Prominent Ear (Otoplasty)


Prominent Ear (Otoplasty)
Otapostasis, which is also commonly known as prominent ear, and is a poorly developed or protruding auricle and earlobe consequent to congenital defects or trauma, can be reconstructed and reshaped by otoplasty surgery. Ear defects and deformities including prominent ear may be a source of intense shame and anguish leading to social and psychological problems, especially in childhood. As they grow up, children who engage in social environments such as kindergartens, day-care centres, and schools may be exposed to harsh reactions and criticism due to the appearance of their ears. Having prominent ears might affect a child’s psychology.

Being the object of derision among peers can lead to poor development of self-esteem, poor interpersonal relationships and communication, social withdrawal, and school failure and even depression. For this reason, the age that children start preschool is considered as the best time for a child to have otoplasty surgery. Having prominent ears is a frequent source of self-esteem issues, not only in children but also in adults. Adults may also need otoplasty surgery in order to get rid of an appearance that can be perceived as a physical disadvantage in social environments, or to get rid of concealing their ears with their hair, or to be able to have a short haircut. Otoplasty is a very common plastic surgery performed to improve the shape, projection and size of the ears. Otoplasty can be performed under general or local anaesthesia. Based on what kind of correction is needed, otoplasty can be performed on an outpatient basis, or may require hospitalization for a short time.

What is the Otoplasty Age in Children?
For children, it is very important to determine the time for otoplasty surgery. Otoplasty is generally not recommended before the age of five. However, it should be kept in mind that your child may grow up with psychological problems if the surgery is delayed for too long.

What Causes Prominent Ear?
The pinna (auricle) consists of cartilage covered with a soft tissue and skin. The pinna completes its development at the age of five. However, the content of the cartilage continues to alter over the years. The auricular cartilage, which is softer and more pliable in younger children, becomes firm and stiff in adults and older persons. The unique shape of the auricle is the result of the many folds that occur during the baby's development in the womb. If some of these folds fail to develop fully, it results in prominent ear(s). As in all facial structures, one ear is not like the other. The aim of surgery is to make the ears less prominent, similar in appearance and more natural.

Preparation Process before Otoplasty
Preoperative preparation starts with a friendly meeting with your surgeon, where all your questions will be answered completely. Your doctor needs to know and understand your expectations and wishes. Therefore, you need to ask and learn what can and cannot be achieved with surgery, and how the appearance and shape of your ears will be after the surgery. Learning this will help you to determine your expectations from the surgery. Quality photos to be taken before surgery not only provide the surgeon with guidance during the operation, but also with opportunity to compare the outcomes of the surgery. If the operation is planned to be performed under general anaesthesia, the patient or his/her close relatives need to have a separate meeting with the anaesthesiologist.

What are Otoplasty Surgery Techniques?
There are many different surgical techniques used to correct prominent ear. In children or young patients, shaping can be done with stitches because the cartilage is softer and more pliable. In order to shape the cartilage as desired, certain areas can be marked to make incisions to fold the cartilage into the proper position and secure it with stitches. Regardless of the technique used, if there is excess cartilage, an incision is made on the backs of the ear fold to remove excessive cartilage and soft tissue. This incision is closed with appropriate suture materials selected considering the aesthetic result and durability. At the end of the operation, a dressing/bandage is applied to provide a slight pressure on the newly formed auricles.

Postoperative Follow-up and Recovery Process
The patient is monitored on the first postoperative day, and the dressing is renewed or removed. The patient generally experiences no severe pain after the surgery; he/she may have a mild pain that can be taken under control with painkillers. For one week, the patient needs to wear a loose headband that covers the ears; then, he/she is required to wear the headband only at nights for the next few weeks. Although recovery is unique for every patient, children can return to school after 7 days, while adults can go back to work in a shorter time. Strenuous physical activity is restricted for 10 - 14 days and contact sports for at least two months. Follow-ups that are scheduled frequently in the first postoperative weeks are usually repeated in the 3rd month and 12th month following the surgery. Within this period, the incision scars at the back of the ears gradually recover. Since the incisions are located behind the ears, the scars are concealed and usually do not cause any cosmetic problems.

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