OTOPLASTY (EARS)
The ears are considered one of the most important parts in the aesthetic concept of a face. They should be discreet, symmetrical, have smooth contours, and be proportional in size to the face. It is enough for the ears to be at an open angle to the head – or prominent – to attract all the attention… in a bad way. Or, if one of the ears has a split lobe (torn or bifid) as a result of an earring or augmentation, or if one or both are missing, the sensation of lack of harmony in the face becomes apparent.
It is estimated that about 3% of the population has the so-called “flappy ears”, to a lesser or greater degree, and it usually causes a lot of discomfort in children, teenagers, and their parents due to their appearance. Growing their hair long or wearing a hat is not always unnoticed, and children end up being affected by bullying.
WHAT IT IS AND HOW IT IS DONE
Congenital (genetic) factors, trauma and neoplastic diseases can cause deformities of the ears. Otoplasty is plastic surgery that can correct, reconstruct, or replace a deformed, defective, or missing ear or pinna. This procedure can reshape the cartilage to create the lost folds and position the ear closer to the head, minimize deformities, and give the most natural and balanced shape possible between the ears and the face.
In planning the Otoplasty we always take into account the symmetry of the face and, if necessary, we operate on both ears. It is worth emphasizing that the procedure does not change the location of the ears. The surgery is done in the ears, on the external part. Our hearing happens internally, in the eardrum. The procedure does not affect hearing. It is one of the most performed plastic surgeries in Brazil.
As for congenital factors, the most common deformity is the position one, the so-called “flappy ear”, in which the ear projects laterally at an angle greater than 90º. This condition usually results from the partial or complete obliteration of a fold of the antelix (the “Y” shaped fold located between the shell and the helix) and the enlargement of the concha (the largest and deepest concavity of the outer ear) of the ear. Other congenital deformities are shape (malformation of the ear) and size (one ear is different size than the other).
We use surgical techniques to create or enlarge the antelope (just inside the edge or helix of the ears) and to reduce the shell cartilage in the correction of birth deformities. Incisions are usually made behind the ear. When necessary in the front part of the ears, incisions are made in their folds to hide them. Internally, non-removable sutures are used to create and fix the newly shaped cartilage.
Another situation in which Otoplasty is necessary is when the earlobe is ruptured. Called “bifid or torn earlobe”, this happens when there is an accident with earrings caught in the clothing, or when they are exaggeratedly heavy, or even when ear reducers are used. In cases where there are no lesions, but flaccid tissues, there is the possibility of making a correction and giving back the youthfulness of the ears. Many times, the restoration of the lobes is done in association with facial rejuvenation surgery or Rhytidectomy.
Other cases that can be corrected by surgical procedures: forward projected lobes, reconstruction of ears after trauma, removal of keloids (unsightly scars), removal of a sebaceous cyst (benign nodule composed of sebum) or lipoma (benign nodule formed by fat cells). Other types of nodules, such as malignant ones, may require other approaches as recommended by the doctor in charge.
The most indicated is general anesthesia for children and young people and local anesthesia with sedation for adults. The procedure can last from 30 minutes to 2 hours, depending on the problem to be corrected.
INDICATION
If “flappy ears”, protruding, asymmetrical, disproportionate, deformed or disfigured bother you or your child, Otoplasty can create a natural, harmonious, balanced and proportional shape between the ears and the face. This plastic surgery can benefit the appearance and self-esteem.
It is recommended to start the surgery at the age of 6 or 7, when the ear cartilage has practically reached its full size.
But Otoplasty in young people and adults is also very common. I always encourage parents to talk to their children about the physical and psychological issues involved in the procedure. Talk about the surgery, check if the child – child or youngster – is willing to go through the process, about the possibility of a change in appearance and if he/she really wants to undergo the surgery. It’s worth remembering that until the age of 18 formal authorization from the person responsible is required for any surgery.
PREOPERATIVE
It is very important to consult the SCHEDULED THE SURGERY? page which has a series of questions for us to talk about during the consultations, to help you with your doubts, and where you will find recommendations for the day of the procedure.
POSTOPERATIVE
Depending on which surgical technique was used, the patient may be hospitalized for 6 to 24 hours. The pain is not usually very bothersome. It is common for swellings and purple spots to appear that can last from a few days to a few weeks, depending on each person. During the first 2 days, the diet should be based on liquid and pasty foods, avoiding chewing.
From the surgeries on cleft lobes or nodules to the correction of congenital deformities, from 1 to 3 days it is already possible to return to normal activities, as long as there is no physical effort. In most cases, the recovery takes 1 to 2 weeks, time that we remove the suture stitches. More intense physical activities are allowed after evaluation. In case of contact sports, such as jiu-jitsu, for example, it is necessary to wait 3 months, because there is intensive contact with the ears.
When the surgery is on the child, the parents are fundamental in the post-operative period to maintain the dressing at the right time and avoid traumas. The child will be bandaged for about 24 to 48 hours after the surgery and then wear a band to protect the ear at night during the first month post-operatively.
Avoid as much as possible any trauma to the ears. Light exercise (such as walking and stretching) from day 10 onward is okay. More intense physical activities and contact sports after evaluation. Exposure to sun, wind and cold should be avoided for a period of 20 days. Thereafter, use sunscreen daily with a minimum of 30 SPF (sun protection factor) on the face and ears.
Depending on the surgery, you must wait at least 2 months to make a new hole for the placement of earrings, avoiding placing new earrings over the incision of the surgery (bifid lobe).
Glasses can be worn after the surgical helmet is removed. The helmet (for motorcycle, bicycle, etc.) must only be used 15 days after the surgery with the post-surgical band to protect the ears.
The results of Otoplasty are almost immediate in cases of “flappy ears”, visible as soon as the bandages are removed. More extensive ear reconstruction results may appear over time.