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  Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears.

For the most part, the operation is done on children between the ages of four and 14. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

 
 
                
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WHAT ARE THE UNCERTAINTIES AND RISKS ?

When ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The commonest risk is inability to meet the very high expectations. Ear is one of the most difficult organs of the body to reconstruct because of its convolutions and contours. While operating on one sided deformity, it may be difficult to replicate the normal ear on the abnormal side.

A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle. Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

HOW DO I PLAN MY SURGERY ?

Most surgeons recommend that parents stay alert to their child's feelings about protruding ears; don't insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

In the initial meeting, your surgeon will evaluate the patient and recommend the most effective technique. He will also give you specific instructions on how to prepare for surgery.

HOW DO I PREPARE MYSELF FOR THE SURGERY ?

You are advised to stop certain drugs like aspirin before the surgery. Your surgeon would give you detailed instructions about diet etc. prior to your surgery. You would be advised to take a head wash with medicated application the day prior and on the day of your surgery.

HOW LONG WOULD I NEED TO STAY IN THE HOSPITAL ?

Ear surgery is usually performed as an outpatient procedure in a hospital, a doctor's office-based surgical facility, or a freestanding surgery center. Occasionally, your doctor may recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight in the hospital.

IS THE PROCEDURE PAINFUL ?

If your child is young, your surgeon may recommend general anesthesia, so the child will sleep through the operation. For older children or adults, the surgeon may prefer to use local anesthesia, combined with a sedative, so that the patient would be awake but relaxed.

WHAT IS THE TECHNIQUE USED ?

Ear surgery usually takes about two to three hours, although complicated procedures may take longer. The technique will depend on the problem.

With one of the more common techniques, the surgeon makes a small incision in the back of the ear to expose the ear cartilage. He will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.

Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.

In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery may be performed on both ears for a better balance.

WHAT CARE DO I NEED TO TAKE AFTER THE TREATMENT ?

Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the hospital with a child until all the effects of general anesthesia wear off.

The patient's head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication.

Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Be sure to follow your surgeon's directions for wearing this dressing, especially at night.

Stitches are usually removed, or will dissolve, in about a week.

WHEN CAN I RESUME MY DAILY ACTIVITIES AND JOIN MY DUTIES ?

Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work about five days after surgery. Children can go back to school after seven days or so, if they're careful about playground activity. You may want to ask your child's teacher to keep an eye on the child for a few weeks.

WHAT OTHER EARS PROBLEMS CAN BE TREATED BY PLASTIC SURGERY ?

Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: "lop ear," when the tip seems to fold down and forward; "cupped ear," which is usually a very small ear; and "shell ear," when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury.

CAN AN ELONGATED EAR LOBE HOLE BE REDUCED IN SIZE SO THAT I COULD WEAR THE EARRINGS AGAIN ?

A number of ladies complain of elongated ear lobe opening due to continuous use of heavy earrings. Most of the surgeons suture the hole with simple sutures and make new hole again. Instead, plastic surgeon can suture the hole in such a way that you would be left with a narrow hole of appropriate size immediately after the surgery. A skin flap would support the earring and hence the probability of recurrence would be very slim. If necessary, you would be able to wear the earring immediately after the surgery.

Ask your surgeon about the effectiveness of surgery for your specific case.

MORE NATURAL LOOKING EARS

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don't expect both ears to match perfectly-perfect symmetry is both unlikely and unnatural in ears. If you've discussed the procedure and your expectations with the surgeon before the operation, you are likely to be quite pleased with the result.

 

 
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