Otoplasty is a procedure designed to “pin-back” prominent ears. Protruding ears have been given many different names (“bat ears,” “lop ears,” “cup ears,” and others) to differentiate between several more unusual anatomic conditions.
The goal of otoplasty surgery is to reshape the ear cartilage in a customized surgical procedure to produce a normal looking ear of the correct size and shape for a natural look.
Dr. Fechner is known for his delicate surgical approach, attention to detail, and the care with which he performs complex facial surgery. As a skilled plastic surgeon with extensive experience, he is often called upon to correct overly-prominent ears in a customized surgery. The care with which the procedure is performed can mean well-hidden incisions, permanent results and faster healing.
As both a surgeon and educator, his level of experience, along with his compassionate, patient-centered approach, has made Dr. Fechner one of the most sought-after plastic surgeons in the Boston area.
Patients or parents who have been bothered by protruding ears can achieve a natural, lovely pair of ears with a tailored surgical procedure. In fact, a person’s ears are typically not even noticed when one looks at the face, unless they are overlarge, protruding, or oddly-shaped.
To have the ear structure look natural, it should not appear “plastered down” as the ears will appear strange – and when placed too close to the head, can be difficult to correct.
Various aesthetic issues affecting ear appearance can lead a person to seek a plastic surgeon in the Boston area, for themselves or a child. Candidates should be in good general health.
The various aesthetic problems that can be resolved with otoplasty (ear surgery) include:
Ear appearance will be determined by the natural shape of the ear cartilage. This cartilage is very soft in newborns and becomes stiffer as the years pass. The ear has a complex shape made of folds and bends of cartilage. Although no one ear matches exactly the next, two main reasons are commonly responsible for ears that protrude.
The first is the absence or flattening of a main ear fold called antihelix and second, a “bowl” that is too large. Dr. Fechner’s experience has revealed approximately 60 percent of patients have variable combination of both abnormalities and 40 percent have a flat anti-helix only. A large ear bowls (called a concha or cavum conchae) as an isolated problem without abnormalities of the antihelix, and is exceedingly rare.
Conservative preservation of the ear cartilage characterizes the up-to-date otoplasty technique favored by Dr. Fechner. Rather than removing cartilage in ear surgery, Dr. Fechner reshapes it with the help of internal sutures to achieve the desired normal-looking shape. In your initial consultation, Dr. Fechner will thoroughly examine your ear structure and take important measurements. Following this examination and evaluation, he will discuss the customized surgical plan with the patient or parents of a child suffering with this condition. The incisions are concealed in the natural fold behind the ear to avoid any visible scars.
Otoplasty is commonly performed in young children before school age, as well as teenagers and young adults. In mature patients, this procedure can effectively and safely be performed in the office under local anesthesia with a sedative. Numbing the ear area for surgery typically requires only a single injection of lidocaine. The ear area is fully numbed for about two hours – the time it requires to perform ear plastic surgery.
The first step is to sterilize the area with a special surgical scrub solution. Dr. Fechner performs otoplasty surgery through relatively small incisions hidden within the crease behind the ears. The back of the ear cartilage is isolated for accurate sculpting of the ear. The normal location of the antihelical (the visible ear structure) fold is determined and sutures are used to fold the cartilage. Careful observation and adjustments during this process is a vital step in achieving a natural outcome.
If a large concha (the hollow of the external ear) contributes to ear protrusion, an appropriate amount of excess cartilage can be removed carefully so as not to leave sharp, unsightly edges. Lastly, the ear lobe is adjusted. Dr. Fechner uses key sutures to convince the earlobe to be balanced and in harmony with the new ear position. After the ear has been moved closer to the head, any excess skin is identified and trimmed. The incision is sutured with a melt-away stitch and a protective bandage is put in place.
Otoplasty can be safely performed in an outpatient setting. Recovery time ranges from seven to ten days. The first dressing must remain in place for 24 to 36 hours. Children will require observation and encouragement from mom and dad to ensure that this important bandage will stay in place for the first night. Ear soreness is normal for a few days, but can be managed with pain medication.
Dr. Fechner will examine the patient after the first dressing is removed ensuring that the healing progress is moving forward as it should. When the bandages are removed, the ears show their new position and shape. The ear skin will appear puffy and may still be bruised. After the bandages are removed, you (or your child) will be able to take a shower. Dr. Fechner finds a soft sports sweatband helpful to protect the ears and hold them in the new position. The sports band should be worn for the next 5 to 7 days. After this time, it is recommended to wear the headband during sleeping hours.
When a child is between four and six years of age, his or her ears have grown sufficiently and otoplasty surgery is now safe and predictable. For young children, the ear cartilage, which determines the ear’s shape, is pliable enough to undergo corrective surgery. Parents commonly consider correction of protruding ears before the child enters school.
Because prominent ears may run as a trait within families, relatives may have a deep personal understanding of the psychological trauma caused by teasing and ridicule from their peers. In children younger than 12, the procedure is commonly performed as an outpatient procedure, with the child in twilight sleep. In smaller children (4 to 8 years), a general anesthetic may be most appropriate.
FRANK P. FECHNER MD. All Rights Reserved.
428 Shrewsbury Street, Worcester, MA 01604