Konstantinos Th. Makripidis M.D.
ENT Surgeon – Facial Plastic Surgery
Member of the European Academy of Facial Plastic Surgery
D.O.H.N.S. Royal College of Surgeons
(Article in the newspaper “Greece Tomorrow”)
Ears: One of the dominant features of the face
The ears are located in a fairly conspicuous place and together with the eyes and the nose are the dominant features of our face. For the harmonious image of a person, the relationship of the size and shape of the ears with the rest of the face is extremely important. The goal of otoplasty is to improve the aesthetics of the ears, therefore their appearance. Any deformity in the appearance of the ears can negatively affect the way we see ourselves, but also the way others see us, ultimately negatively affecting our psychology.
The “protruding” ears
The protruding and large ears, or detached ears as they are scientifically called, are usually inherited. Statistically, 5% of children born worldwide are born with detached ears, regardless of race or geographic area. Released ears are found immediately after the birth of the child.
The protruding ears are the most common deformity of the ear fins. The appearance of the ears and whether they are in harmony with the rest of the face is related to the size and thickness of the cartilage, which is an element of the ear that is under the skin. Under normal conditions, this cartilage “folds”, with the result that the ear flap forms an angle of about 23 degrees with the temporal region of the skull and is practically 1.5 to 2 cm away from the back of the head. If the angle formed is larger and the flap is more than 1.5 – 2 cm from the back of the skull, then the ear is considered discarded.
But very clearly from person to person there can be large differences in how thrown an ear is and in which third – upper, middle or lower – the deformity occurs. Usually the three thirds that are far apart are the upper and middle, but in some cases only the upper part may be far away or all three are far from the back of the skull.
The main cause of drooping ears is the absence of the anther in the ear flap. Otoplasty aims to surgically create the anther, which is absent from birth. Through otoplasty, the ear gets its normal position and shape forever. The degree of difficulty of the left ear is directly related to how strong and hard the cartilage of the ear is. The size of the ears also plays an important role.
What other deformities of the ears can be corrected with otoplasty?
In some cases it is necessary to reduce the size of the ears, because the ears are quite large or their length appears too large in relation to the shape of the face. This can be achieved by “folding” the drooping ears, bringing them closer to the scalp, thus reducing the aesthetic perception of their size. But if objectively the size of the ears is too large, then the surgeon can reduce it by removing a piece of total thickness at the top of the ears and reducing the curve of the fin. This operation can be done in combination with the correction of the drooping ears.
Another deformity that can be corrected with otoplasty is the large size of the lower part of the ears, called the lobe. The surgeon can remove a piece of the lobe, leaving a thin line on the front and back of the new lobe.
Otoplasty Statistics: Who is the Right Candidate for Surgery?
It is important to note that four out of ten ear surgery surgeons are school-age children. Also, otoplasty is a very common plastic surgery in the male population.
The procedure of the operation:
The otoplasty procedure with the classical method can be performed with local anesthesia or intoxication, if the patient is an adult, while if he is a child it is performed under general anesthesia.
According to the classical method, the access to the cartilage correction is accessed from the back of the ear: the surgeon removes a small piece of skin from the back of the ear, thus obtaining the possibility of detachment of the cartilage back and front. After shrinking the cartilage with a laser or radio frequencies, it then carves it with the help of a laser. The goal is to “fold” the cartilage and create those folds that should be present at birth in a normal ear and are absent in this case. Then, in order to make sure that the result will be permanent, stitches may need to be placed in a special way.
The surgeon then makes all the necessary modifications to the back of the ear, and at the end the point is “closed” with special sutures. After the operation, a special bandage is placed around the patient’s head for 6 days. The operation takes about an hour, and in most cases the patient does not even need to be hospitalized. After the operation, the patient may feel for a while a slight numbness and a temporary pain, which, however, passes with the help of a simple painkiller. Generally, when the procedure is performed by an experienced surgeon, it is practically non-traumatic. The patient receives antibiotics for a few days, while he must visit his surgeon again three days after the operation. The person can return to work or school after 5 to 7 days, while participation in sports can take place in 6 to 8 weeks.
Alternatively, another scar-free technique may be used in some patients. This technique is usually performed under local anesthesia. According to this method, the surgeon folds the cartilage and the flap of the ear using special sutures, without creating scars in the ear. However, in order to apply this technique, it is necessary to have specific indications, with the main thing being that the cartilage is quite malleable.
It is desirable for the person to undergo otoplasty at the youngest possible age, in order to correct any deformity of the ears. Otoplasty when performed by an experienced facial plastic is a non-traumatic, painless and completely safe operation, with excellent and permanent results.