COSMETIC EAR SURGERY

Cosmetic ear surgery is done for birth defects of ear as well as for acquired ear deformities.

A)Cosmetic Ear Shaping or Otoplastic Surgery for Birth Defects:

External ear reconstructive plastic surgery is done mainly for cosmetic reasons. It is one of the biggest challenges in plastic surgery. Ear Cosmetic Surgery can improve the shape, position & proportion of the] deformed, prominent, or protruding ears. Otoplasty can restore proportions. Otoplasty surgery creates a natural shape, while bringing balance and proportion to the ears and finally to the face. Correction of even minor deformities of ear can have profound benefits to appearance and self-esteem of affected person.

Bat ears or prominent ears (Lop Ear/Cup Ear/Shell Ear):

The normal ear lies at an angle of 15 degrees from the head. Ears that stand out at a greater angle may be considered to be prominent. Having protruding ears does not usually affect a person’s hearing, but can sometimes cause embarrassment and psychological distress.
Ears are one of the first body parts to develop to full adult size. Prominent ears are easily noticeable in children and may lead to teasing or bullying. Such comments may prompt parents to seek advice from a plastic surgeon usually when their child is attending pre-school. Ear shaping or pinning (Otoplasty) surgery corrects birth deformities of Bat Ear or prominence of the ears & large ears (Macrotia). Ear pinning combines various techniques like removing skin from the back of the ear, cartilage sparing, and scoring techniques as per the deformity.

In the newborn, ‘bat ears’ may be corrected to some extent by gentle taping of the ears to the side of the head or the wearing of a ‘cradle cap’.
If the problem remains uncorrected after infancy, correction is done by cosmetic surgery at about 7 to 8 years of age. Because the ear is near adult size by this age, it is safe to consider surgery at this stage. Depending on the source of ear prominence, an incision is made behind the ear and/or within the fold of the front of the ear. The cartilage of the ear is remodeled and on occasion, some of the excess cartilage and skin are removed to reshape the ear.
Deficient cartilage can be placed through incisions to correct constricted ear deformities.
Thus! Correction of prominent ears is one of the most common and pleasing operations in aesthetic ear plastic surgery. The results are usually immediate, excellent and long lasting giving the ears a natural appearance and the individual increased self confidence. Cosmetic ear surgery can dramatically change your appearance.

Absent Ears (Microtia/Anotia):

Anotia and Microtia are birth defects of a baby’s ear. Anotia means the external ear is missing completely. Microtia happens when the external ear is small and not formed properly. For the Children having absent or severely small and underdeveloped ears since birth or loss of ear due to trauma, ear can be reconstructed using rib cartilage grafts at the age of 8 years. This May require two to three staged reconstruction.
Partial loss of external ear is generally reconstructed by using local tissues. Microtia can be on one or both sides. Microtia occurs in 1 out of about 8,000–10,000 births. The external auditory canal is generally absent (Atresia) in Microtia. In such children hearing may be affected due to incomplete or absent ear structures that are used to pick up sound and vibrations, such as the tympanic membrane.
There are several different options for ear reconstruction:
1. Rib Cartilage Graft Reconstruction: This is the gold standard for ear reconstruction which involves sculpting the patient’s own rib cartilage into the form of an ear. Because the cartilage is the patient’s own living tissue, the reconstructed ear continues to grow as the child does. In order to be sure that the rib cage is large enough to provide the necessary donor tissue, surgeons wait until the patient is 8 years of age. This surgery needs two to three stages.
2. Reconstruction of the ear using a silicon or polyethylene plastic implant (Medpor): This is a 1–2 stage surgery that can start at age 3 to 5 years. Using the porous framework, which allows the patient’s tissue to grow into the material and the patient’s own tissue flap, a new ear is constructed in a single surgery. A small second surgery is performed in 3–6 months if needed for minor adjustments. This surgery has more complications than using rib cartilage graft.
3. Ear Prosthesis: An ear prosthesis is custom made to mirror the other ear & can appear very realistic. They are made of silicone, which is colored to match the surrounding skin. Such ear can be attached using either adhesive or with titanium screws inserted into the skull to which the prosthetic is attached with a magnetic or bar/clip type system. The biggest disadvantage is the daily care involved and knowing that the prosthesis is not real.

B) Ear Reconstruction for Acquired Deformities:

Reconstructive otoplasty is used to correct deformities of ear which are the result of trauma, burns, skin lesion excisions, and hematomas or infections. The critical reconstruction issues for each of these etiologies are different. Car accidents, dog bites, and sports injuries are some of the most common causes of trauma to the ear. Generally, these accidents affect only the outer structure of the ear but sometimes ear canal is also injured,
Ear reconstruction after trauma is a complex issue & one of the biggest challenges in plastic surgery. Many of the innovative techniques used for total reconstruction of congenital ear defects can be applied to acquired defects. Lack of soft tissue cover following a traumatic injury can limit the options available for repair or can require more complex flap coverage. Reconstructive ear surgery combines a variety of procedures to recreate a natural-looking human ear. In some cases, cartilage can be removed from the patient’s ribs to augment the ear and help it attain a more natural appearance.

Earlobe Repair-Auroplasty:

A broken or torn ear lobe is one of the most common cosmetic ear repair surgery in Bembde Hospital. We repair ear lobule using specialized techniques to minimize scarring.
Earlobe repair is performed for a variety of reasons. Some female have a tear in their earlobes from wearing jewelry that sometimes gets longer and eventually rips through the earlobe, especially as the skin thins out with age.
Sometimes hole in ear lobule that’s closer to the very bottom of the earlobe & hence can cause earrings to rip through the earlobe even quicker. Earlobe repair is a minor & quick office procedure using local anesthesia. Pain and downtime are minimal.
Patients can return to work immediately after the procedure. We can re-pierce your ear if you wish using sterile technique.

Ear keloids:

Small keloids of ear respond well to conservative methods but it needs surgical corrections. such as excision & flap or graft cover. Most commonly ear keloid develops due to ear piercing in the cartilaginous part of pinna.

Cauliflower Ear

Due to repeated injury to the ear, cartilage gets separated from the perichondrium and fills with fluid, which becomes permanently cartilaginous and deformed. It needs ear reconstructive surgery for better cosmetic appearance. Such deformities are common in boxers and also can develop due to burns injury to ears.