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Otoplasty

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Otoplasty

Ear correction surgery, or otoplasty, is a surgery performed to correct over protruding ears. Such ears are called as bat ears. They occur because of various reasons. One such reason is a growth abnormality. Otoplasty is a surgery performed mostly on children between the ages of four and 14 years. In children, the reason for otoplasty is mostly the bullying they face in their schools. Adults also undergo otoplasty surgeries for various reasons, most common being cosmetic enhancement.

Good candidates for ear surgery are

    Ideal children for the ear surgery are:

  • Healthy individuals, without comorbid conditions.
  • 5-year-old children.
  • When the ear cartilage is stable.
  • Who can communicate their feelings and those who do not voice objections when surgery is discussed with them.

Ideal teenagers and adults for the ear surgery are

  • Individuals who do not have any life-threatening illness or medical conditions that can impair wound healing.
  • Individuals with a positive orientation towards the surgery.
  • Who have specific goals in mind for the ear surgery.
  • Patients who do not smoke.

Etiology

    The auricle develops in utero during weeks 6-16. Six hillocks originate from the first and second branchial arch. The first, second, and third hillocks originate from the first arch, while 4-6 hillocks are derived from the second arch. The first arch hillocks contribute only to the tragus, crus helices, and helix, and the second arch is responsible for approximately 85% of the auricle.

    The auricle achieves its full shape at the time of birth. By 3 years of age, it achieves 85% of the adult size and is nearly its adult size by age 5 or 6 years. Elongation of the lobule gives the appearance of ear growth, further in life as individuals age.

Pathophysiology

    It is believed that the shape of the auricle is predetermined, and it is not influenced by any folding process. The helix develops rapidly and overhangs the antihelix during 8-12 weeks' gestation. Most embryologists, despite Streeter's theories, believe that the antihelical furl develops over the subsequent 4 weeks, medializing the helical rim. Furl of the helical rim develops during the sixth week.

Indications

  • For correction of ears that protrude more than 20 mm and at an angle greater than 35° from the occipital scalp.
  • One or multiple malformed auricular subunits.

Contraindications

  • Otoplasty or any cosmetic surgery is contraindicated in any patient with unrealistic expectations.
  • Patients unable or not willing to cooperate with post-operative care and follow-ups are not candidates for surgery.
  • In patients with a history of hypertrophic scarring or keloids information has to be given that these may occur after otoplasty, possibly distorting an otherwise excellent surgical result.

Surgical Therapy

  • Otoplasty can be either cartilage splitting (cutting) or cartilage sparing.
  • Cartilage-splitting techniques involve making incisions through the cartilage and repositioning of large blocks of auricular cartilage.
  • Cartilage-sparing techniques avoid full-thickness incisions, attempting to create defined angles and curls in the cartilage.

Steps of an ear surgery procedure?

    Step 1 – Anesthesia

  • Can be Local, IV sedation or General Anesthesia.

  • Step 2 – The incision

  • Correction of protruding ears uses advanced surgical techniques to create or increase the antihelical fold and to reduce conchal cartilage which is enlarged (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the posterior part of the ear. When incisions are necessary on the anterior aspect of the ear, they are made within confined folds to hide them. Internal, non-absorbable sutures are used to create and secure the newly shaped cartilage in place.

  • Step 3 – Closure

  • Skin stitches close the incision. Individualized techniques are used, taking care not to distort other structures and to avoid an unnatural "pinned back" appearance.

  • Step 4 – Results

  • The ear surgery offers near immediate results in the cases of protruding ears and are visible once the dressings that supports the new shape of the ear during the initial phases of healing are removed. The ear being permanently positioned closer to the head, surgical scars are either hidden behind the ear or well hidden within the natural skin creases of the ear.

Postoperative Follow-up

  • The patient is usually seen on the first postoperative day.
  • The dressings are removed, and the inspection of ears is done for any sign of hematoma.
  • The patient is seen on the second postoperative day as well; the ears are inspected, and an elastic skin headband is placed over the head and ears.
  • Prolene (non-absorbable) sutures are removed on the seventh postoperative day. The patient wears this continuously for the next 5 days and during sleep as well, for the following 2 weeks’ time.
  • Moderate redness and edema are expected but usually resolve within the first 2 weeks of surgery.

Complications

  • Hematoma of ear.
  • Chondritis.
  • Hypertrophic scars.
  • Keloids.
  • Relapse.
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Before & After

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Prof. Dr. Mohan Thomas Rhinoplasty Prof. Dr. Mohan Thomas Rhinoplasty

✱ Results may vary person to person.

Prof. Dr. Mohan Thomas Rhinoplasty Prof. Dr. Mohan Thomas Rhinoplasty

✱ Results may vary person to person.

FAQ's

Frequently Asked Questions

We like to assist our clients with a knowledgeable and in-depth collective approach to answer for all your queries and fears with our FAQ mega-base.

The results of Otoplasty are considered permanent if the area has been well protected during the healing period. In 5% of the patients, there may be a marginal reversal of the outcome, and they may require a touch-up surgery. This is usually due to the slippage of the sutures and/ or unraveling of the cartilage to its original shape.

Otoplasty is a day care surgery, and you can go home the same evening. Recovery usually takes about 2-3 weeks but, you need to wear a support band for 3 months so that the ears are protected, and the suture line heals well with a strong scar formation.

There are no major risks of Otoplasty. The only concern can be blood collection behind the ear which can lead to an infection. The second concern may be that the ear unravels, and the procedure may have to be redone.

The otoplasty cost usually is INR 75,000-150,000 + taxes and other costs depending on where it is done, whether only one side or both sides etc. Please come and meet the doctors at The Mohan Thomas Aesthetics who will be able to provide you with a treatment plan and cost.

The surgery results are visible immediately and are usually more pronounced than the final outcome. You should be not sleeping on either of the sides and should keep your head elevated on 2 pillows for 4 weeks.

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