Aesthetic otoplasty (ear plastic surgery)
Floppy ears are the most common congenital deformity in the head-neck area. We distinguish three different deformities: defective formation of the antihelical fold, sizeable and high concha, protruding lobe.
2/3 of patients have a positive hereditary history. There is a strong correlation of this appearance with comments, negative criticism, bad impressions at first sight, it has effects on the daily social interaction.
Therefore, by correcting protruding ears we have an improvement in sociability and achievement of personal goals, probably as a result of increased self-confidence.
The aim of the operation is to create aesthetically beautiful, natural, symmetrical ears as far as possible, which do not look operated on. Their distance from the skull must be about 15 mm while the post-auricular fissure must be maintained. The upper and lower pole must be on the same straight line and antihelix must always be inside the helix.
The ear contour and surface must be smooth without scars and protrusions.
There are techniques which create the folds of the ear with seams and others which abrade or remove cartilage pieces from the ear in order to form it.
In the last decade we have moved away from techniques cutting cartilage as they cause complications like hematomas and sharp unnatural protrusions on the surface of the ear.
With the sutures we achieve a formation in the shape of the ear and reduce its distances from the skull. In childhood the success is bigger as cartilage is soft and pliable.
In adults, when they have particularly thick and hard cartilages, we will apply a combination of techniques in order to achieve sculpting without tension. Depending on the case, slight abrasion of the flap cartilage in its anterior surface will take place, but also reduction in the thickness of the concha, so that the ear can sit correctly in the ideal position and the result after surgery is permanent.
Taking care of the incision with a soft tissue flap
It is a special method in order to avoid palpation of the otoplasty sutures, but also so that the ear cartilage is not stripped in the posterior part.
After the end of sutures and the creation of the new antihelix, the sutures are covered by a soft tissue flap which comes to cover the seams.
This means careful skin handling, maintenance of soft tissue, so that the ear is again smooth to the touch, for the sutures not to risk appearing outwards, a common otoplasty complication.
The operation is done under local anesthesia in adults, but general in children, as it lasts for at least 1-1 ½ hour. We may use absorbable external sutures which do not have to be removed. It is necessary to use a band or sports bandage for 24 hours after the operation. After that, it is only needed during sleep for 2 or 4 weeks depending on the case.
For successful application of new and advanced techniques, find a certified face plastic surgeon.
Otoplasty Without Incision
Otoplasty is the operation which corrects protruding ears. It treats congenital or aesthetic malformations regarding mainly the formation of the antihelix, i.e. the fold in our ear flap.
During the operation the surgeon will use non-absorbable sutures. These sutures will be placed through the small opening of a needle, not visible to the naked eye.
They are specifically designed transdermal sutures placed from the posterior side of the flap and giving the ear the desired shape while they push it backwards near the skull. The difference with the classical operation is that there is no incision and no skin is removed from the posterior side of the ear.
The method has high success rates, in the cases indicated and the results have high rates of stability over time.
In cases with increased cartilage hardness, the method is combined with anterior cartilage abrasion with the use of a fine rasp which will enter through a small incision.
The success of the method depends on the surgeon’s experience and on maintenance of post-operative instructions. The ears must be kept dry during the first week.
A medium-pressure bandage like a sports band is needed constantly during the first days and afterwards only during sleep for 1 month.
The ear flap is formed to a large degree almost like the adult’s at the age of 4 – 5 years. therefore, otoplasty is recommended from that age and it has great success since the child’s cartilage is particularly pliable.
The operation is done under local anesthesia in adults and general anesthesia in children. In both cases no hospitalization is needed. The operation lasts for about 2 hours, depending on the case.
Bandages and the elastic band around the head will remain for only 1 day. Then a simple sports band is placed permanently for the first week and continues only at night for 1 month. The sutures usually are behind the ear. These are absorbable for children. In adults they are removed in 8 – 10 days.
Otoplasty is not a painful operation. If there is mild discomfort during the first days, we prescribe simple painkillers. The results are visible on the next day already and any edemas subside in the first week. There is no limitation to activities from the first day. Attention is required in sports demanding physical contact, or a possible ear injury.
There is no intervention in the middle ear and the drum, therefore travel is permitted from the first day.