Ear Correction Surgery (Otoplasty)
Description (over view)
Ear correction surgery, or otoplasty, reshapes part of the cartilage in the ears, allowing them to lie closer to the side of the head. Most people who have otoplasty are between the ages of 4 and 14. This is because, at that age, ear cartilage is softer and easier to mould. However, otoplasties can still be effective in adults.
Otoplasty can also alter large or stretched earlobes or lobes with large creases and wrinkles. Plastic surgeons can even build new ears for people who were born without them or who have lost them through injury.
Other ear problems that can be helped with otoplasty include:
- ‘lop ear’ – when the tip seems to fold down and forward
- ‘cupped ear’ – a very small ear
- ‘shell ear’ – when the curve in the outer rim, as well as the natural folds and creases, are missing.
If you are concerned about the way you or your child look, and you are thinking about surgery as a way to boost confidence, there may be other ways to achieve this. Talking to a counsellor or psychologist may help you overcome your concerns about your or your child’s appearance. Discuss possible options with your medical practitioner.
There are three main types of otoplasty:
Ear augmentation is needed if the pinna is underdeveloped or non-existent, known as microtia.
Otopexy, an ear pinback, “flattens” protruding ears.
Ear reduction can reduce the pinna when it is too big. When the ears are too large, this is called macrotia.
Why Otoplasty Is Reguired ?
You might consider otoplasty if:
- Your ear or ears stick out too far from your head
- Your ears are large in proportion to your head
- You’re dissatisfied with a previous ear surgery
Otoplasty is typically done on both ears to optimize symmetry.
oplasty won’t change the location of your ears or alter your ability to hear.
Why Iran Is Suitable For Otoplasty ?
Patient Eligibility \ Who Can Have Otoplasty ?
The ideal candidates for otoplasty procedure are people who have:
- Ears that protrude from the sides of the head
- Ears that fold over on top (lop ears)
- Ears that are asymmetrical (different sizes, different shapes)
- Ears that are overly large in proportion to the facial profile
- Ears that need repair due to injury or birth defects
How Is Otoplasty Done? (Procedures)
The procedure routinely takes one to two hours. The supporting tissue of the ears, called cartilage, is reshaped in order to position your ears closer to your head. Dr generally begins the otoplasty surgery by making an incision just behind the ear, in the natural fold where the ear connects to with your head. He then surgically removes the necessary amounts of cartilage and skin required to achieve the desired result. Also, small sutures are used to create a roll in the ear which is often missing giving the ear a flattened look. In some cases the cartilage may need to be trimmed, shaping it into a more desirable form and then pinned back with permanent sutures.
Subsequent scars will be concealed in the natural skin crease. In some cases, especially in ears that need to be reduced in size or are protruding in the middle 1/3 of the ear, external incision of the front (outside surface) of the ear will be necessary. Usually these are placed in areas where they will heal in a more inconspicuous manner. In ear reductions, skin as well as cartilage will most often need to be removed.
Dr will discuss the otoplasty procedure in great detail during your consultation, and will draw pictures of ears and show you photographs of the surgery and before and after photographs of former otoplasty patients. Most children have the ear pinning procedure done under a general anesthetic, but adults often have surgery under a local anesthetic or intravenous sedation.
Preparation & Recovery
How you prepare
– A consultation for otoplasty
Initially, you’ll talk to a plastic surgeon about otoplasty. During your first visit, your plastic surgeon will likely:
- Review your medical history. Be prepared to answer questions about current and past medical conditions, especially any ear infections. Talk about any medications you’re taking or you’ve taken recently, as well as any surgeries you’ve had.
- Do a physical exam. To determine your treatment options, the doctor will examine your ears — including their placement, size, shape and symmetry. The doctor might also take pictures of your ears for your medical record.
- Discuss your expectations. Explain why you want otoplasty and what you’re hoping for in terms of appearance after the procedure. Make sure you understand the risks, such as possible overcorrection.
If you’re a good candidate for otoplasty, your doctor may recommend that you take some steps to prepare beforehand.
Food and medications
You’ll likely need to avoid aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.
Also, be sure to make plans for someone to drive you home after surgery and stay with you for the first night of your recovery.
What you can expect
Before the procedure
Otoplasty can be done in a hospital or an outpatient surgical facility.
