Ear Surgery: Otoplasty

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What is it?

Otoplasty is a surgery performed for the correction of deformities in the outer ears, (for e.g., protruding ears) and to reshape them. The goal of this procedure is to make the ears symmetrical and natural looking.

At what age?

Autoplastic can be performed most effectively in adults and adolescents. However, in some extreme cases, where a child complains of his/her appearance and suffers psychologically because to it, Otoplasty may need to be considered in children as well. The child will need to be at least 7 years of age, in order to be considered for this procedure. In some cases, Otoplasty expenses may be covered by the Health Insurance system (l’Assurance-Maladie).

Techniques

Several options like striations, incisions, resections and sutures, are available to carry out this procedure. In most cases, a strip of skin from behind the ear, may need to be removed to carry out the procedures. But this of course depends on the nature of the problem and the technique chosen to resolve it. The choice of technique happens at the time of consultation, and varies from case to case.

Scars

Usually, the post-surgical scars occur only in the Postauricular Sulcus, which get concealed in the natural crease behind the ear. But in some cases, minor additional incisions in front of the ear pavilion, may become necessary. But such additional incisions can easily be concealed within the folds of the ear.

Recovery

The recovery course varies from one individual to another. In general, the recovery is quite painless, and only requires simple analgesics. The sutures used are usually non-absorbable, and will be removed 10-15 days after surgery.  Post-surgical dressing comprises of an elastic bandage around the head. This helps maintain the proper position of the ear throughout the recovery phase. On the second day after surgery, a lighter bandage will replace this. Some diffuse swelling and bruising may occur, but these will disappear over a few days.

The patient will need to wear a restraining headband, throughout a period of 15 days, after which it will need to stay on only during the night. The full extent of the effectiveness of the treatment will only be visible after 2-3 months of surgery. The scars fade away over a period of 2-3 years.

Anesthesia

Several options are available and the surgeon and the anesthetist jointly decide on the type of anesthesia to be used for a particular case. In most cases, local anesthesia potentiated by neuroleptanalgesia will be sufficient.

Possible complications

Hematoma: this is a form of internal bleeding leading to the blood collecting in the retroauricular region. It requires a rapid surgical intervention to drain out excess blood.

Infection: This is not very common, but in the rare case of pus (micro abscesses) formation on the sutures, infection might occur, but can be treated fairly easily.

Delayed healing: Healing can be delayed due to wound disruptions caused by hematoma or infection. These can be treated easily.

Abnormal healing: This is a rare complication caused by skin necrosis above the cartilage, which may leave visible scars. This condition more common in smokers, given the fact that tobacco prevents microcirculation.

Persistent edema: this involves some swelling and it may take up to several months to heal completely.

Abnormal Scars: Speed of recovery varies from patient to patient. Abnormal scarring (like expanded, adherent, hyper or hypo pigmented, hypertrophic or keloid scarring) is a potential complication that may occur in some rare cases. Keloid scars occur more often in ears. However, the risks are quite low, estimated rate of 1 out of every 500. The treatment can prove to be complicated, and may include steroid injections, silicone compressions, and scar revisions.

Imperfect Results: despite the best efforts, results may not always up to the scratch. Unexpected complications may cause scarring and other delays in recovery leading to such gaps. Sometimes, this calls for secondary surgery under local anesthesia.

Conclusion

Otoplasty of protruding ears is a well-documented medical procedure, known to yield excellent results. It is well worth the effort, considering the fact that it can eliminate major sources of complexes due to appearances, leading to psychological problems, especially in school-going children.

 

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Docteur Dany GZAÏEL - Cosmetic & Aesthetic Surgery

Doctor Dany GZAÏEL - Cosmetic & Aesthetic Surgery 

18, Rue de Magdebourg
 75116  PARIS - FRANCE
Tél : +33 1 45 05 26 16

Fax : +33 1 46 21 85 42-docteurgzaiel@free.fr