Reconstructive ear surgery is a godsend for literally thousands of Britons. The procedure, also known as otoplasty or pinnaplasty, is capable of instantly improving the quality of life of people suffering from ear deformities. For children, otoplasty provides salvation against chronic and vicious bullying that could create life-long mental and psychological problems.
Ear deformities are congenital, and afflict between 15 and 20 percent of all new-borns. Ear deformities can also be caused later in life through accidents, violence, burns and bites. Small wonder then that otoplasty is the ninth most popular form cosmetic surgery in the UK.
The anterior and posterior Auricular muscle on a human head model. Image courtest of Wikimedia Commons.
The three-dimensional construct of the external ear, or auricle, makes it one of the most complicated body parts to repair. Many view otoplasty as the most demanding form of cosmetic surgery as surgeons are required to balance science and creativity for each type of ear surgery.
Otoplasty repairs ear deformities by reshaping the auricular cartilage to achieve streamlined and symmetrical ears while maintaining, at once, both the rigidity and flexibility of the ears. The difficulty is further compounded by the lack of suitable organic and synthetic replacement materials for the cartilage. Over the years, surgeons have experimented with a wide range of replacement materials, ranging from maternal cartilage and Vitallium trays to tissue-engineered cartilage and polyethylene implants, but all to no avail; the success of an otoplasty procedure still rests mainly in the hands of the surgeon.
The procedure typically requires the surgeon to make an incision behind the ear flap to expose the cartilage. The surgeon will then manipulate the cartilage to achieve the optimal blend of functionality and aesthetics.
Otoplasty is not recommended for children under five years old as their ears are still growing. Reshaping their ears at such an early age will definitely disrupt the natural development of the ears and lead to further corrective surgeries as they grow older.
NHS typically doesn’t provide coverage for otoplasty, and the procedure costs somewhere between £2,500 and £3,800 in the private sector.
Patients will be required to wear a large bandage around the head for up to a week (usually three days). After that, the bandage will be reduced to a headband which needs to be worn in bed. Patients will experience mild discomfort and pain during this period. Adults can normally return to work after the third day.
After the first week, stitches and sutures will be removed. The headband must be worn until instructed otherwise by the doctor (this depends on the size and location of the wound). Children can resume schooling around this time.
However, patients should not go swimming or engage in any contact sports for an additional two months.
• Swelling and bruising: Slightly painful, but manageable using the painkillers that doctors will prescribe. Patients might also experience the occasional numbness around the ears.
• Infection: Keep the wounds and dressing clean and dry to avoid infections.
• Hematoma: Excessive bleeding is more likely to occur with adults, particularly involving smokers and those with hypertension
• Seroma: Accumulation of fluid and blood plasma under the skin.
• Asymmetry and Surgical Failure: After the ear cartilage has settled down, patients may notice that the ears lack symmetry and appear lopsided. For some patients, the reconstructed ears may also fall out of shape. In both instances, a corrective surgery is required.