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Otoplasty

(Setting back prominent ears)

Summary

  • General anaesthetic
  • Operating time about 1,5 hours
  • Daycase
  • Back to school/work in 1-2 weeks
  • Headband for 6 weeks

Otopexy in Kenya

Prominent ears are common. In many cases the shape and lie of the ears is inherited, and a family trend can be seen. The most prominent ears often lack a normal fold, and occasionally one ear is more prominent than the other. Children with prominent ears are sometimes teased, particularly during their school years, and this can lead to a loss of self-confidence.

If protruding or disfigured ears bother you or your child, you may consider plastic surgery. Ear correction surgery — also known as otoplasty — can improve the shape, position or proportion of the ear. It can correct a defect in the ear structure that is present at birth that becomes apparent with development or it can treat misshapen ears caused by injury. Ear surgery creates a natural shape, while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self- esteem.

Who is a good candidate for otopexy?

Within the first few weeks of life:
When an ear is noted to be prominent, it is possible to reshape it by applying a small splint to the rim (e.g. „ear buddy“). The cartilage of a new-born’s ear is very floppy and easily remoulded and after several weeks of splintage a permanent correction can be achieved. By the age of six months the cartilage is too hard to be remoulded and a surgical solution is required.

Children who are good candidates for ear surgery are:

  • Healthy, without a life-threatening illness or untreated chronic ear infections
  • Generally 5 years old, or when a child’s ear cartilage is stable enough for correction
  • Cooperative and follow instructions well
  • Able to communicate their feelings and do not voice objections when surgery is discussed
  • The best age for doing an otoplasty would be before entering school. This is a safe age for the anaesthetic, and will ease the social burden on potentially being teased at school.

Teenagers and adults who are good candidates for ear surgery are:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for ear surgery

During the consultation, you will be asked what results should be achieved from otopexy. This will help your surgeon understand your expectations and determine whether they can be realistically achieved.

Otopexy – the Operation

Pinnaplasty or Otoplasty is an operation which adjusts the shape of the cartilage within the ear to create the missing folds and to allow the ear to lie closer to the side of the head. Because the operation is carried out from behind the ears, a small scar is left close to the groove between the ear and the side of the head. The procedure can be carried out under local anaesthetic in adults, but in young children a general anaesthetic is usually required. Where the lobe of the ear or bowel (concha) is especially large, a small procedure to reduce its size may also be required.

After the procedure – Your recovery

  • The procedure will be a day case procedure allowing the patient to go home the same day.
  • The head will be wrapped in a bandage to protect the newly formed ears and keep them warm.
  • A small protective dressing is usually worn after a few days until the stitches are removed at between 7-10 days after surgery.
  • Once the dressing has been discarded, it is wise to wear a protective head-band or bandage at school or when sleeping to avoid the ears being bent forward against the pillow. This should be worn for at least 6 weeks.
  • The ears are often sore and tender for several weeks and painkilling medication such as Paracetamol may be required.
  • We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
  • The hair can be washed after the dressing and the stitches have been removed.

Results after an otopexy

The scar behind the ear usually settles well, but on rare occasions it can become red and lumpy. A small number of patients, particularly those who are very sensitive about the precise shape of their ears, may require a minor adjustment procedure. The vast majority of patients, however, are well pleased by the result, and the procedure has a high satisfaction rate.

It is recommended that although parents may feel that their child’s ears should be corrected to avoid teasing and stigmatisation it is best to wait until the child recognises the problem and wants the ears corrected. Children are generally more co-operative and happy with the outcome when they fully understand why the surgery is taking place. Pinnaplasty is also performed during the teenage years and in adult life, when either a local or general anaesthetic can be used.

How long will the results last?

Ear surgery offers almost immediate results in cases of protruding ears, visible when the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well hidden within the natural creases of the ear. The results of the otoplasty surgery are permanent. In later years, it is almost never apparent that the surgery has taken place. There is a small risk that the repair may not hold properly, and further adjustment surgery is occasionally required. This would usually become apparent within a year of the surgery.

What complications can occur?

Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.

In children the operation is carried out under general anaesthetic, and this carries with it a very small risk. In a small number of patients (approximately 3%) the scars can become thick and red, and may require further treatment. Bruising and swelling os very common and will settle within two weeks. Infection is not common, but should this occur it would require treatment with antibiotics and regular dressing changes. Sometimes the dressing can chafe the ears to produce a break in the skin which can take a long time to heal. The ears are often a little numb after the procedure, and this usually takes several weeks to settle.

For further information about what is involved in this type of procedure, please contact Valentis Clinic on  +254 725 045 705 or contact Dr Tilman Stasch at info@valentisclinic.com  if you have any questions regarding your forthcoming surgery.