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Otoplasty

Your ears are crucial to your front view: when the shape, size, or position of the ears is abnormal or asymmetrical, and it bothers you, an ear correction can be an option for you. The most commonly performed surgery to correct protruding ears is called pinnaplasty. Protruding ears are often familial, and many children are teased at school, causing them great embarrassment and loss of self-confidence. From a practical standpoint, most girls and women want to wear their hair up but feel self-conscious about their ears sticking out.

Recovery
Treatment
Anaesthesia
Consultation

Three Types of Ear Correction:

  1. Correcting protruding ears

  2. Adjusting the shape of the conchal bowl

  3. Correcting torn or long earlobes

The correction of prominent ears is sometimes performed on children as young as ten years old. Children that young will always undergo these surgeries under general anaesthesia.

It All Starts with a Consultation

No two pairs of ears are the same. The cosmetic needs and expectations of patients are unique. To ensure that you are happy with the result of your treatment, Dr Pirayesh develops a customised surgical plan for each patient. During the consultation, he will take the time to get to know you, discuss your requirements and help you make an informed decision.

He will ask about your general health and medical history and examine your ears. He will ask you to point out what you want to improve, after which he will indicate whether your wishes are realistic. He will explain the surgery to you, answer any questions you may have, give you instructions on how to prepare for the operation, and inform you about the cost. 

Ear Overview and Timeline

Duration of the operation: 1 to 1 1/2 hours
Anaesthesia: local anaesthetic or general anaesthetic administered by a specialised anaesthetist
Length of stay: outpatient; you may return home straight after the surgery. You can drive yourself if you wish. If you have had a general anaesthetic, you must stay for a few hours and be picked up or take a taxi because you cannot drive yourself.  
Post-operation: swelling and bruising around the ears. A compression bandage will be put around your head to prevent swelling, which you must wear day and night for the first week. You will receive pain medication and instructions on wound care.
Complications: rare: infection, allergic reactions, slow recovery
temporary: swelling, bruising, and redness of the scars
specific: raised scars, asymmetry of the ears, and prolonged sensitivity during cold weather
Recovery time ear pinning: The first week, your ears will be swollen and painful, for which you can take a regular painkiller like paracetamol. Because you need to wear the compression bandage day and night the first week, most patients take the first week off work and rest. You won’t be able to sleep on your sides for some time, and the swelling will take weeks to dissipate. After one week, the bandages are removed, and you may wash your hair. For the next three weeks, you must wear the bandage during the night. 
Recovery time earlobe and conchal bowl surgery: Bandages are put on the earlobes to protect the incisions. You can go home straight after the procedure. Because scars discolor under the influence of sunlight, you must protect your ears with a high SPF for the first months. You must refrain from having your ears pierced for a few months because the tissue needs time to heal properly. 
Results: the results of your ear surgery can be judged after one month.
Scarring: Dr. Pirayesh has developed a program, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections, to ensure that your scars heal in the best possible way. 

Ear Surgery in Five Steps

Dr Pirayesh will mark the surgical site on the day of your surgery. In addition, he will take several photographs of your face and profile, so you can later review the results properly.

Step 1. Anaesthesia

If you are nervous, we can give you a mild sedative. You will then be given a local anaesthetic, which will be a little unpleasant, after which you will feel the surgeon working on your ears, but you will feel no pain.

Step 2. The incisions

When pinning back your ears, Dr Pirayesh makes a vertical incision behind each ear, hidden in the natural crease between your ear and head. Then he removes a segment of cartilage and attaches the cartilage with subcutaneous sutures. When performing a conchal bowl correction, he typically doesn’t remove any cartilage but attaches the outer ear to achieve the desired shape. In the case of an earlobe surgery, either a piece of the earlobe is removed, or a torn earlobe is re-attached.

Step 3. Suturing and bandaging

Once the ear has the right shape and position, the skin is closed with tiny, soluble sutures. In the case of an ear pinning surgery, the remaining cartilage will be closed with permanent sutures to secure a lasting shape. The topical sutures are virtually invisible and lie in the crease between your ear and your head. The sutures of an earlobe surgery fall into the fold underneath your earlobe and will, over time, be virtually invisible. In a torn earlobe surgery, the sutures often fall at the edge of the ear and will eventually be barely visible and certainly not notable.

Step 4. Recovery and aftercare

You may return home almost immediately after surgery; you can drive yourself. You will receive pain medication and instructions on wound care.

 

Ear pinning surgery:

  • Your ears will be swollen and painful for about a week; you may take paracetamol for pain relief

  • The swelling can last a few weeks; this is perfectly normal

  • You should rest for a few days and not endeavour to bend or lift. You must hold your head upright as much as possible.

  • You need to wear a compression garment for the first week to prevent swelling and pressure on the surgical wounds, and you have to wear it day and night for one week and three weeks after that during the nights.

  • You will not be able to sleep on your side for some time

  • After a week, the bandage will be removed, and you may wash your hair

  • As a rule, you will be able to resume your normal activities after a week

  • The results of your ear surgery can be judged after one month

  • You may resume practising contact sports after six weeks

  • Avoid the solarium or sauna, and avoid drinking alcohol and taking blood-thinning painkillers like aspirin for ten days before and ten days after surgery (paracetamol is allowed)

 

Earlobe and conchal bowl surgery:

  • The earlobes are protected with surgical tape to protect the wounds

  • Because scars discolour under the influence of sunlight, you must protect your ears with a high SPF for the first months. 

  • You must refrain from having your ears pierced for a few months because the tissue needs time to heal properly. 

  • You may resume practising contact sports after six weeks

  • Avoid the solarium or sauna, and avoid drinking alcohol and taking blood-thinning painkillers like aspirin for ten days before and ten days after surgery (paracetamol is allowed)
     

Step 5. Wound healing and scarring

Dr Pirayesh is very savvy when it comes to promoting rapid healing. He has developed a customised regimen, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections, to ensure that your scars heal in the best possible way.
This regimen has ensured that many of Dr Pirayesh’s patients have hardly noticeable scars. However, it is impossible to pre-determine if patients will have problems with their scars healing.

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