Dr. Alberto Henao M.
Facial Plastic Surgery
OTOPLASTY
Otoplasty is a surgery in which the deformities of the ear are resolved; These can be very varied from the total absence of the ear ( microtia ) to simply a very notable projection of it due to the absence of the antehelix or helix.
The most frequent otoplasty is the operation of detached ears (separated, prominent, of blow, in a loop). In traditional methods (best known are those of Converse, Stenström, and Pitanguy), the surgeon makes an incision behind the ear to expose and reshape cartilage.
There are now new techniques for incision-free otoplasty, and permanent sutures are simply placed behind the ear under the skin to help keep the new shape of the ear in place. Among the best known methods are the Fritsch method and the Merck method.
Diagnostic Appointment
WHY GET AN OTOPLASTY? The correction of the blowing ears leads to an improvement in the appearance of the face, which makes us feel good and regain confidence in ourselves. Mainly in the case of children with detached ears, this defect leads them to be teased by their schoolmates that affect them significantly.
WHAT DOES THE DIAGNOSIS CONSIST OF? This is to determine what are the causes that are altering the shape of the ears to correct them properly.
WHAT TECHNIQUES ARE THERE? To treat the fact that the cartilage of the shell is larger than normal, we proceed to remove this excess cartilage and then, by means of suture, the flag is repositioned in its place.
In the case of the lack of crease of the upper part of the pavilion or antehelix, by means of suture it is given the correct shape, folding the cartilage until it adopts the appropriate shape. We use a technique in which no cuts are made in the cartilage, so there are no irregularities in the anterior face of the pinna, so the ear does not appear to have been operated on. The intervention in adults is carried out with local anesthesia and sedation and the same day they can leave the hospital.
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Process
There are different techniques to approach the problem of protruding ears. The most widely used is the weakening of the cartilage through insufficient folds, the correction of defects related to the malformation and the final suture to fix the surgical changes. All intervention is performed in the posterior auricular pavilion, seeking to hide any trace of the surgery.
However, it is the surgeon who determines the surgical practice according to the dimension of the problem.
The surgery is performed under general anesthesia for children and local anesthesia and sedation in adults. Once the patient is sedated the surgeon proceeds to mark the points of the ear that will allow him to delimit the areas to be treated.
The surgeon manually recreates the correct position of the ear in order to define the fold that the antehélix will have. After marking, the approach is carried out, which usually includes excision or removal of tissue, weakening or thinning of cartilage, remodeling and removal of cartilage in order to decrease the shell cavity. (All these procedures may vary in their execution).
The surgeon shapes the ear anatomically, improving its position and, to reinforce the fixation of the new position of the shell, applies some absorbable points. Generally, an antibiotic ointment is used and the wound is protected first with a fine tulle and later with gauze or dressings to finally surround the head with an elastic band whose time of use is determined by the doctor, to later only go to night use.
Dressings help control bleeding, maintain the position given to the ears, and protect and protect the ears during the healing period. The intervention can last up to two hours due to the care that the surgeon must take when treating these delicate structures and the stitches are generally removed after 8 or 10 days. The effects are usually highly satisfactory especially for children. Edema and bruising can occur in the two weeks after surgery, although it does not always occur. Special emphasis should be placed on warning the adult patient to quit smoking well in advance of surgery, since tobacco can seriously affect healing and the overall recovery process.
The patient is usually treated with antibiotic, anti-inflammatory and analgesic medication to manage any discomfort. Likewise, the patient must remain with a bandage around his head for 48 hours after surgery or as long as the doctor determines appropriate, and then an elastic band for three weeks. Although complete healing and recovery of the area may take a few weeks, the patient may see a decisive change in appearance after surgery. Most of the patients report greater tranquility and security regarding their appearance.
It is important to clarify that medicine has developed important surgical techniques in order to minimize the scars that may result from this practice and to give the best possible appearance in the correction of prominent ears, with which truly amazing results are obtained. However, the patient must be very clear about his expectations and know that otoplasty is not performed in order to achieve perfect ears, but to improve the appearance of these in relation to the facial contour.
Postoperative and care after otoplasty
Despite the comments you can find on the internet and the bad experiences suffered by some patients, otoplasty is by no means a complicated procedure, neither during or after the intervention. It is a very gratifying operation, since patients are usually fully satisfied and in most cases the only regret is not having undergone it before.
After surgery, the patient may leave the hospital a couple of hours after the intervention. Even if they are children and have undergone general anesthesia, recovery is quick and they can go home the same day. The patient during the first days (more or less a week) should wear a bandage around the head that will help hold the ears and help prevent them from bending during the recovery period. After a few days, the bandage will be replaced by a more discreet one, similar to a headband. This lighter and more comfortable, will take care of protecting and keeping the ears in the proper position during the healing period.
After the intervention, the ears will be tender and swollen and the patient may experience some discomfort, which will calm down with the pain relievers or treatments prescribed by his plastic surgeon.
Care: When cleaning the operated area, you must remove the bandage very carefully. During the first month of the intervention it is recommended not to carry out physical activities.
The patient will be able to return to their sports activities 4-6 weeks after the intervention. Until the stitches are removed, it is advisable not to wet the dressings. It is convenient to avoid the lateral positions at bedtime and do it with the head and back slightly upright.
The affected area should be cleaned daily with water and neutral soap and then dried with cold air.
You may experience some loss of feeling or tingling. It is totally normal and will disappear over the days.
When will I be able to join work / school ?: The patient will be able to join their normal life 5 days after the intervention, one week if the patient is a minor. Of course, the final result can be checked and valued after 3 months.
Is it possible to play sports after an otoplasty ?: It is better to wait four weeks to start playing sports and it should always be light and calm. To practice contact sports, such as soccer for example, it is preferable to allow six weeks after surgery. If in doubt, it is advisable to consult with the surgeon to act according to his opinion.
Are the scars visible after an otoplasty ?: As in any surgery, there are always scars, although the Plastic Surgeon always tries to make them as discreet as possible in the natural fold behind the ear. They may have a reddish appearance after the intervention, but little by little their color and appearance normalizes. Consult the otoplasty web section before and after to see our success stories.
