Aesthetic Plastic Surgery

The correction of ears requires surgery, called “otoplasty, aimed at reshaping the pavilions considered excessively visible. The operation is usually performed on both ears, but may be unilateral. A otoplastie intends to correct the anomalies of cartilage present at the flag of the ear and responsible for its “off”. We can broadly identify three types of defects that are often more or less associated with each other:

* Too angulations between the flag of the ear and the skull realizing the true “delamination” (helix valgus).
* Excessive size of the cartilage of the conch (see diagram) projecting the ear forward, which accentuates the look off (hypertrophy of the shell).
* A lack of kinking reliefs normal cartilage that fact that the flag of the ear has a too smooth, like “déplissé” (failure to kinking of anthélix).

Principles

The intervention aims to correct these anomalies finally remodeling cartilage in order to obtain ears recollées “symmetrical, size and natural aspects, thus putting an end to teasing and other remarks that could be the origin of psychological problems or conflicts at school.

A otoplastie can be done in adults or adolescents, but most of the time the correction is seen in childhood, where it can be done from the age of 7, when the child complains its appearance and suffers.

Structure of the ear
Before surgery

A close examination of the ear was made by the surgeon to analyze the changes.

A pre-operative assessment is normally done in accordance with

In case of anesthesia other than purely local, the anesthetist will be seen in consultation at least 48 hours before surgery.

Any medication containing aspirin should be taken within 10 days preceding the intervention.

For boys, a haircut is short of desirable. (For girls, a pony tail would be welcome)

The head and hair are washed thoroughly before the operation.

Depending on the type of anesthesia, he will be fasting (nothing to eat or drink) 6 hours before surgery.
Types of anesthesia and hospital procedures
Types of anesthesia

Three methods are possible:

* Local anesthesia pure analgesic where a product is injected locally to ensure insensitivity ears.
* Local anesthesia depth by tranquilizers administered intra-venous (anesthesia “guard”).
* General anesthesia classic, when you sleep completely.

The choice between these different techniques will be the result of a discussion between you, the surgeon and the anesthesiologist.
Terms of hospitalization

Usually the operation is performed in “ambulatory”, ie days in hospital with an output allowed the same day after several hours of surveillance.

However, in some cases, a short hospitalization may be preferred. The entrance is then in the morning (or sometimes the previous day in the afternoon) and the output is usually allowed by the next day.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results. However, it may hold common basic principles:

* Skin Incisions: Usually they are located only in the retro-auricular sulcus, ie in the natural crease behind the ear. In some cases, small incisions will be made at the front of the flag, but they will be hidden in natural folds. It should be noted that at no time did the hair cut.
* Dissection: The skin is then peeled off as needed to access the cartilage.
* Remodeling cartilaginous: The principle is to create or enhance the natural landforms and refinement by kinking, possibly maintained by fine sutures deep. Sometimes, sections or resection of cartilage are needed. Finally, the flag is lowered in a good position compared to the skull and fixed by profound points.
* Sutures: Traditionally, the son resorbable are used, otherwise they must be removed to the 10th day.
* Dressing: It is realized with an elastic band around the head to maintain the ears in a good position.

Depending on the surgeon and the importance of correcting defects, a bilateral otoplastie can take half an hour to an hour and a half.

Incisions
FOLLOW-UPS

The pain is usually moderate and, if necessary, resisted by an analgesic treatment and anti-inflammatory.

Otherwise, a consulting surgeon or his team needed.

The first large bandage will be removed between the 2nd and 5th day after surgery. Beyond that, it will usually be replaced by another bandage lighter for a few days. The ears may appear swollen, with reliefs masked by edema (swelling). Blue more or less important are sometimes present. This possibility should not worry: it is transitory and does not the final result. A strip of restraint and protection (such as “strip tennis”) must be worn night and day for a fortnight, and then only at night for several weeks. During this period, physical activity or sport with a risk of contact should be avoided.

Exposure to extreme cold is not recommended for at least two months because of the risk of frostbite because of the transient decrease of the sensitivity of the ears.
The result

A period of one to two months is necessary to assess the final outcome. This is the time for fabrics that are relaxed and all the swelling was reduced, showing clearly the relief of the ear. After this time, only the scars are still a little pink and indurated before fading. The intervention will most effectively allowed to correct the discrepancies and get ears normally positioned and oriented, although Plicata symmetrical, size and appearance natural, not bloated.

In most cases, the results are definitive. However, a recurrence of the décollement (usually partial) may occur in the medium term, then may require a little re-intervention.

Overall, this simple in principle and in its realization allows generally correct effectively unsightly that are the ears that are the subject, particularly in schools, frequent teasing or remarks that could be the cause of school conflicts or psychological difficulties.
The result of imperfections

They can occur secondarily, for example due to unexpected reactions or tissue scarring unusual phenomena. Thus we can sometimes observe a slight asymmetry between the two ears, small irregularities reliefs or kinking a little too prominent, a narrowing of the orifice of the ear, or a perception of deep son.

These small flaws, when they exist, are usually mild and do not attract the eye. However, if any, they are always accessible to a small “touch” that will most of the time under simple local anesthesia.
The possible complications

A otoplastie, although carried out mainly for aesthetic reasons, remains a real surgery, which involves the risks associated with any medical procedure, however small.

We need to distinguish between complications related to anesthesia those relating to surgery.

Regarding anesthesia, during the consultation, the anesthetist inform itself on (the) patient (e) the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent anesthesiologist, engaged in a real fact that the surgical risks are now almost statistically insignificant.

Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.

Regarding the surgery: choosing a plastic surgeon, qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove.

Fortunately, the real complications are very rare in the wake of a otoplastie made in the rules. In practice, the vast majority of happens without any problems and patients are fully satisfied with their result.

Nevertheless, and despite their rarity, you should be aware of the potential complications:

* Post-operative bleeding: it is more important than just a spot of blood on the dressing (which has nothing to worry about), this may justify a re-intervention to stop the bleeding at its source. The blood may not s’extérioriser and lead to a hematoma that it is often preferable to evacuate.
* Infection: it is fortunately very rare thanks to the measures of asepsis opératoire draconian. If it happens, however, it requires prompt treatment to prevent cartilage damage which could be serious.
* Skin necrosis: exceptional, it sometimes occurs because of problems with traffic on the thin skin of the front of the flag, next to a relief cartilage. The healing process occurs normally through dressings local beach leaving a small scar.

* Abnormal Scars: despite all the attention paid to the achievement of sutures, scars located behind the flag of the ear may be the site of inflammation and hypertrophy embarrassing, even an evolution “Keloidal Scar” (sustainability of scar hypertrophy) whose treatment remains difficult.

In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards. The use of a qualified plastic surgeon can assure you that it has the training and expertise to know to avoid these complications, or treat them effectively if necessary.

Filed under: Aesthetic Surgery