Ear aesthetics is a surgical procedure that is made to correct deformities of shape and size of the external part of ear called pinna and earlobes, occured structurally or caused by past trauma, surgery.
Ear completes its growth within the fetal process and it takes %90 percent of its fully growth size about the age of 6 years. Among the structural deformities of the ear, there are partially or fully absence of ear, subcutaneously buried ears,
oversized ears, growth of a secondary process anterior to ears, flat and anterior faced pinnas. The acquired deformities of the external ear are seen, mostly due to the tumor resection and trauma. Ears are made of cartilage. The shape is given to ear by reforming the cartilage structure. In lack of cartilage, repairment is done with cartilage from the other ear or ribs.
What is prominent ear?
A prominent ear is a defected ear that is caused by a wide angle between the pinna and the skull and absence or insufficient growth of the curve that should be shaped as a Y on the surface of internal side of the ear. Additionally, existence of a deep and wide dish shaped cartilage structure right front of the external ear canal gives the ear a bigger and more anterior look. As a result, a prominent ear is an ear that is widened to the anterior, flat at the upper 1/3 part, and creates an impression that it is bigger than a normal sized ear. It is the most common deformity of ear. It's psychologically exhaustive being the subject of mockery at social environments from childhood. Especially, children at school age are exposed to reactions that is not easy to handle from their circle of friends. Men and women prefer hair styles that will cover their ears to minimize the aesthetic concerns resulted from this situation. Especially young girls of school age who have to gather their hair by an order suffer deeply. Even wet hair that does not allow covering ear at exiting sea or pool is a problem on its own. Ideal timing for a prominent ear surgery is 6th age that the same age comes across the completion of ear growth and preschool period. Cartilage structure is easier to reform at childhood because of its soft form and easier to stabilize the shape that is given. Cartilage hardens with age. It gets difficult to give a new shape to cartilage and even it is seen rare, the risk of taking its first shape because of the cartilage memory increases.
What is an autoplasty surgery?
Autoplasty surgery is a surgical operation that is made to restore normal size and shape of ears by reforming the cartilage structure that forms the pinna. It creates the missing folds on the front side of the external ear and allows the ear to lie closer to the side of the head. Different techniques are used for this purpose. The cartilage is reached by an incision made behind the ear. The Y-shaped fold that should exist at the 1/3 superior of the auricle is formed by using suture techniques. Also if the dish shaped cartilage called choncha has excess width and depth causing the ear to protrude forward, a cresentic excision of the cartilage is added to the procedure. Cartilage structure is reshaped and the angle between ear and skull is narrowed. Excessive growth of earlobes and forward angulation is also corrected with excision and incision techniques applied from the back side of ear. The incision is sutured with self absorbable suture material. A drainage tube is placed to prevent forming of hematomas with the condition of removal the next day. Autoplasty surgery is an aesthetical operation that is appropriate to be done at hospital conditions. General anesthesia is preferred for children. The procedure can be done with local anesthesia and sedation on adults. Adults are discharged 5-6 hours after the surgery and children are preferably discharged the next day with a prescription for antibiotic and analgesic.
How is postoperative phase?
At the end of the surgery a bandage is made as a dressing that covers both ears, forehead and the neck. This bandage is opened and replaced with thinner bandage that is easier to cover especially for women at 4th day. After 1st week, the dressing is discarded and the patient wears a protective head-band or bandage This head-band is advised to use when sleeping to avoid the ears being bent forward against the pillow for 4 weeks. It helps preserving the shape and angle given by surgery. Swelling and bruising that appears on ears and especially on front face begins to decrease after 3rd day. In recovery process trauma, contact based sports, sauna, Turkish bath and hot environments should be avoided and patient should avoid sleeping on his/her ears. And direct contact of the back of eyeglasses that counters to the back of ear can be disturbing. It might be necessary to adjust the eyeglass temporarily.
Copyright/Main Edition 2012 Limited Revision 2022 Prof. Dr. Z. BURCAK TUMERDEM ULUG
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