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Ear Plastic Surgery
Overview
In general, ears are not the center of
most people’s attention. How often have you heard someone
say: You know, he's got the nicest ears I've ever seen. In fact, ears for the most part, should not be noticed. Most
people could not draw an accurate ear from memory if their
life depended on it. I think this is the point regarding
ear plastic surgery. Ears are meant to be not noticed. If
they are noticed it is usually because there is something
wrong with them; there is something about the ear that is
unusual and brings one's attention to it. Commonly, this
is because the ear is protruding outwards. Normally, these
ears are not bigger than normal. It is just that instead
of staying close to the scalp, they bend outward.
This problem is more common in men than
women and seems to be associated more with English descent. Many people with this problem do not care too much. Some
people think it adds character. This is a healthy way to
think about it. If, however, it does bother you, there are
plastic surgical options that are very effective at correcting
the problem.
The problem starts at birth and is due
to a congenital lack of curvature of the cartilage within
the ear. Normally, the ear cartilage bends backward toward
the scalp, but in people with protruding ears this curvature
never occurs and the ear remains protruding outward. If noticed
within 6 weeks of birth, it is possible to reshape the cartilage
by just molding it into proper position without surgery. In
fact, this is often done with certain breeds of dogs. After
6 weeks, however, the cartilage becomes too firm and is no
longer amenable to non surgical readjustment. At this point,
it is best to wait until the age of 4, at which time the ear
has grown to about 85 per cent of its adult size, before considering
surgery. Of course, after 4 years of age it can be done at
any time and is commonly performed during the summer months
when children are out of school.
Correction of this failure of cartilage
curvature requires surgically removing skin and applying sutures
strategically to re-create this bending of the cartilage. Sometimes, there is too much cartilage and some of it must
be removed.
A completely different type of problem
is the underdeveloped ear or one that has never developed
at all. These two types of problems are called microtia and “anotia” respectively. These are much more
difficult problems and may very well be associated with other
congenital problems. Dr. Cruise has extensive experience
with treating all of the ear deformities.
 Dr. Cruise's philosophy regarding Ear Plastic Surgery
 My philosophy about whether or not have ear plastic surgery is pretty much summed up in this section, Are you a good candidate I would just like to add that if you are a mother or a father with a child who has protruding ears, you should talk to your child about it. He/she may not come right out and tell you that he/she feels self-conscious about his/her ears, yet it may show up in other ways. The child may have problems at school or while dealing with other children.
As far as the surgery is concerned, I use a very specific suturing technique in order to re-create the natural curve of the ear cartilage. I often find, but not always, that it is necessary to remove some cartilage at the very base of the ear so that it lays flatter against the scalp. This is all part of the art of ear plastic surgery.
During consultation with me, we will take digital pictures and then show them on a computer monitor to decide exactly what needs to be done. These pictures provide a lot of information in preoperative planning as well as understanding exactly what the patient wants. After the procedure we will repeat the pictures to demonstrate the difference.
Benefits
The goal is simple; to make one's ears
lay flat against the scalp like everybody else's. Having
a protruding ear does not affect one's ability to hear, but
it can make a huge impact on self-confidence. It is often
said that, Kids can be cruel and this certainly
applies when peers make fun of children who have protruding
ears. Because the procedure is safe and predictable, the benefits
of surgery usually outweigh the risks.
If you have microtia or anotia the treatment
options are much more complex. Here, the case is to create
an ear where there once was none so that the child will fit
into society. Reconstructed ears will never look exactly
like the one God makes, but they can be reconstructed such
that when a child goes out into public he/she does not draw
attention and ridicule.
Possible complications
In Dr. Cruise's hands, complications are infrequent but they must be discussed. The most common complication is inadequate setback of the ears. If this is the case, the procedure can be repeated in order to obtain the desired results. Other possible complications are too much setback of the ears, infection and wound healing problems, fluid or blood collection, unfavorable scarring, and asymmetry or contour irregularities.
Are
you a good candidate?
People who are good candidates for ear
plastic surgery are those who feel very self-conscious about
the way their ears look. They may wear hats, scarves, or
other things to cover their ears so that they cannot be seen. Another scenario is the one where the schoolchild is made
fun of repeatedly by the classmates. This can be devastating
for a child.
