EAR RESHAPING SURGERY
Ear procedures performed include:
- Ear Pinning (Otoplasty): Precise, effective stitch technique
- Ear Reduction: Reducing ear size to improve appearance and balance
- Earlobe Surgery: Split, large or prominent earlobes can be corrected
- Secondary Otoplasty: Correcting poor outcome from failed surgery
- Abnormal kinks and folds: Such as stahl’s bar, cup ears or rim kinks
- Ear reconstruction: for birth abnormalities and after accidents
The commonest ear problems are prominent ears (ears that stick out). They can be a significant source of teasing at school and embarrassment in adults. Surgery to correct prominent ears is effective and predictable using sutures from behind the ear. This procedure can be performed under local or general anaesthetic as dictated by age and patient’s wishes.
Another new treatment for correcting prominent ears is the earfold, an implant which is introduced through a small incision under the skin. This grips the ear cartilage and immediately adopts a pre-set shape. It is, however, not suitable for all types of ear prominence as it only has one modality of action.
Prominent Ear Correction
Surgery is performed from behind the ear. A small ellipse of skin is removed to gain access to the ear cartilage. The fold of the cartilage visible on the front of the ear (antihelix) is recreated with several non-dissolving sutures. In some ears the conchal bowl (the deep concavity of the ear) is excessively prominent. This is repositioned with sutures or, if very stiff, some of the conchal cartilage is removed. The skin is then closed behind the ear with dissolvable sutures.
Correction of prominent ears can be performed at any age after 5 years. Although it is possible to perform the surgery before the age of 5 it is not advisable as the operation requires understanding and co-operation from the patient.
In children a general anesthetic is necessary. In adults it is possible to perform the surgery under local anesthesia. This is usually combined with some sedation to make the experience more comfortable.
There will be a surgical scar behind the ear which will not be visible.
A head bandage covering the ears and forehead only will be placed at surgery. The aim of the bandage is to make healing more comfortable and minimize minor bleeding that may occur. The bandage is kept on for 3-5 days; however it can be removed earlier if uncomfortable. The patient will be advised to wear a headband at night and during sport activities for 6 weeks.
There will be some discomfort of the ears and this is alleviated by basic painkillers such as paracetamol. This usually settles after 1 week; however the ears can remain slightly tender to touch for 6 months following the surgery
This is a procedure with a very high level of satisfaction. Complications are very rare and minor. There may be some bleeding from the wound which is of no consequence. Infection rate is very low at 1%. In the majority scars heal very well and are almost invisible. In a small group of the population thicker (hypertrophic) scars may form which may need further treatment.
There is a small risk (5%) of partial recurrence of the ear prominence. This is most likely to occur in the first six months and can be corrected if necessary.
Earfold is an implant created to correct prominent ears by reshaping the anti-helix. It is introduced through a small incision under the skin of the ear and grips the ear cartilage and immediately adopts a pre-set shape. The earfold is made from Nitinol alloy (titanium and nickel). The implant consists of a thin strip of metal plated with 24 carat gold to limit its visibility through the skin. No dressings are needed following correction and return to most activities is possible after one week.
Insertion of earfold implant is a quick and easy procedure performed under local anesthetic. A small incision (5mm) is made within the rim of the ear and the implant (which is pre-mounted on an introducer) is released to correct the prominence. One or two dissolvable sutures are needed to close the incision.
The earfold implant is designed to re-shape the antihelix. If the prominence of the ear is primarily as a result of conchal bowl prominence then the earfold will not correct this and a different surgical procedure will be required.
No bandage is necessary following earfold insertion. There will be minor bruising and swelling following its insertion which will subside over a period of 2 weeks.
The implant itself has no associated health risks. The implant can be felt under the skin and is almost invisible.
There is a very small risk of infection and in the majority this settles with antibiotics. In rare situations (<1%) the implant may come through the skin. If this happens then the implant has to be removed and the skin heals without any problems. The ear prominence may re-occur after this, especially if this happens within 6 months of insertion, and thus a further procedure may be required.