Reconstructive Otoplasty

Microtia (a deformity causing parts of the ear to remain undeveloped), as well as injuries causing a patient to lose or damage parts of the outer ear, can negatively affect a patent’s appearance and self-esteem. Reconstructive ear surgery can correct cosmetic and medical problems occuring on the outer ear, including microtia and damage resulting from serious injury.

What is Microtia?

Microtia is a congenital defect of the ear that occurs in approximately three of every 10,000 live births. The literal translation of the medical name is “small ear,” and the defect can be either unilateral, affecting only one ear, or bilateral, affecting both. With bilateral microtia, there is a greater risk of hearing loss, but many patients can achieve excellent levels of hearing with reconstructive ear surgery and bone conduction hearing aids. Both bilateral and unilateral microtia presents itself in three basic degrees of severity:

• Grade one: The child’s ear appears normal but is noticeably smaller than it should be, and it may or may not lack an external auditory canal.
• Grade two: Some features of a normal ear are missing, such as the outer portions of the cartilage known as the helix and anti-helix.
• Grade three: The most severe form of microtia, presenting an almost complete lack of organized cartilage and normal ear features, although a malformed earlobe may exist. Also, there is usually no external auditory canal.

There is no evidence linking microtia to the actions or health of the mother during pregnancy, and the cause of the defect remains unknown. However, the deformity can sometimes be related to other conditions such as craniofacial microsomia and Treacher Collins syndrome. Reconstructive ear surgery techniques can be used to restore a natural appearance to the ear as well as to improve hearing capabilities.

Ear Reconstruction Surgery - The Procedure

Complete ear reconstruction surgery is typically performed in four stages, with each stage involving one or two procedures. To achieve the best possible results and ensure a successful recovery, surgeons often complete the stages in intervals of two or three months.

Stage One:  There are two procedures involved in the first stage of reconstructive ear surgery: the surgeon must remove healthy cartilage from the patient’s ribs; next, the cartilage must be placed in a pouch of skin beneath the damaged or deformed ear. This phase takes about four or five hours, and requires a recovery time or about two to three days in the hospital.

Stage Two:  The second stage of the surgery involves the creation of the new earlobe. This is an outpatient procedure normally taking about an hour to complete. Sutures are removed after approximately one week.

Stage Three:   The reconstructed ear (now consisting of an earlobe and cartilage frame) is lifted from the side of the head, followed by the application of a skin graft to the ear’s underside. The skin graft is small, and usually taken from the patient’s upper buttock. A protective dressing covers the graft site as it heals. This phase of ear reconstruction is a two-hour outpatient procedure. Sutures are removed a week after the procedure.

Stage Four: To give the appearance of an ear canal, the surgeon creates an opening in the conchae, or center of the ear’s cartilage frame.  Further alterations will be peformed to create balance and symmetry and balance amid the ear’s contours. This outpatient procedure lasts about two hours. One week later, the sutures are removed.

After each stage of ear reconstruction surgery, it is very important that patients avoid contact sports of any kind for about four weeks. Patients should also pay close attention to the surgical site in case any side effects of otoplasty present themselves. Although the risks associated with reconstructive ear surgery are minimal, all surgical procedures have potential complications. Carefully following the instructions provided by your surgeon is essential for achieving optimal results and a successful recovery.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Kovanda Plastic Surgery

Reconstructive Ear Surgery after Trauma

Lacerations, burns, and infected or torn piercings are the most common causes of injury to the ear. When all or part of the ear is damaged by a traumatic injury, reconstructive ear surgery can play a role in treating and healing the wound. The extent and length of the surgery will depend upon the severity of the injury; torn earlobes can be corrected through a variety of outpatient procedures and do not take long to correct, while a total reconstruction requires many months of surgical treatment. In certain instances, reconstructive techniques can be employed immediately; however, some injuries may necessitate healing of the initial wound before the reconstructive ear surgery process can begin. The most important thing to do after any kind of trauma to the ear is seek immediate attention from a medical professional in order to protect this sensitive area from further damage.

Search Facial Plastic Surgeons in Your Area

Reconstructive ear surgery , whether completed to correct microtia or damage resulting from an injury, should only be performed by an experienced facial plastic surgeon. Finding the right doctor can be difficult, but with DocShop’s directory of specialists you can  locate an expert in your area.