EL-ROUBY-CLINIC

Otoplasty (Ear Reshaping or Ear Reconstruction)

What is Ear Surgery?

While many people are born with ears they like, others would like to make changes to their ears. For those who were teased, and made fun of as children, a surgical procedure, ear surgery, or otoplasty, provides an opportunity to improve upon the appearance of one’s ears. This surgical procedure pins ears closer to the head, reduces the size of large ears, and reshapes them. This can result in the ears appearing more normal, smaller, or not stick out as much.

This procedure is especially helpful for young children in helping them avoid having to endure teasing and ridicule from others. The ears are almost fully grown when children reach the age of 4 and this is the age most children can begin having this operation. Ear surgery can be performed on adults as well, with no additional risks involved.

During the procedure, We makes a small incision in the back of the ear to expose the ear cartilage. The cartilage is then sculpted, and bent back toward the head. Stitches may be used to help maintain the ear’s new shape. Other techniques are used to improve upon the appearance of the ears. Ear surgery results in more natural-looking ears that lie flatter against the head and appear more normal.

With the increasing popularity of various cosmetic surgery procedures, including Ear surgery, it is imperative that the prospective patient research and understand different issues like what the procedure can and cannot treat, inherent risks, costs, and so on. Keep in mind, cosmetic surgery is just that – a surgical procedure whose results cannot simply be erased. When considering any form of cosmetic surgery, it is important to have a good understanding of the procedure before making a decision. Take some time to view the introductory information we have provided on Ear Re-shaping. While the information contained in this website will provide you with a basic understanding of the procedure, it may not answer all of your questions. To get complete answers to the questions you are seeking, we recommend that you contact us.

Who is the Candidate for Otoplasty or Ear Reconstruction?

- Typical candidates for this surgery are actually younger patients. If the candidate is a child, he must wait until the ears are almost fully grown, usually between ages four and six, before undergoing surgery. Having ear surgery at a younger age carries psychological and physical advantages. The cartilage is extremely flexible, thereby permitting greater ease of shaping; and secondly, the child will experience psychological benefits from the cosmetic improvement. This is done at a young age so that the child can avoid being teased during their school years.
- Adults can also undergo ear surgery, without taking on any additional risks. They usually have this done to enhance their appearance, and to improve self-esteem. Adult patients do not take on any additional risks by having ear surgery at an older age. However, they should understand that the firmer cartilage of fully developed ears does not provide the same molding capacity as in children.

- An ideal candidate is one who is looking to improve certain ear shape or size problems. These include:
a- Large ears.
b- Protruding ears.
c- Lop ear, Cupped ear or Constricted ear (when the seems to fold down and forward).
d- Shell ear (when the curve in the outer rim, as well as the natural folds and creases, are missing).
e- Stahl ear or Spock's ear (pointed outer rim).
f- Cryptotia (Absence of depression between ear and head in back of the ear).
g- Micotia or anotia (Small or Absence of ear with or without external ear opening) 3 grades.
h- Ear lobes with large creases and wrinkles (old age).
i- Accessory lobe (Skin tags in cheeks with or without cartilage).

What is ideal shape of the ear?

Actually, there is different shapes differ by race, age, sex, religious ethnics and personal variations. So, there is no ideal ear shape but the ideal ear for you is that proportional to your other facial features.
- At birth, the height of the ear is 66% of adult size.
- The ear is approximately 85% of full size by age 6 years and 90% by age 9 years.
- The height of the average adult ear ranges from 5.5-6.5 cm (15 years male & 13 years female). The height of the ear is approximately equal to its distance from the lateral brow at the level of the helical root.
- The width is approximately 55% of the height.
- The normal protrusion from the head is 1.5-2.0 cm or approximately 15-20�.
- Its top aligns with the brow, and the lobular tip aligns with the base of nose.
- The long axis of the ear does not parallel the nasal dorsum but is approximately 15-20� posteriorly rotated from the perpendicular axis of the body.

Where do I begin?

