The normal ear forms an angle of approximately twenty-three degrees with the temporal skull. When the angle is much bigger, we have a deformity known as prominent ears. The psychological problem that accompanies this deformity can be quite intense, especially in youngsters and it is suggested that the problem must be solved before the school age . The surgery can be done from the age of 6-7 years when the ear has completed its development of about 85%. The most common problems regarding the ear are: a) Very strong concha, so that the angle is much greater than 23 degrees and the ears are prominent b) lack of the formation of the antihelix fold, and as a result a flat ear c) a combination of two d) Protruding ears are both very small. Depending on the problem, we use the proper otoplasty technique.
If the parents get aware of the problem immediately after the birth of the child, the can take advantage of the plasticity of the ear cartilage during the first days due to the estrogens of the mother circulating in the newborn’s vessels, and can solve the problem without surgical procedure, just using a proper bandage. If such procedure isn’t done, the best age for the operation is just before the child goes to school, as the ear has already reached the 85% of its growth. So, when the child meets others of the same age, won’t have complexes created from prominent ears and other youngsters won’t create him or her problems. Usually in this age the operation is carried out in general anesthesia because children are not able to stand still and cooperate for about 1 -1 ½ hours, the time for the operation to complete.
Adults are usually -but not always! – more cooperative than children and the operation can be done under local anesthesia. After studying the ear and deciding what is wrong we will choose the right procedure for each patient (Mustardè, anterior scoring ect). The incision is done behind the ear and is not visible. We correct the conchal hypertrophy, we model the antihelix fold, we score the cartilages so they become more flexible and we place the proper sutures that hold the ears in their new position. Finally we suture the dermal incisions.
Children that will undergo this procedure under general anesthesia will remain in clinic for at least 24 hours. If the procedure is carried out under local anesthesia the patient is dismissed right after the operation and can return home. For one week the patient will have a bandage covering the ears and after that must wear for at least three weeks an elastic hair ribbon to protect the ears. Possible side effects are: Cheloid or hypertrophic scar formation, small hematomas or seromas. The patient returns to his/her normal activities very soon and after the removal of the first bandage can almost do everything with the exception of anything that can injure the ears.