If you, or your children, are self-conscious
about the appearance of the ears it is certainly worth your
while to look into the treatment options. If, on the other
hand, you or your family member has what appears to be a large
or protruding ear but is not worried about it, it is probably
best not to do anything at all. The whole point of ear plastic
surgery is to make one feel more comfortable about the appearance
of their ears. Like the old saying, If it's not broke
don't fix it. There is no medical reason except, of
course, for the psychological one to have ear plastic surgery.
Do's
and Dont's prior to surgery
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Medications. Certain medications thin your blood and should not be
taken within 3 weeks of surgery. The most notable is
aspirin and aspirin containing products. Vitamin E and
many herbal products also thin the blood and should not
be used within 3 weeks of surgery. Dr. Cruise will go
over this more thoroughly prior to the procedure.
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Sleep. It is important to get a good night's rest prior to the
procedure. If you think this may be a problem, please,
do not hesitate to ask Dr. Cruise for something to help
to sleep.
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Smoking. Please do not smoke within 3 weeks before and
after surgery. Smoking has a profound effect on reducing
wound healing capabilities. It significantly increases
the likelihood for infection, wound healing problems,
and scar formation. It also affects your airway, therefore,
makes anesthesia much more difficult.
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Eating. Do not eat within 8 hours of surgery and do not drink
within 6 hours of surgery. It is OK to take medications
with a sip of water. Please discuss all medications with
Dr. Cruise and the anesthesiologist.
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Washing. It is a good idea to wash the surgical area thoroughly
the night before and the morning of surgery. It is important
to wash your hair the morning of surgery and to comb it
straight back. Do not apply hair spray or make up.
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Arrival. It is best to arrive on time so everything goes smoothly. Please be sure to have someone else drive you.
- State of mind. Remember,
this should be a happy and exciting time. A certain amount
of nervousness is normal but you should not be overly concerned. Dr. Cruise and ICRS are well trained and experienced. Excessive
worrying can actually be detrimental and you should discuss
this with Dr. Cruise prior to surgery so that something
can be prescribed to make sure you remain calm.
Anesthesia
ICRS uses only board certified anesthesiologists
to make sure you have the best anesthesia possible. The anesthesiologist
will discuss with you what type of anesthesia is best for
you. He/she will take into consideration your medical history,
the procedure, and your personal wishes.
Normally, this procedure is performed
under general anesthesia especially if children are involved. It is possible, however, to perform it on certain patients
under local anesthesia with or without sedation.
After
the procedure
The procedure itself will take about
2 to 3 hours.
Immediately. Right
after the operation you will be watched for 1 or 2 hours and
encouraged to walk around. Dr. Cruise is a strong advocate
of good pain relief so you will be given as much pain medication
as necessary both immediately after the operation and for
the next 4 to 5 days. You will have a bulky dressing on. It will secure your ears so they are not at risk of being
damaged. It is important to sit or lay with your head elevated
and not to lay on your ears.
That evening. It is recommended that you take it easy. You can walk around,
eat, but not too much more. Keep your head dressing on and
your head up at all times. You should take as much pain medication
as necessary and try to go to sleep early with at least 3
pillows underneath you to keep your head up.
First
48 hours. You can take a body shower the day after. Just be careful. Do not remove the head dressing; keep it
on until you see Dr. Cruise in the office. You will see him
most likely the third day after the operation at which time
the dressing will be taken down, the area cleaned up, and
a new smaller dressing applied. Depending on the situation
and the age of the patient, he/she will be told whether or
not this dressing can be changed at home or not.
First
week. The majority of the bruising and swelling will
go away in about 2 to 3 weeks. There will not be that much
pain and you will be able to do most activities except strenuous
ones. You should keep your head elevated until at least 2
weeks after the procedure.
Beyond. Swelling will not completely resolve for about 6 months but,
as mentioned above, the majority of it will be gone by 3 weeks. The final result will not be evident until one year when all
the swelling has resulted and skin contraction is complete.
Recovery
time
Some people with sedentary jobs go back
to work after 2 days. If your job, however, requires a lot
of strenuous activity it may take as long as 4 weeks to return
to work. Most people return to work in about 4 days.
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