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Ears: Otoplasty
A Common ProblemProbably one of the most common conditions affecting the outer ear is the “lop ear deformity.” Essentially this is a congenital problem whereby there is a failure of development of a specific crease or fold to the upper portion of the outer ear. Instead of an ear position close to the scalp, the ear protrudes far away from the scalp. Additionally, more fullness and prominence of the cartilage of the center portion of the ear can also cause additional protrusion of the ears, which essentially contributes as well to the ear protrusion and the “ears sticking out” phenomena. Ridicule and TeasingChildren who are born with a lop ear-anomaly often times do quite well up until the time of school. At this time, the natural human tendency is unavoidable and traumatic teasing and ridicule, particularly in the classroom and on the playground. As for adults, hairstyles may be worn in such a fashion that camouflages the protruding ears, but when ponytails are desired or short hairstyles become more commonplace the protruding ears become anxiety-provoking for both men and women with lop-ear deformity. Overall, the deformity has the potential to cause deep inherent emotional scars that may not be realized by even the closest family member or friend. Indeed, friends and relatives are often unaware of the significant psychological trauma. Realization of the inherent personal significant of the protrusion deformity may only manifest directly following a successful otoplasty operation. Counseling is sometimes successful in dealing with the problem, however, surgical treatment of protruding ears can be quite rewarding for both a young child and an adult. What is Otoplasty?Otoplasty involves reshaping, remodeling, and reforming the outer ear. Specifically, otoplasty resolves the lop-ear deformity and the protrusion of the aesthetically displeasing lop-ear appearance. When Should Otoplasty Be Performed?Preferably, otoplasty if performed on children before the first grade. Addressing the problem early helps to avoid significant ridicule and teasing that is generally unavoidable after the first grade. From a developmental and physiologic point of view, the procedure may generally be performed any time after the age of five. Surgery the outer portion of the ear (auricle) is less desirable before age five due to concerns for less than complete cartilaginous development and outer ear growth. Commonly, adult men will seek treatment for the lop-ear anomaly when they decide to change their hairstyle or when they no longer desire to wear a hat for camouflage. Women will seek treatment when short hair becomes fashionable or when they desire to wear their hair up. For adults, the decision for the otoplasty is primarily dependent upon one’s own resolve to improve a reasonably simple problem, particularly since the solution carries minimal associated effort or risk. The ProcedureOtoplasty is usually performed on an outpatient basis under IV sedation or general anesthesia. An overnight hospital stay is not required. After anesthesia, an incision is simply made behind the ear. The resultant incision is hidden well. Even with men or in an individual with a short hairstyle or ponytail, the incisions are difficult to notice after appropriate healing. Ear cartilage is then meticulously reshaped and remodeled in a precise manner to obtain a contour that is less protruding, more natural, and aesthetically more in contour with the rest of the head and face. A measured amount of cartilage and skin is sculpted and trimmed away. The upper ear crease is created by weakening the cartilage in the back of the ear at the site where the new crease is to be created. Ear cartilage is then folded on the weakened site and repositioned. Sutures are placed to secure the cartilage in the appropriate position. The result is an ear that is natural in appearance. The procedure takes approximately one hour to perform. Bleeding is minimal. The RecoveryA turbine type dressing/bandage is worn around the head and ears directly following the procedure. The patient goes home the evening after the surgery and the turbine is left on until it is removed in the office the next day. The head is elevated at night after the procedure in order to avoid unwanted pressure on the top rim of the ears. Hair washing is permissible approximately two days after the surgery; however, care must be taken to avoid placing direct pressure on the ears. Walking and routine house activities are allowed one week after the procedure. Strenuous activity is to be avoided for two weeks following the procedure. ExpectationsThe degree of improvement for each individual is dependent upon a number of factors. Generally, otoplasty achieves a very reasonably high level of satisfaction for each individual. However, the underlying physical and anatomical characteristics of the individual are important for the ultimate result. Additionally, the artistry, craftsmanship, and experience of the facial plastic surgeon significantly influences the final result as well. Overall, one should expect improvement and reasonable symmetry. The need for revision to a certain region occurs on occasion and often times can be addressed in the office. Thousands of otoplasty operations are successfully performed each year in the United States.
Also See: Procedures Overview
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