For those deciding to have ear surgery, the first step is to make a consultation visit. Parents should pay attention to their child’s feelings about the current ear condition and not insist the child have surgery. Parents must be confident about what is in the child’s best interest.

During the consultation, We and patient discuss issues such as the patient’s reasons for wanting ear surgery, evaluate the current ear condition, and explain the various what can be done, and the details of the surgery. We shall also provide instructions on how to prepare for the procedure.

How is Otoplasty procedure performed?

- The type of anesthesia used typically depends upon the age of the patient. If ear surgery is performed on a younger patient, we recommend general anesthesia, allowing the child to sleep through the operation. For older patients, local anesthesia may be used, allowing the patient to be awake but relaxed.

- The operation takes about two to three hours, depending on the type of problem.
- We makes a small incision in the back of the ear to expose the cartilage.
- Then, we sculpt the cartilage and bend it back toward the head.

- Occasionally, a larger piece of cartilage may be removed, which will provide a more natural-looking fold when surgery is complete.
- Sometimes, the skin is removed and stitches are used to fold the cartilage back on itself. This is done to reshape the ear without removing cartilage.
- Stitches may be used to help maintain the new shape as well as close the incision.

- In most cases, ear surgery will leave a faint scar in the back of the ear, which fades over time.
- Even when only one ear is protruding, surgery is usually performed on both ears for a better balance.

Ear Reshaping or Otoplasty Recovery:

N.B. It is important to have realistic expectations and understand that ear surgery is meant for improvement, not perfection. Both ears matching perfectly due to surgery is highly unlikely (naturally).

- Most patients can go home within a few hours after surgery.
- In most cases, the patient’s head will be wrapped in a bulky bandage immediately following surgery. This will help provide the best molding and healing.
- Throbbing and aching in the ears is to be expected, which can be relieved with medication.
- The stitches are removed about a week after surgery.
- It is recommended that patients avoid any activity where the ear might be bumped. Usually adults can go back to work within five days after surgery, while children can return to school within seven days.

How is Ear Reconstruction procedure performed?

- It is 3 or 4 Staged Procedure, with 3 to 6 months between each stage.
- The type of anesthesia is general anesthesia.
- Each stage takes about two to three hours, depending on the type of problem.
- First Stage: Rebuild the Cartilages of the ear by natural graft of rib or costal cartilage or synthetic material like medpore. The frame of the ear is embedded under the scalp skin.
- Second Stage: We deliver the embedded cartilage using split skin graft in back of the ear.
- Third Stage: Reconstruction of the ear lobe and create the external ear opening.
- Forth Stage: may be needed in some cases to refine the results by otoplasty of the normal ear for a better balance.

Ear Reconstruction surgery Recovery:

N.B. It is important to have realistic expectations and understand that ear surgery is meant for improvement, not perfection. Both ears matching perfectly due to surgery is highly unlikely.

- Most patients can go home within a few hours after surgery.
- In most cases, the patient’s head will be wrapped in a bulky bandage immediately following surgery. This will help provide the best molding and healing.
- Throbbing and aching in the ears is to be expected, which can be relieved with medication.
- The stitches are removed about a week after surgery.
- It is recommended that patients avoid any activity where the ear might be bumped. Usually adults can go back to work within five days after surgery, while children can return to school within seven days.

What are the risks to having ear surgery?

Risks involved with ear surgery are minimal.
- A small percentage of patients may develop a blood clot on the ear as a result of the operation. However this condition can dissolve naturally or be drawn out with a needle.
- Another risk is infection occurring in the cartilage, which can cause scar tissue to form. This can be treated with antibiotics.


What are the typical costs associated with Ear Surgery?

Often the price says nothing about the quality of the work. Most multicenter clinics charge much more than private doctors — their advertising budget is more and the owner of the clinic has to take his 20% or 30% off the top. In my opinion, you are less likely to get a quality procedures at these multi-center locations.

Although price is a factor when deciding on surgery, the most important factor is that you feel you are getting a good quality, natural-looking result from the procedure.

