involves getting direct visualization of the sinuses by inserting an endoscope through the nose. Using state-of-the-art tools and instruments, diseased tissues and obstructions are removed. There is very little swelling after this procedure, and only mild discomfort. No external scars are obtained because this sinus surgery is performed exclusively through the nostrils. It is less extensive than other procedures and it can be performed on an outpatient basis.

IMAGE-GUIDED SURGERY

There are always areas of concern when it comes to inserting an endoscope into the sinuses because they are close to the eyes, brain, and major arteries. Image-guided sinus surgery eliminates those concerns with the use of new technology. This surgery is most often recommended when the individual has severe chronic sinusitis, has had previous surgery that changed anatomical landmarks, or if the patient has congenital anatomical abnormalities in the sinuses. In this procedure, a CT scan is combined with real-time imaging to determine the location of the instruments using infrared signals. It is easier to navigate surgical instruments in this manner.

Snoring

We're dedicated to providing diagnosis and treatment

WHAT IS SNORING?

Persistent loud snoring could be an indication of sleep apnea, which blocks the airway and interrupts the restorative REM sleep cycles. Untreated apnea can lead to long-term health conditions like diabetes, cardiovascular disease, and even play a role in obesity. Furthermore, snoring interrupts sleep patterns and can lead to daytime fatigue and loss of focus, which can be extremely hazardous in the workplace and normal daily activities, such as driving.
Some amount of snoring is considered normal and harmless, such as during times of illness when the nasal passageways are stuffed and swollen. When you fall asleep, the muscles in the throat relax and the airways narrow. For some people, they narrow too much, so they are forcing air in and out of these narrowed tubes and creating a vibration in the surrounding tissues. This is what creates that harsh, hoarse, vibrating sound.

CAUSES OF SNORING

  • Deviated septum
  • Nasal polyps
  • Enlarged uvula, tonsils, or tongue
  • Elongated soft palate
  • Small jawbone
  • Large neck size
  • Smoking
  • Frequent allergies

IS IT SLEEP APNEA?

There are several types of sleep apnea, but snoring is the most common symptom of all types. Symptoms include:

  • Insomnia (difficulty falling or staying asleep)
  • Excessive daytime sleepiness
  • Difficulty with focus and concentration
  • Problems with memory
  • Irritability and inability to cope with stress
  • Anxiety
  • Frequent bouts of depression
  • Headaches, especially upon wakening in the morning

IS SNORING PREVENTING ADEQUATE SLEEP?

Snoring is a harsh, hoarse sound that occurs when breathing is obstructed while one is sleeping. Oftentimes, snoring indicates a serious health concern. It can also be a nuisance to a spouse or partner.

TREATMENT FOR SNORING

Generally, the first line of treatment for snoring is lifestyle changes, i.e., weight loss, avoiding alcohol, changing sleep position, and treating nasal congestion. If obstructive sleep apnea is the cause of snoring, then other treatments may be considered including:

  • Use of oral appliances
  • Continuous positive airway pressure (CPAP) machine
  • Surgery (traditional or laser)

The most common treatment for this type of snoring is the use of a CPAP machine or an oral appliance. The CPAP involves wearing a mask that pressurizes oxygen while you sleep. The mask is attached to a pump that provides enough oxygen to keep the airways open. As many people find this an uncomfortable treatment measure due to the mask and loud noise of the machine, oral appliances such as a form-fitting dental mouthpiece may be considered. It advances the position of the jaw, soft palate, and tongue to keep the airways open.

Tonsillectomy

WHAT IS TONSILLECTOMY AND WHY WOULD IT BE NEEDED?

Tonsillectomy is the removal of the tonsils through surgical measures. There are two tonsils, oval-shaped pads, located at the back of the throat on either side, which can become enlarged, inflamed, and painful.
Previously one of the most common treatments for inflammation of the tonsils (tonsillitis), tonsillectomy is now frequently done for sleep-disordered breathing; however, it may still be used to treat the chronic inflammation of the tonsils.

WHY IS TONSILLECTOMY IN HOUSTON PERFORMED?

