EAR SURGERY - OTOPLASTY
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COSMETIC EAR SURGERY FOR PROTRUDING EARS
Protruding or prominent earlobes are congenital malformation that is noticeable right after birth. Parents usually notice this deformation very early and very often (especially mothers) believe that the cause is child sleeping on its ear, so they try to correct it with band-aid. Naturally, without success.
EAR SURGERY CANDIDATES
Protruding ears correction is done after six years of age. Plastic surgeons mostly suggest that this surgery should be done before starting the school, because of other kids teasing and giving various nicknames to the child (Dumbo, Flappy Ears) which can later create low self-esteem. However, according to statistics, patients most often decide for this type of surgery between 10 and 18 years of age, and naturally there are many older patients. Women can hide moderate degree of ear deformity with their hair. If the ears extremely protrude, virtually no hairstyle can hide them.
It is interesting that small children between six and ten are extremely motivated for this type of surgery. It is known that children do not like much to go to doctor's and that they are afraid on very thought of injection. Us that are dealing with these issues, in our experience have seen many children that climb on surgical table themselves and show exceptional cooperation (apart from few exceptions) during this surgical procedure, probably happy to end their friends' teasing.
Any emotional instability, unrealistic expectations are very important factors for negative selection of patients.
PREOPERATIVE TREATMENT
Ear can be protruding on one side, on both sides, in addition, both ears can be protruding symmetrically or asymmetrically. With such ears aside from prominence there are often present other deformities of earlobe.
If the angle between backside of the ear and the head is larger than 30 degrees than we say that the ear is prominent. There are other angles and parameters that are considered (e.g. conchoscaphoid, etc.) that will be determined by the plastic surgeon during the first examination if you decide to undergo the surgery. Whether the ear is prominent can depend on its dimensions. Small ear may look completely normal even if the conchoscaphoid angle is wide, while big ear with massive antihelix bend may look prominent. Children that undergo prominent ear surgery mostly do not have clear vision how their ears should look like. It is important to them that they end their friends' teasing, while the older patients have clear vision how their ears should look like. During the first examination Dr. Milan Jovanovic will ask you to show exactly how you would like your ears to look like, which will help him to understand your expectations.
EAR SURGERY OBJECTIVE
Objective of the ear surgery is to correct prominence, to achieve natural shape of the ear and remove psychological burden on the patient. That can be achieved by correction of upper end of the ear, by preserving smooth and regular helix line, by reduction of postauricular sulcus angle etc. depending on shape of the ear, that is to create completely natural shape of the ear.
EAR SURGERY PROCEDURE
First surgical techniques for correcting prominent ears were described back in 1845 when Dieffenbach and later Monks as first described this surgery that was based only on skin excision. Of course, these techniques are long abandoned. Today's techniques for prominent ear correction are based on ear cartilage modeling whose cornerstones were set by Luckett, later Pierce, Convers etc. For the patient is not important to know which techniques are being used, but it is important to know that the most important part is cartilage modeling (which is depending on method being used) mostly based on sawing of cartilage and its bending (Mustarde), thinning of the cartilage (Pierce), crushing, scarification (Stenstrom, Chongchet), grinding, cartilage abrasion from its front and rear side, as well as different techniques of cartilage excision.
Dr. Milan Jovanovic has earlier used aforementioned techniques, and since he has noticed many faults of these techniques he uses his own technique for more than ten years with which he achieves outstanding results, which he has published many times. He uses this technique depending on the shape of the ear, which he preoperatively assesses with consulting the patient.
Postoperative incision is located behind the ear and is not visible postoperatively, because it is hidden on the back of earlobe.
Ear surgery lasts for one to two hours. With smaller children it is done in general or local anesthesia with supporting analgosedation, while with older children and adults it is done in local anesthesia.
POSTOPERATIVE COMPLICATIONS
Complications can be acute (they appear just after the surgery) and chronic (they appear later). Of acute the most common is hematoma (accumulation of blood between skin and cartilage). Of chronic the most common are hypertrophic scar, rarely keloid, numbness that is temporary. If the ear surgery is done correctly, complications are very rare.
POSTOPERATIVE TREATMENT
After a few hours spent in hospital, the patient can go home. Depending on the technique use, bandages are left for three to seven days. After two weeks sutures are removed. Strenuous activities and contact sports should be avoided for a month or two. Postoperatively the patient is obliged to report to regular check-ups in agreement with his surgeon, when control photographing, results comparison and analysis is done.
