Ear Surgery / Otoplasty Toronto
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An otoplasty, or ear pin back surgery, is the procedure used for correcting prominent and/or outstanding ears by reshaping them and setting them back near the skull. This procedure was first described in India in the 10th century and, over the years, has been modified by surgeons in an attempt to create normal looking ears.
What is considered to be an abnormal ear?
Most normal ears have an auriculo-cephalic angle (the angle between the ear and the head behind the ear) of 25 to 35 degrees. An angle of more than 40 degrees is considered abnormal. The incidence of protruding ears in Caucasians is of 5% and most of these ears lack one of the folds we normally have and have some excessive cartilage.
Who is a candidate for this operation?
Basically anybody that has prominent or misshaped ears can have an otoplasty. Ear deformities come in many shapes and forms and this operation is geared to milder deformities where the ear is too prominent, outstanding, cupped or lopped. More major ear deformities such as microtia (a congenitally underdeveloped ear) require more extensive reconstructive operations. An otoplasty can be performed in both children and adults, but it is most commonly done in kids.
Why is it more commonly performed in children?
There are several reasons why otoplasties are done in children most often. First, it is important to know that the human ear reaches 85% of its adult size by age three and the ear cartilage stops growing by the age of five or six. Second, it is best to consider an otoplasty in children under the age of six because the teasing and cruelty that some of these kids endure does not start until after that age. Third, the ear cartilage in kids is softer and easier to reshape.
Can an otoplasty be performed in adults?
Absolutely! Otoplasties are performed in adults of various ages all the time. The ear cartilage in some adults is a bit stiffer and less pliable, but we can still perform this operation and correct the deformities with outmost success.
How is this operation performed?
Traditionally this operation has been performed by stitching, cutting or thinning the ear cartilage in order to reshape it and cutting some skin from the back of the ear. All these techniques are done by placing incisions in the back and, in some cases, the front of the ear.
Is there a less invasive way of doing this?
Yes. An exciting new technique is the Incisionless Otoplasty. We place permanent stitches through the skin and bury them under it without having to make any cuts at all. The stitches reshape the ear cartilage to the desired form and position. The cartilage is then scored with a needle through the skin to promote some controlled scar tissue formation that will help maintain the new ear shape permanently.
Can the Incisionless Otoplasty be performed in anybody?
Anybody who is a candidate for a traditional otoplasty may also be a candidate for the incision less technique. A facial plastic surgeon that is trained in this operation should be able to assess the patient and easily decide if he/she is a good candidate.
What type of anaesthetic is used for the operation?
Otoplasties can be performed under local or general anaesthesia. General anaesthesia is most commonly used in children and most teenagers and adults undergo the procedure under local anaesthesia, but, ultimately, it is the patient’s choice.
How long is the operation?
It usually takes about half an hour per ear with a traditional technique and slightly less with the incisionless otoplasty.
What is the recovery like?
Most children have a special bandage around the ears that is kept on for 24 hours. Older children and adults that undergo the incisionless procedure do not require any bandages and only have some antibiotic ointment placed on the ears for about five days. All patients are asked to use a soft headband at night for the first two weeks. There is a little bit of swelling and minor bruising on the ears that is gone in a week or so. The ears may be a bit sore for the first 7 to 14 days and look normal after the first week. The strength in the newly formed cartilage will increase over the first two months.
What can go wrong?
Otoplasty is a very safe operation. Bleeding and infection are the most common complications of the traditional technique and are both very rare. Bruising is the most common side effect of the incisionless procedure. Loss of the achieved correction is the really the worse thing that could happen and this can be easily corrected with a new stitch if needed.
Are patients happy with this operation?
As surgeons we are excessively critical of our work and our results. The beauty of this operation is the incredibly high patient (and parent) satisfaction. Even when we may not be completely satisfied with the result, the patients are usually ecstatic about it and showing off their new ears!
Why should one consider an otoplasty?
In kids, it is usually parents who wish to have the ears corrected. Very often one of the parents has had the same problem and don’t wish their child to have to endure the teasing they did. Adults with prominent ears have usually thought about it for years and have been scared to undergo the operation or did not have the means to do so. It all boils down to self-esteem and being happy with one’s appearance.