As mentioned, tonsillectomy is used to treat the following conditions:

  • Chronic, recurrent, and severe tonsillitis
  • Complications arising from enlarged tonsils, such as difficulty swallowing or breathing
  • Recurrent bleeding
  • Rare diseases of the tonsils or cancers

RISKS OF TONSILLECTOMY

Like all other surgeries, tonsillectomy comes with some general risks and possible complications. These include, but are not limited to:

  • Negative anesthetic reaction: The medication that puts you to sleep during the surgery can have a negative impact on the body and brain. Side effects of this medication after the procedure can include nausea, vomiting, headache, and muscle soreness. More serious problems arising from anesthesia could include the risk of death.
  • Swelling: This could cause breathing problems if the tongue and soft palate become overly swollen.
  • Bleeding during the procedure: Very rarely, severe bleeding during surgery can occur, requiring additional treatment and a longer stay in the hospital or surgical center.
  • Bleeding during the healing process: It is normal for a little bit of bleeding to occur during the healing process, but excessive bleeding can lead to more problems and the need for additional treatment.
  • Infection: It is rare for infection to occur after the procedure, but it is still a possibility, especially in humid climates like Houston.

WHAT TO EXPECT FROM A TONSILLECTOMY IN HOUSTON

Usually done as an outpatient procedure, a tonsillectomy is a common surgery that will allow the individual to go home the day of the procedure, barring there were no complications. During the tonsillectomy, general anesthesia is administered, which means the individual will not be aware of the experience. The ENT surgeon in Houston will cut out the tonsils using a blade (scalpel) or other specialized surgical tool that uses high heat or sound waves to remove the tissues or stop the bleeding. During the recovery process, there is usually pain in the throat and sometimes in the ears, but it may also radiate into the neck and jaw. Often, the surgeon will prescribe medications to reduce the pain, but it is also recommended to drink a lot of fluids, take in soft foods, and get plenty of rest. The normal recovery time for a tonsillectomy in Houston is 10-14 days.

FACELIFT (RHYTIDECTOMY)

The technical name for a facelift is “Rhytidectomy.” In this surgical procedure, excess face and neck skin are removed and the tissues under the skin are tightened. Activities such as smoking, sunbathing, outdoor activities, and stress can alter the appearance of the face. Additionally, as we age deep creases may form between the nose and mouth, the jaw line may from slack and sag, and fold and fat deposits may appear around the neck. A face lift can reduce these signs of aging, resulting in firmer, fresher appearance.

NOSE RESHAPING & REDUCTION (RHINOPLASTY)

Rhinoplasty is a surgical procedure done to correct a prominent, unusual asymmetric or irregular nose. It is one of the most commonly performed cosmetic procedures. Rhinoplasty can also be used to correct an undesirable nasal tip or to reshape the span of the nostrils. This surgery can help with your self-image if you are self-conscious about your nose.

FACIAL IMPLANTS

Facial liposuction removes the fatty deposits in your face and neck. Benefits include a more natural look than a face lift, fewer risks, scars, and rapid recovery.

FACIAL LIPOSUCTION

We’re dedicated to providing diagnosis and treatment Facial liposuction removes the fatty deposits in your face and neck. Benefits include a more natural look than a face lift, fewer risks, scars, and rapid recovery.

Deviated Septum Surgery
(Septoplasty)

A deviated septum is a sideways displacement or malalignment of the wall between the two nostrils and passageways. The septum directs airflow and supports the nose. It is made up of cartilage in the front and bone in the back. Deviated septum occurs when the bone or cartilage is no longer straight. Correction of this deviation is called septoplasty.

RISKS OF TONSILLECTOMY

Additional names for this procedure include septal reconstruction and submucous resection of the septum. It may be part of a plan to treat chronic sinusitis, bleeding, inflammation, or sleep apnea. Deviated septum surgery may also be performed if there are nasal polyps that need to be removed.
Prior to the septoplasty, the surgeon may want to have a look at the passageways using a lighted instrument called an endoscope. The patient will then receive general or local anesthesia for the procedure, which will take anywhere between 60 and 90 minutes. During the deviated septum surgery in Houston, the surgeon will work through the nostrils and separate the mucosa from the underlying bone and cartilage. The bent cartilage is then reshaped and straightened, after which the mucosa is replaced. A deviated septum surgery can be performed in our Houston outpatient center, so the patient can go home that same day, barring there were no complications.

WHAT TO EXPECT AFTER SEPTOPLASTY

There may be a nasal splint or pack placed after septoplasty in order to stop bleeding and keep the septum straight through the healing process. The ENTAC surgeon will provide detailed and important aftercare and follow-up instructions, which must be followed exactly. For example, the patient should not blow their nose or sneeze with their mouth closed because it will cause pressure changes. There may be some swelling and pain, but these will subside within a week or two after the procedure.

WHAT ARE THE RISKS OF SEPTOPLASTY?

As with all surgeries, deviated septum surgery (septoplasty) is not without its risks. There is the risk of anesthesia, as well as infection and bleeding.