Protruding or prominent earlobes are congenital malformation that is noticeable right after birth. Parents usually notice this deformation very early and very often (especially mothers) believe that the cause is child sleeping on its ear, so they try to correct it with band-aid. Naturally, without success.
EAR SURGERY CANDIDATES
Protruding ears correction is done after six years of age. Plastic surgeons mostly suggest that this surgery should be done before starting the school, because of other kids teasing and giving various nicknames to the child (Dumbo, Flappy Ears) which can later create low self-esteem. However, according to statistics, patients most often decide for this type of surgery between 10 and 18 years of age, and naturally there are many older patients. Women can hide moderate degree of ear deformity with their hair. If the ears extremely protrude, virtually no hairstyle can hide them.
It is interesting that small children between six and ten are extremely motivated for this type of surgery. It is known that children do not like much to go to doctor's and that they are afraid on very thought of injection. Us that are dealing with these issues, in our experience have seen many children that climb on surgical table themselves and show exceptional cooperation (apart from few exceptions) during this surgical procedure, probably happy to end their friends' teasing.
Any emotional instability, unrealistic expectations are very important factors for negative selection of patients.
PREOPERATIVE TREATMENT
Ear can be protruding on one side, on both sides, in addition, both ears can be protruding symmetrically or asymmetrically. With such ears aside from prominence there are often present other deformities of earlobe.
If the angle between backside of the ear and the head is larger than 30 degrees than we say that the ear is prominent. There are other angles and parameters that are considered (e.g. conchoscaphoid, etc.) that will be determined by the plastic surgeon during the first examination if you decide to undergo the surgery. Whether the ear is prominent can depend on its dimensions. Small ear may look completely normal even if the conchoscaphoid angle is wide, while big ear with massive antihelix bend may look prominent. Children that undergo prominent ear surgery mostly do not have clear vision how their ears should look like. It is important to them that they end their friends' teasing, while the older patients have clear vision how their ears should look like. During the first examination Dr. Milan Jovanovic will ask you to show exactly how you would like your ears to look like, which will help him to understand your expectations.
EAR SURGERY OBJECTIVE
Objective of the ear surgery is to correct prominence, to achieve natural shape of the ear and remove psychological burden on the patient. That can be achieved by correction of upper end of the ear, by preserving smooth and regular helix line, by reduction of postauricular sulcus angle etc. depending on shape of the ear, that is to create completely natural shape of the ear.
EAR SURGERY PROCEDURE
First surgical techniques for correcting prominent ears were described back in 1845 when Dieffenbach and later Monks as first described this surgery that was based only on skin excision. Of course, these techniques are long abandoned. Today's techniques for prominent ear correction are based on ear cartilage modeling whose cornerstones were set by Luckett, later Pierce, Convers etc. For the patient is not important to know which techniques are being used, but it is important to know that the most important part is cartilage modeling (which is depending on method being used) mostly based on sawing of cartilage and its bending (Mustarde), thinning of the cartilage (Pierce), crushing, scarification (Stenstrom, Chongchet), grinding, cartilage abrasion from its front and rear side, as well as different techniques of cartilage excision.
Dr. Milan Jovanovic has earlier used aforementioned techniques, and since he has noticed many faults of these techniques he uses his own technique for more than ten years with which he achieves outstanding results, which he has published many times. He uses this technique depending on the shape of the ear, which he preoperatively assesses with consulting the patient.
Postoperative incision is located behind the ear and is not visible postoperatively, because it is hidden on the back of earlobe.
Ear surgery lasts for one to two hours. With smaller children it is done in general or local anesthesia with supporting analgosedation, while with older children and adults it is done in local anesthesia.
POSTOPERATIVE COMPLICATIONS
Complications can be acute (they appear just after the surgery) and chronic (they appear later). Of acute the most common is hematoma (accumulation of blood between skin and cartilage). Of chronic the most common are hypertrophic scar, rarely keloid, numbness that is temporary. If the ear surgery is done correctly, complications are very rare.
POSTOPERATIVE TREATMENT
After a few hours spent in hospital, the patient can go home. Depending on the technique use, bandages are left for three to seven days. After two weeks sutures are removed. Strenuous activities and contact sports should be avoided for a month or two. Postoperatively the patient is obliged to report to regular check-ups in agreement with his surgeon, when control photographing, results comparison and analysis is done.