Ear Pinning (Otoplasty)
Written by Dr. Julian De Silva
Prominent ears that stick out are often this is seen by looking at a person face on. In children they can be the source of ridicule and can undergo surgery once the ears are fully grown, around 5-years old. Ear pinning also termed otoplasty is the cosmetic surgery used to reposition the ears closer to the patients head that results in a more natural looking appearance. The procedure is regarded as a cosmetic surgery as it does not effect the functioning of the ears and can be done in combination with other procedures. There is artistry in the surgery to ensure that pinning of the ear is effective and the ears do not return to their original position, and over-pinning of the ears should be avoided as this looks un-natural.
Surgery consists of making an incision in the back of the ear in the natural fold a strip of skin and cartilage is removed to allow for an improved shape and contouring of the ear, followed by placing some anchoring sutures that will stabilize the ear cartilage to give a long-term result. Dressings are placed for a several days, then headbands are used for two weeks in the afternoons to continue light pressure during the healing process. The ears may be uncomfortable for a week particularly when sleeping on the side. The scar is hidden in the crease behind the ear.
Ear lobe Repair
An enlarged ear piercing or torn earlobe is a common occurrence, and may result from injury, piercing too close to the edge of the earlobe, wearing heavy loop earrings, hereditary factors or trauma. The result may be a partially or completely torn earlobe. The repair of a torn earlobe is performed with local anesthetic and surgery is customized to the extent of the tear, amount of tissue loss and the tear location. The cosmetic surgery consists of soft tissue revision of the area around the tear and placement of a single or double layer of stitches to complete the earlobe repair on both the front and back surfaces of the ear. When there has been a loss of soft tissue of the ear, the procedure is more challenging, and reconstruction involves rotation of the healthy ear lobe position to maintain the curvature of the earlobe, ensuring it keeps a natural looking shape and matches the other side. The risk of surgery on an earlobe is the development of a scar or keloid, a thickened and nodular scar. Keloids of the ear are treated with medical anti-inflammatory agents, although surgical revision is sometimes required. After waiting a period of 6 weeks, the ear lobe is re-pierced. The position of the ear piercing is key and Dr. De Silva takes great care in positioning the new piercing site to match the patients expectations and patients’ other ear.
Ear Surgery Frequently Asked Questions
How long is the recovery from a Otoplasty?
The results of the surgery are immediate, although local swelling can make the ears look larger for the first week. The swelling and local bruising takes about 1 week to mostly resolve, and the great majority of patients return to work after one week. There is a small incision behind the ear and the superficial skin sutures are removed after approximately 1-week. Patients are advised to avoid strenuous activity 3 weeks after the otoplasty.
What are the risks or complications of Otoplasty?
All cosmetic surgery has some risks, generally speaking otoplasty is very safe. With otoplasty there is a small risk of infection, bleeding, allergy, over or under-correction of the ear position. Dr. De Silva advises against otoplasty in patients with increased risk of infection. Dr. De Silva uses techniques to reduce the risk of complications and match the position of the right and left ears.
How long do I need to wear a headband?
We recommend that you wear a headband at night for 4 weeks after the procedure. The headband provides support to the ear while the soft tissues and cartilage of the ear is healing.
What type of anaesthesia do I need for otoplasty?
Otoplasty can be completed with local anaesthesia, Dr. De Silva prefers his patients to have sedation anaesthesia, also known as twilight anaesthesia, this enables his patients’ to have a comfortable and relaxed experience with a fast recovery. With sedation Dr. De Silva’ s patients are able to go home within 30 minutes after the procedure. General anaesthesia can be used for otoplasty in children, it is not necessary in adults.
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