Reconstructive Ear Surgery (Otoplasty) Explained

Reconstructive ear surgery can correct a wide range of medical and cosmetic outer ear problems, including birth deformities and damage caused by traumatic injuries. Defects such as microtia (which causes parts of the ear to remain undeveloped), and injuries resulting in partial ear loss can have a significant impact one's overall appearance and self-image. Learn about the cosmetic improvements made possible through ear reconstruction surgery and the otoplasty techniques explained below.

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

In general, total ear reconstruction surgery takes place over the course of four separate stages, with one to two procedures performed at each stage. For optimal results and recovery, most otoplasty specialists complete the stages at two to three month intervals.

Stage One: The first stage of ear reconstruction surgery involves two procedures: retrieving healthy cartilage from the ribs, and then inserting the prepared cartilage into a pocket of skin under the deformed or damaged ear. This step of the surgery takes between four and five hours, and requires two to three days of recovery time in the hospital.

Stage Two: During the second stage of the ear reconstruction process, the new earlobe is created. This outpatient surgery takes approximately one hour to complete, and the sutures are removed one week after the operation.

Stage Three: In the third stage of reconstructive ear surgery, the newly formed ear (cartilage frame and earlobe) is elevated from the side of the head and then a skin graft is applied to the underside of the ear. The small skin graft is typically taken from the upper buttock area, and the graft site heals on its own under a protective dressing. This outpatient surgery lasts about two hours, and the sutures are removed one week after operation.

Stage Four: The fourth stage of ear reconstruction surgery is when the surgeon creates an opening in the conchae (to give the appearance of a natural ear canal) and works to achieve symmetry and balance amongst the contours of the ear. The procedure is outpatient and lasts approximately two hours. The final round of sutures will be removed one week later.

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.

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 quickly and easily.