Ear Plastic Surgery Vancouver

Cosmetic Ear Plastic Surgery Vancouver

Probably no younger patients come to the attention of the surgeon performing cosmetic facial surgery than those seeking ear plastic surgery. Because prominent ears are noticed early in childhood and quickly become the objects of ridicule from other children, it is most common for parents to bring children to a consultation soon after a child begins pre-school, and most surgery to set back the ears is done in childhood.

Because the ridicule and abuse directed at a child with outstanding ears is significant, medical insurance will often cover the cost of ear plastic surgery on children, which generally means up the age of sixteen.

The satisfaction rate with this type of surgery is very high, and the rate of major complications is very low, making otoplasty a high yield procedure. Even when a patient has come through childhood without having undergone surgery, and finally decides to opt for surgery, it is unusual to have significant dissatisfaction with ear plastic surgery and most patients are thrilled with the results.

The typical patient comes with a story that he or she has never felt comfortable with shorter hair styles, and is very self conscious about his or her appearance.

Historically, there have been many operations devised to make the ears less prominent, and there continue to be many different ways to achieve reasonably similar anatomical goals.

Anatomy in Ear Plastic Surgery

Although many patients come complaining that their ears are too large, it is highly unusual for the actual vertical and horizontal dimensions to be outside the range of normal. The ear ranges from about 5.5 to 7.5 centimeters in length. It is unusual even in patients who have “big ears”, for these measurements to be exceeded.What a plastic surgeon sees is different.The distance of the outer edge of the ear to the side of the head is where the ear becomes different in patients who want their ears set back. Patients generally start to see the ears as being out of proportion when this distance becomes greater than about two centimeters.

The outer ear, which is what concerns the patient, is made up of skin covering a very complex cartilage shape, with many prominences and hollows:

The helix, which is the rolled rim.
The antihelix, a convex roll in the middle of the ear, branching in two towards the top.
The scapha, a long hollow between the helix and anti-helix.
The concha (from the greek, seashell), the bowl – like depression in the middle.
The tragus, a little bump in front of the ear canal
The Ear canal, the tunnel leading to the middle and inner ear
The lobule, the fleshy portion at the bottom from which earrings hang

The ear cartilage folds determine how far the ear protrudes from the side of the head. A fold at the anti-helix bends the ear back toward the side of the head; when this fold is very slight or absent, the ear curls away from the head sticks out more than usual.

There may also be a deeper concha, the bowl-shaped area immediately next to the ear canal, and this may also cause the ear to protrude.

Treatment in Ear Plastic Surgery

Otoplasty may be performed on an out-patient basis in a private operating room setting. It rarely requires an overnight stay. The surgery takes one to two hours, and may be done under general or twilight anesthesia combined with local.

There are many surgical techniques for setting the ears back into a normal distance from the side of the head. Most involve creating a greater curve to the anti-helix and may involve reducing the depth of the concha. Some smaller alterations to the cartilage may also be involved.

Usually the operation involves removing some skin from the back of the ear, which, when the era is folded back, will be excessive. The main efforts are directed towards re-shaping the cartilage. To do this the surgeon usually first makes it more flexible. This may be done by cutting, scoring, or rasping (which is like filing with a rough instument). This alone may cause the cartilage to curl, but often stitches are used to give a controlled curve and these may be permanent or semi-permanent stitches under the back surface, or may be external stiches used to hold the shape for ten to fourteen days. If the concha is deep, a small crescent of cartilage may be removed, again from the back of the ear, and the cut cartilage edges are stitched. The incision behind the ear is closed, and a bulky head bandage is applied. After a brief period in the recovery room, the patient is usually discharged.

Post-operative care following ear plastic surgery in Vancouver

The major risks of surgery are similar to the risks of any other surgery, including bleeding, infection, nerve injury, and loss of feeling. All of these are rare. Severe pain not responding to the usual pain killers in the first twenty-four to forty-eight hours may indicate pressure build-up from bleeding; gradually or suddenly worsening pain after the first day may mean infection.

Many patients ask me if the surgery will affect their hearing. Because the outer ear is not the hearing organ, which is deep in the head at the end of the ear canal, the short answer to this question is no. But if you cup your ear with your hand while listening you will hear a change, and making the ear less outstanding from the side of the head will have a small effect on the quality of sound.

I usually see otoplasty patients the first or second day after surgery and change the dressing. A fresh, soft bandage is more comfrotable, and is left on for the remainder of a week, after which the stitches behind the ear are removed.

I suggest to patients that once the dressing is removed they wear an athletic headband over the ears at night for about three weeks, to prevent deforming the ear when sleeping. Much of the swelling goes down quickly, so the ears look near normal within a week to ten days, but the final shape is not seen for months.