Otoplasty costs are variable according to the deformity and the used technique. Usually the cost is ranging from 1000 to 1500 U.S. dollars. For Ear Reconstructive Procedures, the cost for each stage is about 1000 U.S. dollars. When dealing with costs, you also need to take into consideration the fact that the procedure may need to be repeated. Most medical insurance providers do not cover the Otoplasty procedure but do for ear reconstructive procedures.

Frequently asked questions from patients when considering undergoing Ear Surgeries?!

Personality analysis by Ear?
"The ear is spiraled shaped like the nautilus which in metaphysics takes us to sacred geometry and the movement of consciousness - golden ratio.
Ears should exhibit good, fleshy inner and outer helixes. Thin and poorly shaped outer helixes may reveal diminishing health.
- Set Close to Head: Planner, thrifty, cover his bets
- Protruding: Curious, creative
- Small lobes: Creative, good with detail
- Large lobes: Independent, strong willed
- Large ears: Intellectual, likes sports
- Longer than wider ears: Keen, impractical
- Small ears: Instinctive, controlling
- No lobes: Unresponsive, lacks purpose, emotional problems
- Distorted lobes: Sneaky ".

Q - What is ideal shape of the ear?
A - Actually, there is different shapes differ by race, age, sex, religious ethnics and personal variations. So, there is no ideal ear shape but the ideal ear for you is that proportional to your other facial features.

Q - Is it possible to do ear reconstruction with scared head after accident?
A - Yes, but the success rate is less than 80 %.

Q - Is it possible to rebuild completely lost ear (by trauma or congenital)?
A - Of course it could be done in multiple sessions with few months apart.

Q - What is the duration of the Otoplasty procedure?
A - Ranging from 1 to 2 hours.

Q - What is the type of anesthesia, and when I can return to normal life?
A - According to your age. Local anesthesia with or without sedation if adult or General anesthesia if child, and you can practice your normal life 2 hours after the finishing the procedure.

Q - What are the symptoms that may occur in the first five days after Otoplasty?
A - headache which could be managed by pain killer’s medications and there may be edema or swelling of the face.

Q - What are the guarantees that the success of the process?
A - There is no doubt that the followers of the medical instructions and close follow up visits are the main factors for the success of any surgical procedure. If not, the process to achieve the agreed outcomes before, the process repeats at reduced cost.

Q - When can we get the final results?
A - after the first three to six months.

Q - Is the reconstructed ear seems naturally?
A - Not completely natural appearance but like normal ear especially in functions as holding glasses and hearing aids.

Q - What is ideal age for Otoplasty?
A - Ear reconstruction should not be done before 6 year old. However, Otoplasty could be done at any age.

Q - If you are not Egyptian, What is the minimum period for follow up?
A - Five days.

Q - What is the non-surgical Ear reconstruction?
A - Prosthesis could be manufactured and hold in place by magnetic screws or glasses.

Q - What are the contraindications of Otoplasty?
A - There are no absolute contraindications but the patients should inform their surgeons about any allergies, serious medical conditions, and medications they may be taking.

Q - Where will the ear surgery be performed?
A - In hospital if general anesthesia is needed or in outpatient bases (clinic) if local anesthesia will be used.

Q - In my case, what technique is most appropriate in helping me achieve my cosmetic goal?
A - It depend on the your age and the present deformity.

Q - How much does ear surgery cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
A - Ranging from 1000 to 1500 U.S. Dollars. Medical insurance cover ear reconstruction but not Otoplasty procedures.

Q - What is the surgeon’s level of experience in performing ear surgery?
A - Consultant or Doctoral in Plastic surgery.

Q - What percentage of patients experience complications with ear surgery?
A - 5%

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Summary of Otoplasty:

The time of the procedure: from one to two hours.
Type of anesthesia: local anesthesia +/- sedation or General.
Location: hospital or clinic without postoperative hospital stay.
Expected Side effects: Temporary swelling, and pain, Some bleeding and rarely infection.
Recovery time: return to work after 2 hours and the final outcome within 3-6 months.
Cost: according to deformity, and age ranging from 1000 to 1500 U.S. dollars, or 5000 to 8,000 Egyptian pounds.
Results: a lifelong.

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