Sometimes the procedure is done with sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia — which renders you unconscious — may be given before your procedure.
During the procedure
Otoplasty techniques vary based on what kind of correction is needed. The specific technique your plastic surgeon chooses will determine the location of the incisions and the resulting scars.
Your doctor might make incisions:
- On the backs of your ears
- Within the inner creases of your ears
After making incisions, your doctor might remove excess cartilage and skin. He or she will then fold the cartilage into the proper position and secure it with internal stitches. Additional stitches will be used to close the incisions.
The procedure typically takes about two hours.
After the procedure
The patient will need bandages over their ears for several days after surgery. While the bandages are in place, they will not be able to wash their hair.
After removing the bandages, a loose but supportive headband is worn over the ears at night.
This will help remove tension from the ears. The headband should be worn loose to prevent the ears from being pulled forward if the patient moves while sleeping.
The individual can return to school or work within a week of surgery. Regular activity and exercise can restart within 2 weeks.
Patients should avoid activities that could cause trauma or injury to the ears during the recovery period. Physical contact sports, such as judo, rugby, or football should be avoided for at least 3 months. Swimming should be avoided for up to 8 weeks after surgery.
Post-surgical numbness may continue for several weeks, and mild bruising may be present for up to 2 weeks. The ears may feel stiff for several months. Soreness, particularly at night, can last for a few months.
The desire to change the appearance of the ears should come from the child.
Pediatricians and child psychologists recommend that children be old enough to understand what the operation involves beforehand.
Non-Surgical Otoplasty Non-surgical otoplasty doesn’t require any incisions and only uses sutures to pin the ears back and achieve a more symmetrical appearance. These special sutures are woven into the ears and will remain in place permanently. The sutures are not visible or palpable after a brief recovery period. Patients can expect instant results and a headband will only need to be worn at night for 1 – 2 weeks, making it easier for them to return to school or work. Non-surgical otoplasty procedures take about an hour to complete and only require local anaesthetic and oral sedation. Patients will only experience some mild discomfort during the recovery process and will be able to return to their normal daily activities after a few days. Since no incisions are made, scarring is not an issue with this otoplasty option. One of the biggest benefits of non-surgical otoplasty is that the results can be reversed several days after the procedure should the patient not be happy with the results. Patients may experience some mild bruising and swelling following their procedure but they will see immediate results. As with any cosmetic or surgical procedure, infection is always a possibility, which is why it’s important to keep the ears clean.
Some ear deformities in children, including protruding ears and Stahl’s deformity, can be treated with ear molding in the early weeks of life, when the cartilage in the ear can be reshaped by the application of splints and Steri-Strips. One technique involves making a mold in the shape desired for the child’s ear from dental compound and attaching it to the ear with methyl methacrylate glue. The ear and the mold are held in place with surgical tape and covered with a tubular bandage or ear wrap for reinforcement. The mold and tape must be worn constantly for six weeks, with a change of dressing every two weeks. Ear molding is reported to be about 85% effective when it is started within six weeks after the baby’s birth. The chief disadvantage of ear molding is its ineffectiveness in treating ear deformities characterized by the absence of skin and cartilage rather than distorted shape.
There are no effective alternatives to otoplasty in treating ear deformities or injuries in adults; however, some plastic surgeons use custom-made silicone molds to help maintain the position of the ears in adult patients for several weeks after surgery.
Risks & Complication
Some complications can arise with this procedure.
- Infection: rarely, an infection of the skin and cartilage of the ear may occur. This can be treated effectively with antibiotics.
- Bleeding: a hematoma or blood clot can form under the skin of the ear. There may be severe pain, inflammation, and bleeding of the wound. Bandages will have to be removed to treat the hematoma and the lesion.
- Suture complications: this depends on whether the sutures are absorbable, monofilament, or braided. Removing the sutures may sometimes be slightly difficult.
- Recurrence: the ears start sticking out again. Sometimes, revision surgery will be required.
- Unsatisfactory appearance: Sometimes, the results of reconstructive or cosmetic surgery are not what the person hoped for.
Other problems that can occur include:
- Asymmetry: it is difficult to set the ears back in exactly the same way
- Partial Correction: the ears are not positioned close enough to the head
Overcorrection: the most common complication, where the ears are positioned too close to the head