Otoplasty

Aesthetic surgery for pinning back the ears is the primary treatment for protruding ears. Protruding ears can cause great distress and embarrassment, and effect overall self esteem. The cartilaginous skeleton of the ear is the foundation for the ear’s overall appearance. There may be several components that cause the ears to protrude: excess cartilage within the inner part of the ear (ear base) – the concha, and/or deficiency of cartilage curvature (abnormal development) – the anti-helix. During the surgery, excess cartilage is removed if indicated, and the remaining cartilaginous framework is redesigned to resemble a complete and normal ear.  All this is achieved by a small and inconspicuous incision behind the ear. The surgery itself may be performed under local anesthesia in adults, or general anesthesia in children. Duration of surgery is approximately one and a half hours for both ears. This is a relatively simple procedure with a fast recovery period. In most cases, overnight hospitalization is not necessary.

The ear reaches approximately 80% of its final size at ages 6-7, and therefore ear repair can be performed from this age and older without deleterious effects on normal ear growth. It is recommended that surgery be considered once the patient notices the defect in him or herself. Any older population benefits just as well from such surgery.

During the pre-surgical consultation the ears are fully examined. Any asymmetry between the ears is evaluated, as well as causes for protrusion. It must be noted that some asymmetry always exists between the ears, even when the ears are completely normal. In this surgery, asymmetry can be improved, but complete symmetry is hard to achieve, even at the hands of the most proficient surgeon. During the consultation, the realistic goals of the surgery will be discussed.

Recovery from the surgery is short. The initial healing period is can be accompanied by local tenderness, swelling and edema, and transient skin bruising that disappears within a few weeks.

Surgery for pinning back of the ears entails minor excision of overlying skin. Through this excision there direct access to the cartilaginous skeleton of the ear, and as such it is possible to resourcefully manipulate the cartilage to achieve fine results. At the end of surgery the initial incision is closed, usually with absorbable sutures that obviates the need for their removal. The area is then bandaged in a “helmet” manner for a number of days. During the first follow up visit in the clinic, the bandages are removed, after which the treated area is wrapped with a protective sweatband for two weeks.

It is recommended that one not lean on the area for the first few weeks. Washing the head in the shower is recommended after three days from surgery for the first time.

The ear achieves its final shape after several months, once the swelling and local edema has passed. Efficacy of the surgery is indefinite. In some rare cases, recurrence of protrusion occurs, in which case the need for an additional surgery is indicated.

Complications of the surgery are rare, and include:

-Bleeding that may require draining in an operating room setting

-Local infection that is usually treated conservatively

-Hypertrophic or Keloid scarring (depending on family genetics)

-Asymmetry

-Necessity for an additional surgery

-Temporary or permanent numbness of ear

More information regarding the surgery will be made available upon consultation.

Please take a look at “Before and after” pictures.

Earlobe Repair

Surgery for earlobe repair is indicated in situations where earrings have left a large hole in the center of the lobe, especially when worn for many years, but also after any trauma to the earlobe. The goal of surgery is to find the best reconstructive solution for remedying the unaesthetic appearance of the deformity. During this surgery, the deficient earlobe tissue will be reconstructed and made complete, and the skin lining the piercing hole will be removed. This surgery is done under local anesthesia and in the clinic setting. Duration of surgery is approximately 20 minutes. The procedure is simple, and recovery is instantaneous. No special bandaging is required.

Piercing holes that have stretched over time are primarily caused by the earring’s weight succumbing to the force of gravity. At times, a distinct tear is noticeable in the earlobe. An unsightly earlobe hole can also be caused by accidentally pulling an earring with too much force and subsequently causing a tear.

Surgery for earlobe repair can be performed when the piercing hole has exceeded a few millimeters in length. The deformity may or may not be present in both ears at the same time.

During the pre-surgical consultation, the earlobes and the piercing hole will be examined. It must be noted that there is always some asymmetry that exists between organs (e.g. eyelids, ears), and earlobe repair will not necessarily solve any existing asymmetry, and may in fact cause a certain amount of unevenness between the ears. The expectations of surgery by the patient will be matched with the anticipated surgical outcome.

Surgery for earlobe repair is performed via a simple technique that is based on excision of the skin lining the piercing hole, and subsequent closure of the gap both in front and behind.

Sometimes during surgery, when it is suspected that the earlobe will take on an elongated shape, a special closure technique in the shape of a “Z” is done in order to preserve the normal dimensions of the earlobe and not distort them.

After completion of the repair, the gap is sutured and covered with antibiotic ointment. There is not need for further bandaging of the ear. Recovery from the procedure is exceptionally fast – the following day the patient is capable of returning to normal daily activity.

Duration of recovery is approximately one week. During this period, mild discomfort and/or tenderness is possible, with slight local swelling and edema. Sensation in the overlying skin is usually preserved. Mild bleeding may occur in the area. Sleeping on the side of the ear is to be avoided during the first week. Showering and hair washing is possible after two days time.

After the first week, further recuperation is quick. It must be noted that the earlobe will attain its final shape only after several months, due to the natural healing and scarring processes.

It is recommended that the ear be re-pierced no earlier than 6 months after surgery in order to avoid recurrence of the condition.

Complications of the surgery are rare, and include:

-Bleeding that may necessitate drainage in the operating room

-Infection – usually treated conservatively

-Hypertrophic and/or keloid scarring

-Worsening of any existing asymmetry between the ears

-Shortening of the earlobe

Earlobe Reduction

Certain men and women suffer from exceptionally large earlobes, at times significantly disproportionate to the size of their ears or face. Wearing heavy earrings for extended amount of time (years) can lead to enlarged earlobes over one’s lifetime. It is possible to treat elongated and enlarged earlobes with a simple surgical procedure in the clinic, necessitating only local anesthesia. In this surgery, shortening of the earlobe is carried out in a manner that restores a normal and aesthetically pleasing appearance to the ears in particular, and to the face in general.

During the pre-surgical consultation, the ears and earlobes are thoroughly examined. The patient’s expectations from surgery are tailored to meet realistic results.

Duration of surgery is between 30 minutes and an hour. The shortened earlobes are closed with sutures that are removed in the clinic one week to ten days afterwards. The initial recovery period may be accompanied by increased tenderness, swelling and edema, and transient bruising of the skin that fades away within a few weeks. The final profile of the ear takes shape several months after surgery, when all swelling has passed and final scar tissue has formed. Additional piercing of the ear is not recommended until 6 months after surgery.

Complications of surgery are rare, and include:

-Bleeding

-Local infection – usually treated conservatively

-Hypertrophic and keloid scarring (influenced by genetics)

-Asymmetry

-Narrowing of the earlobe

Additional information regarding this surgery will be made available during the pre-surgical consultation.