EAR SURGERY OR OTOPLASTY

When dealing with prominent ears, so called sticking-out ears, we must consider this might cause significant suffering, especially during childhood, when children go to school. It is also important for adults who have suffered from this deformity for a long time. An easy and simple surgery can solve this problem.
Before proceeding with the surgery we have to figure out if the “sticking-out” or advancement is caused by the absence of the fold called antihelix or by prominent concha (concha is the concave area between the outer ear and the external auditory meatus). Sometimes sticking-out ears is caused by both, the absence of antihelix and a prominent concha.

Once initial assessment is done as previously described, we proceed to surgery.

First of all, we draw the antihelix by folding the outer ear backward. Then, small volume of local anesthesia is injected when adult patient who can stand local anesthesia is operated on, otherwise a child who can not stand local anesthesia undergoes sedation.

Following anesthesia, inked needles are used to score the location of the desired fold in the cartilage. Next, a small ellipse of skin is excised from the backside of the ear including previously marked points. After that, the area of the cartilage we want to bend to conform the antihelix is weakened. Many techniques exist to perform the maneuver (Moustarde, Davis, etc) to bend and weaken the cartilage. We have published our own technique using a 4 mm burr to bend the antihelix harmoniously after weakening the cartilage offering very natural shape. Based on our experience we consider that debilitating the cartilage using the scalpel produces too deep and acute cuts resulting in unnatural antihelix.
We also can lower the height of the concha to conform and confer the new shape. Afterwards, non-absorbable transparent sutures are placed into the backside of the ear to bend it. Tension is applied progressively in order to achieve symmetry with contralateral ear.

Patient goes back to normal life style just after the procedure although sleeping with a hairband for 15 days, to keep the ears in the right position avoiding undesired folds deforming our aesthetic outcome, can be very helpful.