Ears (Otoplasty)

Ear reconstruction surgery…

is a more complex procedure usually performed in a pediatric hospital setting under general anesthesia. Ear reconstruction surgery is usually performed on individuals that are born without all or part of an external ear (known as microtia) or who are missing all or part of their external ears due to an injury. The term microtia indicates a small, abnormally shaped or absent external ear. It can occur on one side only (called "unilateral") or on both sides (called "bilateral"). The unilateral form is much more common, occurring in approximately 90% of people who seek out this kind of plastic surgery.

When it comes to reconstructive outer ear surgery, each case is unique. This is because there is no one type of ear deformity. Individuals who suffer from microtia may be born with no outer ear, part of an ear or an ear that is disfigured. Luckily, this cosmetic ear surgery can restore confidence and normalcy for these youngsters who were born with this type of congenital ear defect.

Ear reconstruction surgery is not to be confused with the ear pin back. A surgical pin-back of the ears is a simple operation that pins ears that stick out to the side of the head. True ear reconstruction surgery is much more elaborate and involves quite a bit of sculpting and grafting on the part of the plastic surgeon to create a new ear. The intention of almost all re-constructive ear surgery is to recreate the cartilage of the upper ear.

Plastic surgeons have been trying to find a way to completely duplicate the human ear for years. As microtia usually only affects one ear, a common tact is for the plastic surgeon to make a mold of the existing perfect ear and try to duplicate it.

The ultimate challenge for the plastic surgeon is to create a natural looking ear. Replacements for the ear's special cartilage and skin must be located on other parts of the patient’s body before surgery can begin. Preferably the cartilage and skin that they find from other places on the body must be soft, flexible and without hair. Often the cartilage is removed from the patient’s lower floating ribs beneath the rib cage and the skin is often removed from the inner thigh or groin area. Outer ear reconstruction is a delicate procedure.

It is also important to note that the more of the existing ear that the plastic surgeon has to work with, the more likely there are to be good results. It is important for parents or patients to be realistic in their expectations of what the final result may look like. If there is not much existing tissue to work with the plastic surgeon may only be able to approximate the appearance of an outer ear and not truly duplicate it. There are some key challenges to overcome when approaching any ear reconstruction. It can involve many detailed consultations, planning and deft surgical work.

The surgery itself generally only takes a few hours, with more complicated reconstructions taking more time. Depending on how much of the ear needs reconstruction, the patient may require a series of operations spaced out over a one or two year period. The healing process can quite long.