Introduction to Otoplasty (Ear Plastic Surgery)
Prominent or defective ears are a problem with quite a significant number of people. This is a problem experienced not just by the older people but also among children. It is estimated that approximately 5% of all children get prominent ears which ends up being a subject of bullying and teasing in school. The problem ends up affecting how a person perceives him/herself. This can go as far as making a child loath going to school because of the teasing they get due to either the size or angle of their ears. Some adults, on the other hand, are always struggling to hide prominent ears through hats or with long hair. Decades ago this was the only option people had, but this is not the case anymore. Through Otoplasty, a surgical procedure used to correct ear deformities, adults and a section of children no longer have to live through the psychological burden caused by prominent or deformed ears.
What causes prominent ears?
The primary cause of prominent ears is genetics. If any of your parents or their lineage has a member with oversized or protruding ears, then your chances of getting this condition are significantly high. Deformed ears caused by genes can manifest themselves in various ways. In some cases, one will experience partial or a total lack of development of antihelix or deep concha (cup) around the external ear during their childhood. This problem becomes more conspicuous as an individual grows older. Another characteristic of protruding ears caused by genetics can be oversized concha and the inclination angle of concha on the head. The angle through which concha are, mounted can make them divert too much from the head causing the ears appear more prominent. The ear cartilage fold angle can also have a similar effect.
Some patients can only have one of these conditions while in other cases an individual may have more than one or all of the above conditions.
Accidents can cause deformities of the ear and Otoplasty can still be used to correct these issues. There has hardly been any case of prominent ears being created by accident.
Types of Otoplasty
Before a doctor can consider a child for this operation, he/she must be over five years old. Above this age, the ears are usually fully grown, and hence it makes it easier for the physician to identify the specific problem causing these protruding ears. Sometimes prominent ears can be noticed as early as after birth, and in these cases, the ears can be rectified without having to undergo surgery. When discovered at this early stage, a silicone device can be attached to the ears such that it naturally molds the ear enabling it to grow proportionally to the rest of the body while acquiring the correct folding in just three weeks. The problem is that at this early stage doctors may diagnose it as a temporary condition that will look normal after, the baby’s growth only for it to turn out into a permanent state at which the only treatment option is Otoplasty.
Various Otoplasty approaches can be used. Different techniques apply for different conditions, and hence for a surgeon to know which method works best, they have to examine the cause of the problem and factor in your expectations before providing a way forward.
- Ear Pinning
Ear pinning is one type of Otoplasty that is performed with the patient under general anesthesia for children and local anesthesia and sedation in adults. This surgery takes typically around 1-2 hours depending on the scope of the operation. The doctors make a small incision just behind the ear exposing the cartilage. The surgeon will then start reshaping the cartilage and removing excess skin until the desired size and shape is achieved. In cases where there was severely protruding from the ears, the doctor will go further to reposition the ear bringing it closer to the head. The incision is then sealed using non-removable sutures or stitches. These will be covered with tape for safer healing and to reduce swelling.
Ear pinning is one of the ideal otoplasty techniques for people with excessive prominent ears. In this method, the surgeon can conduct cartilage scoring and can also remove as much skin as possible from the back of your ears to deliver the desired results. Ear pinning can be achieved through two principal methods. The choice on which of these methods will be used is dependent on the amount of correction that is being done. The two ways are:
- Cartilage Sparing – This is a non-invasive otoplasty procedure used during ear pinning that utilizes sutures and stitches. The method, therefore, leaves behind smooth and natural-looking results.
- Cartilage scoring – This is a more aggressive approach where the surgeon digs in to remove, add or rearrange tissues through a tiny incision. This technique is ideal when you are looking for a significant impact. Its drawback, however, is that there is increased chances of scarring. These scars are subtle and rarely conspicuous.
- Reconstructive Ear Surgery
Reconstructive otoplasty is a surgical procedure used to correct not just genetic deformities but also ear problems caused by injuries. One of the common issues fixed by this technique is Microtia a rare congenital disability. This method is used to treat other defects caused by torn or infected piercings, lacerations, burns, etc. Reconstructive ear surgery can be done in different approaches. In some cases, the surgeon can remove cartilage or add other tissues to provide a pleasing and natural look. This method can also be used to graft the ears. Grafting in reconstructive ear surgery requires the surgeon to take skin tissue from other parts of the patient’s body, e.g., upper buttock and use it to augment the ears.
- Ear Reduction Surgery
While other patients are more focused on achieving equal ear angles and inclinations, others try to reduce the size of the ears. This procedure is carried out on both adults and children and is always performed on an outpatient basis. In this type of otoplasty, the surgeon will sculpt large ears until they are proportional to the head or meet the patient’s needs. In this surgery, the doctor gets rid of the excessive and unwanted skin and cartilage and may also go ahead to reshape the ear. Ear reduction surgery can also be conducted on the earlobe alone for a patient with excessive tissues in this part. This operation can also be done together with ear pinning and helps to deliver symmetrical and balance between ears and the face.
What’s Bilateral Otoplasty?
Some people have always confused bilateral otoplasty as a type of plastic ear surgery, but this is not correct. Bilateral otoplasty refers to the correction of both ears. Patients with ear deformity especially the ones caused by genetics usually affect both ears. The doctor in such cases has to perform the surgery on both ears to achieve uniform results. Bilateral otoplasty hence has the same impact and subjects you to the same complications as surgery done on one ear. Patients may experience a slightly more throbbing or itching effect when undergoing plastic surgery on both ears than the ones having the operation on a single ear.
After the operation, the surgeon will prescribe some pain medications to make the recovery process bearable. The pain on the first day will, therefore, be minimized. Presence of the dressing that’s covering incisions also assists to make healing safer although most patients find it annoying. This tape needs to be left on for at least three days as it also helps to safeguard the incisions from infections. For better recovery, you are also urged to sleep with your head covered with a ski band for 1-2 months to prevent the ears from folding. Any bruising or skin discoloration caused by the surgery will disappear after ten days. Adults can usually resume full daily activities after one week. You should also wait for your physician’s green light before you start engaging in strenuous activities.
Potential Otoplasty Complications
Complications after ear plastic surgery are rare especially if the operation is done by an experienced and certified surgeon. In some cases, the results obtained may be undesired or may start reversing earlier than expected. In such instances, the patient can seek the services of a physician to perform a revision surgery to solve the problem. Typically, the younger the patient is, the less the chances they’ll need a recurrence surgery. This is because the cartilage of younger patients is less developed and hence reshaping and resizing it is more natural and is likely to remain intact than mature cartilage.
Other complications include skin necrosis, bleeding, and internal bruising. This bruising can be solved by removing or replacing the stitches used in covering the incisions.
Otoplasty Insurance Information
A few insurance companies do reimburse costs incurred in ear surgeries especially among young patients. For most adults, you will have to contact your carriers to find out whether your cover has a reimbursement policy for this particular surgery.