Otoplasty is the surgery that properly replace the so called “sticking-out ears”, creating a pleasant morphology of the ear without affecting hearing. It can be performed on one or both ears, depending on the blemish to correct. Anesthesia is local without sedation.
Scars are frequently hidden in the furrow behind the ear, even if sometimes, to correct some flaws, it may be necessary to add some little scars visible on the front of the pavilion itself.
When it is recommended
The surgery is performed in cases where the auricle presents an excessive front projection, often accompanied by the absence of the fold of the anthelix. It may be appropriate to take action on both ears, or on one, and the surgical technique may differ on each side. The surgery is also performed frequently on children from 4 years old, in order to reduce their possible discomfort at school age.
Preoperative preparation
To perform otoplasty surgery is essential that the patient is carefully checked through standardised medical examinations. The patient should be in good health and in good general condition. It is recommended to stop taking antiplatelet medications or blood thinners such as aspirin and stop smoking (at least two weeks in advance). The patient must promptly report to her surgeon the appearance of any symptoms of the disease which could make advisable to postpone the surgery (cold, sore throat, cough, skin diseases recently arisen ). It is recommended to wash hair, carefully, the day before. The day of the surgery the patient must arrive fasted (from midnight of the previous day if the surgery has to be performed under anesthesia), without any nail polish on the nails of feet and hands and with the elastic sheath earmuffs recommended by the surgeon for the post surgery .
The surgery
The surgery, on both ears, can last about 120 minutes, and is made under local anesthesia, with appropriate use of an additional intravenous sedative, in order to reassure the patient. For children it may be necessary general anesthesia. Generally, we proceed to the removal of a small "hourglass" of skin behind the ear, to the remodeling and repositioning of the ear cartilage. In order to recreate the natural fold of the pavilion (antihelix) we shall proceed to the weakening of the cartilage of the ear. Scars are hidden in the back-headset, but sometimes, some small scars on the front can be added.
Postoperative
After the surgery, the surgeon places a compressive turban shaped dressing that the patient should keep for a few days until the stitches are removed after ten days. In the postoperative period, the patient may experience a mild pain, which can easily be content with common painkillers. To wash hair with warm water, can be made from the fourth day, with particular care not to wet the scar and not heat it too much with the hair dryer. Once removed the stitches, about 10 days later, during the night, the patient will have to use an elastic bandage for 30 days, this will provide greater protection to the ears while sleeping. After two weeks it is possible to resume sport activity as long as you do not expose your ears to possible trauma. It is recommended to avoid for a month to wear glasses with heavy frames and direct exposure to sun or intense heat (eg .: sauna, UVA).
Possible risks and complications
Complications of otoplasty surgery are rare. Sometimes a slight bleeding may occur and the consequent hematoma between the cartilage and the skin, which needs to be drained quickly. Rarely, infections can appear, however they are successfully treated with antibiotics. In case of development of pathological scarring (keloids) we will proceed to local corticosteroid therapy and the use of silicone patches. Exceptionally you can have relapses: the ear can return, although partially in a prominent position compared to that obtained with the operation. In such cases it may be appropriate to make a new fix, usually under local anesthesia.
Insurance
The otoplasty surgery can sometimes be done in agreement with the NHS or with major insurance companies. This possibility, however, has only a few well-defined conditions, as in the case where there is involvement of the region headset, or in some malformation syndromes or in case of a certificate of a child psychiatrist attesting to a personality disorder secondary to the problem headset.
Results
The results of otoplasty surgery are immediately visible despite the post-operative swelling, and thre is a mutual satisfaction of the patient and the surgeon. The correction obtained is stable over the years and very rarely it can be necessary to remove small remaining imperfections This action will be performed only after at least three months after the operation.