Turbinate Reduction
(Turbinectomy)

The nasal turbinates are masses inside the nose that warm and humidify the air we breathe. A turbinate reduction, or turbinectomy, is performed to reduce the size of these tissue masses.

TURBINATE ANATOMY

When the turbinates become unusually large, they can obstruct airflow and make breathing difficult. This is generally exacerbated by lying down and can cause chronic runny nose. Nasal obstruction is a very common problem. An obstruction of these passageways can lead to an individual breathing through their mouth, which leads to dry mouth and sore throat. The turbinates are located on the sidewall of the nasal cavity, projecting into the passageways as ridges of tissue. Inferior turbinates are usually the ones that become inflamed and block airflow.

THE TURBINATE REDUCTION (TURBINECTOMY) PROCEDURE

It is important to note here that turbinectomy does not cure allergies. If allergies are a concern, then a turbinate reduction procedure will likely not give the relief that is needed from the chronic runny nose and difficulty breathing.
Extramural Turbinate Reduction. This is the physical removal of part of the turbinate, but taking no more than 25%. General anesthesia is administered, and the recovery period is usually about four to five days. This method is very rarely recommended.

LIMITATIONS OF TURBINATE REDUCTION

As mentioned, usually no more than 25% of a turbinate is removed. It is not recommended to take more than that, as it will risk the development of empty nose syndrome. Additionally, it should be noted that the turbinectomyin Houston might not work for everyone. Some may even need to have the procedure performed on more than one occasion to get adequate relief.

POSTOPERATIVE CARE FOLLOWING TURBINECTOMY

One can expect pain, nasal stuffiness, fatigue, and mild drainage following the procedure. The pain is usually mild and well controlled with postoperative pain medications prescribed by the physician. The stuffiness, drainage, and fatigue should start to resolve after the first week. It may be necessary to use nasal saline sprays or irrigation after the turbinate reduction in Houston.

BROW LIFT
(TEMPORAL BROW LIFT)

Dr Aguilar has performed hundreds of brow lifts, endoscopic brow lifts and related brow lift procedures. This procedure also known as a forehead lift reduces the wrinkles that occur across the forehead as well as those between your eyes.
It also improves the frown lines that happen between your eyebrows while raising sagging brow that hood the upper eyelids.

EYELID LIFT
(BLEPHAROPLASTY)

Your eyes are your most expressive facial feature. Your eyes tell the world when you are happy or sad, angry or tired. However, extra skin and fatty tissue around eyes can also age you & give others a false impression of who you really are and how you feel inside. Most Patients need either their top eyelids surgically improved or bottom lids; referred to as “bags”.
Blepharoplasty corrects this problem by removing excess skin and fat from both the upper and lower eyelids. As one of the most commonly performed plastic surgeries by Dr. Fred Aguilar, Blepharoplasty is often combined with other procedures such as facelifts, Temporal Brow Lift or injectables such as Botox or “fillers” (ie. Sculptra, Juvaderm, Restylane, etc). The result of an upper or lower blepharoplasty resuscitates a more refreshed look; which creates a very natural appearance and assists in maintaining a more youthful look without the “overdone” appearance.
The upper eyelid lift is achieved by first creating a slim incision inside the natural crease of the eyelid. The incision extends just past the outer edge of the eye into the natural laugh lines, making the tiny incision line practically invisible after surgery.
The lower eyelid lift is designed to eliminate puffiness and bulging fat under the eyes. For patients who have an excess of fat and skin under their eyes, the incision for the lower eyelid lift is made just below the eyelash line, where the resulting line will be nearly undetectable. For patients who do not have an excess of skin under their eyes, the surgeon may remove extra fat through an incision on the inside of the lower eyelid. Occasionally patients need both upper & lower lids done; which would be discussed at your one-to-one consultation with Dr. Aguilar Blepharoplasty surgery is performed under general anesthesia or I.V. sedation, and usually takes one to two hours. As it is an outpatient procedure, patients are able to be driven home that same day. Patients usually return to work within one week depending on individual healing process.
Directly after an eyelid lift surgery, Dr. Aguilar will recommend that the patient keep their head elevated and use cold compresses regularly to diminish post-operative bruising and swelling. Sutures will need to be removed on the fourth or fifth day after an eyelid lift, and patients can expect most swelling to subside after one week. Some bruising may last for up to two weeks, but this can be easily hidden with make-up once the swelling is gone. The results of an eyelid lift will be dramatically apparent after the first two weeks. Patients will continue to see improvement in the eyes as the scars soften and mature over the next several months.

4126 Southwest Freeway Suite
1210 Houston, TX 77027
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