A patient suffering from a congenital defect, injury, or trauma to the ears may feel self-conscious about his or her appearance. Fortunately, help is available; reconstructive ear surgery (known as reconstructive otoplasty) can correct both cosmetic and medical deformities of the outer ear and restore a patient’s self-confidence, in addition to improving his or her hearing.
Congenital Defects
Reconstructive otoplasty can be a boon to people suffering from microtia, a birth defect that results in undeveloped ears; the condition can be either unilateral, affecting one ear or bilateral, affecting both. Because the ears are underdeveloped, hearing loss is often associated with this condition. Reconstruction of the ear canals or surgically implanted hearing aids can drastically improve hearing.
Stages
Reconstructive ear surgery typically consists of four stages, often completed in two- to three- month intervals. These consist of:
- Stage One: Healthy cartilage is removed from the patient’s ribs and placed in a pouch of skin beneath the damaged ear.
- Stage Two: A new earlobe is created.
- Stage Three: A skin graft is added to the earlobe and cartilage frame, which is lifted from the side of the head.
- Stage Four: An ear canal is fashioned from the center of the cartilage frame.
Trauma
Those with damage to the ears resulting from an accident or injury (such as a burn, laceration or torn piercing) are often viable candidates for reconstructive ear surgery. The type of surgery, and its success, depends on the severity of the trauma and may range from a simple outpatient procedure to a total ear reconstruction that takes months. Your best bet is to seek immediate medical attention following any type of trauma to the ears.
Individuals who have suffered trauma to the ears, and those born with defects, can often benefit from reconstructive ear surgery. Known as reconstructive otoplasty, this procedure is used to correct medical and cosmetic deformities of the outer ears, helping to restore self-confidence and improve hearing ability.
Procedures
Reconstructive ear surgery is most commonly used to treat defects related to microtia, trauma, cancer and prominent ears. There are three different types of reconstructive ear procedures, depending on the defect being treated.
Microtia is a birth defect that causes incomplete development of the ears, and affects approximately one in 6,000 babies. It may affect one or both ears, and is often associated with hearing loss. Microtia repair involves the removal of healthy cartilage, usually from a patient’s rib cage, and constructing a new ear using that tissue. If a new ear canal is needed, one can be created from cartilage, as well.
A similar technique is employed to treat ear defects that result from trauma or cancer surgery. Injuries from burns, lacerations, torn piercings and other accidents vary in severity; surgery may take the form of a relatively easy outpatient procedure or a total ear reconstruction. In some cases, prostheses may be needed to enhance the appearance of the ears.
Prominent ears are those that protrude abnormally. One or both ears may be affected. The condition is often inherited. A procedure called an otoplasty is used to improve the shape, position or proportion of the ears, and can be used to correct defects such as prominent or unusually large ears. This surgery involves an incision behind the ears and the removal of skin and cartilage to reshape the ears. Sutures are used to “pin” them into place, if necessary.
Otoplasty
Otoplasty is a cosmetic surgical procedure to change the shape, position, or size of the ears. It can correct defects of the ear that have been present from birth, or those resulting from injury or trauma. It is typically used to treat disproportionately large or protruding ears, and usually involves both ears to keep them symmetrical.
Who Can Get Otoplasty?
To qualify for otoplasty, an individual should be healthy, and not suffer from any condition that might impede healing. Children should be at least five years old, when their ears have reached their full size.
As with any surgery there are certain risks and potential complications involved; these include scarring, infection, bleeding, asymmetry, changes in skin sensation, and skin contour irregularities. Deciding whether the benefits outweigh the risks is a personal decision, but your surgeon will be happy to answer any questions you have.
How Is Otoplasty Performed?
Either local or general anesthesia will be given during your otoplasty procedure, depending on the complexity of the surgery and your doctor’s recommendation, and can be performed in a hospital or outpatient surgical facility.
The procedure takes about two hours on average. Incisions are typically made on the back of the ears or within the inner creases where scars will be less visible; your surgeon then removes excess cartilage and skin before folding the cartilage into position and securing it with stitches. Care is taken to avoid overcorrection, which can result in a “pinned back” look.
Following surgery, your ears will be covered with bandages for a few days. There will be some pain and discomfort, which can be treated with over-the-counter or prescription medication per your doctor’s discretion. You’ll be advised to keep pressure off your ears. When the bandages come off, your ears will probably be swollen and red.
It’s usually recommended you wear a loose headband at night for a few weeks to protect your ears when you roll over in bed. Otoplasty offers immediate results in most cases.
Earlobe Repair
Body piercing has been popular for decades and continues to attract both men and women. Normally when skin is punctured, the hole closes on its own and heals without a sign. When the earlobes are pierced, an earring is put in immediately to prevent the hole from closing.
Why Have Your Earlobe Repaired?
Over time, skin will grow into the hole and line the internal surface of the puncture. Once this happens, the hole may shrink, but is unable to completely close, even with the piercing removed.
Regular ear piercings can become cosmetically unappealing to some people. Worse still is the increasingly common practice called gauged earlobe stretching. This involves the use of expanders, known as gauges, to stretch the earlobe wide enough to insert increasingly larger decorative plugs. This can cause thinning and distortion of the earlobe tissues and lead to permanent damage.
Patients with ear piercings – especially those who wear gauged earrings – sometimes come to regret their decision afterward. Surgery to close earlobe holes is possible, but tricky; gauge earring defects require new tissue in order to close the hole.
How Is Earlobe Repair Performed?
Suturing it shut would result in an earlobe with an abnormal contour, so tissue is recruited from other areas of the earlobe in what is known as a local flap reconstruction. The procedure is generally performed in an outpatient setting using local anesthesia.
Sutures to close the skin should remain in place for several days afterward before being removed. Some swelling is common and to be expected, but that should go away after a few days.
Keloid Removal
These overgrowths of scar tissue can form on the lobe and cartilage of the ear and are caused by trauma to the skin, usually from a piercing, surgical scars, acne, chickenpox, insect bites and tattoos.
Keloids start as small round bumps and can continue to slowly grow over a few months They range in color from pink to dark brown.
How Are Keloids Removed?
There are both surgical and nonsurgical methods of removing keloids. Most doctors will recommend a combination of treatments in order to prevent the keloids from returning.
Keloids can be surgically removed with the use of a scalpel. A pressure earing worn after the procedure places uniform pressure on that section of your ear, which can prevent a keloid from forming after surgery. These earrings, while uncomfortable, must be worn for 16 hours a day for six to twelve months.
Radiation can help reduce the size of a keloid and is often used in conjunction with surgery.
Nonsurgical options include:
- Corticosteroids
- Cryotherapy
- Laser treatment
- Retinoid creams
- Silicone gels
Call The ENT Center of Central Georgia at (478) 743-8953 for more information or to schedule an appointment.
