Ear Surgery

Introduction

Prominent ears can be a distraction that takes the focus off of the central features of the face. Patients often present to the office after years of trying to hide the appearance of the ears by such means as selecting hair styles that de-emphasize the ears or never wearing baseball caps and head bands. While variations in cause and presentation exist, the majority of prominent ears result from problems with development of the cartilaginous skeleton of the ear.

BeforeAfter

Before and after of an ear demonstrating poor development of the natural folds of the ear, leading to a prominent ear. Correction showing restoration of natural and appropriate positioning of the ear. *Results May Vary

Anatomy

Ear shape is determined by the size and arrangement of the cartilage found under the skin of the ear. Most cases of ear prominence result from enlargement of the central bowel shaped cartilage, called the conchal cartilage, or from improper bending of the outer portions of the cartilage, known and the antihelical fold. The antihelix divides into a Y shaped pattern as the backwards bending fold extends toward the top of the ear. When this bend is under-developed, the ear cartilage protrudes outward and away from the side of the head. Correction of the shape of the ear involves either reducing the prominence of the conchal cartilage, creating the proper backwards fold of the anthelix, or a combination of the two.

Ear Surgery

Procedure

Ear procedures usually takes approximately one hour per ear to perform and can be completed using just numbing medicine, with no other anesthesia. Most patients prefer to be asleep for the procedure, however. In this case, patients receive anesthesia by vein, and once asleep, have a soft balloon is put in their mouth to prevent them from snoring during the procedure. The balloon is removed prior to waking up at the end of the case.

The procedure is performed through an incision that is placed in the fold between the ear and the side of the head. This incision location is imperceptible, even in boys and men with short or no hair. Through that incision, conchal cartilage can be reduced by excision or through sutures that reduce its prominence. When improper folding of the antihelical cartilage is present, the front surface of the cartilage is weakened to allow molding of its shape. Sutures are then used to hold the new position, with all of this being performed through the incision hidden behind the ear.

BeforeAfter
BeforeAfter

Before and after of an ear demonstrating poor development of the natural folds of the ear, leading to a prominent ear. Correction showing restoration of natural and appropriate positioning of the ear. *Results May Vary

Recovery

Patients wake up with a light wrap around the ears. The wrap is worn for two days to help minimize swelling. Once the wrap is removed, patients are instructed to wear a head band at night for two weeks following the procedure to prevent any unexpected trauma to the ears while sleeping. There is mild to moderate discomfort or throbbing for the first few days after the procedure, however most patients need nothing more than Tylenol for pain. Normal activities can be started immediately, including exercising, but wearing of a helmet is prohibited for 3 weeks.

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