Prominent ears, sometimes called “bat ears”, are congenital malformations that affect up to 5% of the population and, in most cases, have a genetic origin. It can be unilateral or bilateral and is not associated with any hearing impairment. As a general rule, it manifests itself until the 3rd month after birth and, if is not treated, will remain throughout life. The affected ears form an above average angle to the head, appearing too far apart. In addition, the upper part of the ears looks flat, not showing the normally observed fold – the antihelix.
OTOPLASTY
Otoplasty is a surgical procedure that aims to correct deformities and improve the appearance of the ears. The most common reason why people seek otoplasty is to treat prominent ears. When not treated, this characteristic can cause psychological trauma and can affect the patient’s personality and self-esteem. To avoid bullying and the emotional impact these children are subjected to, many parents choose to have the surgery as soon as possible.
The first step in achieving your otoplasty is to share your complaints and expectations about the surgery with the medical team;
2. Treatment plan
According to the characteristics of the ears and desired results, a personalized treatment plan will be devised to improve the appearance of your prominent ears;
3. Detailed explanation
During the otoplasty medical appointment, you will understand what the surgery consists in, the associated risks and the pre and postoperative care;
4. Quote
After the medical diagnosis, you will be presented with an exact price for your otoplasty according to the surgical plan that was drawn up. If you wish, you can immediately schedule a date for your surgery.
All surgical procedures involve scarring. However, the scars of otoplasty are hidden behind the ear (in the crease between the ear and the scalp), and are hardly visible. Over time, they become thinner and more discreet.
OTOPLASTY
RESULTS
After removing the headband, you will notice an immediate change in your appearance, observing that your ears are closer to the head, more symmetrical and proportional. However, due to the swelling, it may take up to 3 months (approximately) to see the surgery’s end result.
Otoplasty is usually performed in an operating room with local anesthesia and sedation in children, or only local anesthesia in adults. The decision regarding the type of anesthesia is made by the anesthesiologist and depends on several factors, namely the patient’s clinical history. Regardless of the type of anesthesia used in otoplasty, the patient will not experience any pain or discomfort during the procedure. Once the surgery is finished, the patient will be awakened by the anesthesiologist (in case of sedation), and will be transported to a recovery room, where she/he will remain for a few hours, before being discharged on the same day.
.
STEP-BY-STEP OTOPLASTY
1
MARKING THE PATIENT
The patient's ears are marked before administering anesthesia;
2
ANESTHESIA
Anesthesia options include sedation with local anesthesia or local anesthesia only. In case of sedation, it is administered intravenously by the anesthesiologist, before the local anesthetic;
3
DISINFECTION
The entire area to be treated is cleansed and disinfected to prevent infection. Operative fields are placed to isolate the ears from the external environment;
4
INCISIONS
The otoplasty incisions are usually made behind the ear in the crease between the ear and the scalp;
5
CARTILAGE RESHAPING
Restructuring the cartilage enables a lower angle between the head and the ear, with the ears ceasing to project outwards;
6
INCISIONS CLOSING
The otoplasty incisions are usually closed with sutures that are removed 7 to 10 days later;
7
POST-ANESTHESIA CARE
The patient is awakened by the anesthesiologist (in case of sedation) and is then transported to the recovery room with the headband, remaining under observation before being discharged, which usually happens in the same day.
Do not take aspirin, anti-inflammatories, or anticoagulant medication in the two weeks prior to the otoplasty. You must inform the medical team of any medication you are on and any medical condition you suffer from;
Do not smoke the month before surgery and during the healing process. Tobacco compromises tissue oxygenation, negatively affecting healing;
If you get a cold or feel ill in any way in the days prior to the surgery, the medical team should immediately be informed.
Carefully read all the documentation provided to you, as it is important that you haveyou’re your doubts clarified by the day of the surgery;
Organize your routines in advance so you can rest and recover peacefully;
Do you still have questions regarding your otoplasty, preparation or postoperative? Do not wait for the day of surgery and ask all your questions beforehand.
Surgery Day
On the day before surgery, you should have light meals only, in order to avoid indigestion. You must be fasting for 8 hours before the surgery - do not eat or drink any liquids including water.
Shower with the prescribed antiseptic shower gel the day before and the day of surgery.
Do not wear jewelry or a watch, do not wear makeup or nail varnish.
Do not wear contact lenses;
Bring comfortable clothes to wear when you are discharged - preferably with buttons or a zip.
After discharge, you can neither drive nor go home unaccompanied. If you have no one to take you home, you must inform us in advance.
Recovery and postoperative care
Rest and avoid any type of effort in the first 8 days;
You should always be accompanied during the initial 48 hours, as you might need assistance;
Use the postoperative headband 24 hours/day for 1 to 2 weeks, and then use it while sleeping for another 2 to 4 weeks;
Sleep with your head in an elevated position (at least two pillows) during the first week;
Do not lie down all the time - it is important to walk around to promote circulation;
Take the prescribed medication;
Avoid direct sun exposure and use sunscreen;
Put ice on the area around the ears, but be careful not to let it burn your skin;
Do not smoke;
Drink plenty of water and follow a balanced diet;
Do not perform any physical activity for 4 weeks
You can go back to work 1 to 2 weeks after the procedure;
Attend all follow-up appointments.
BENEFITS OF "TRADITIONAL" OTOPLASTY
Improves confidence and self-esteem
Many people with prominent ears suffer from low self-esteem and young children are often bullied by peers. Otoplasty can improve the confidence of these people, preventing future trauma.
Renovates the feeling of “being normal”
Muitos pacientes referem uma sensação de libertação emocional, juntamente com uma sensação de “regresso à normalidade”. No caso das senhoras, referem pequenas mudanças que fazem a diferença como: apanhar o cabelo, fazer penteados, deixar de tapar as orelhas com o cabelo ou com chapéus, etc.
Otoplasty is a safe surgery
Otoplasty is a quick surgery with a relatively low degree of complexity. It is often performed under local anesthesia and is characterized by a quick and smooth recovery.
PORTUGUESE MEDICAL ASSOCIATION, Nr. 47051. Specializing in Reconstructive and Aesthetic Plastic Surgery and Subspecialist in Aesthetic and Cosmetic Medicine.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
PhD in Medicine from the University of Münster in Germany.
After completing her specialty, she became a Senior Graduate Assistant (Oberärztin) at the Fachklinik Hornheide and the University of Münster. She is currently involved in various research projects at the University of Münster, where she is supervising doctoral students. She is also a regular correspondent for scientific and leisure magazines in Germany.
Portuguese Medical Association – registration number 51027, specialising in Otorhinolaryngology.
With a Master’s degree in Medicine from the Faculty of Medicine in Lisbon, Dr. Catarina went on to specialise in Otorhinolaryngology at the Santa Maria Hospital in Lisbon, having joined the teaching staff of the Otorhinolaryngology chair as a free assistant. Her training in otorhinolaryngology had a strong component in head and neck surgery, but also in rhinology, otology and paediatric laryngology.
Any surgery has associated risks and an otoplasty is no exception. However, otoplasty is a surgery with a relatively low degree of complexity, with a very low risk of complications and with a very high level of satisfaction. For it to be performed safely however, it is essential to choose a reconstructive and aesthetic plastic surgeon enrolled with the Portuguese Medical Association and with several years of experience with otoplasty and facial surgery.
HOW MUCH DOES AN OTOPLASTY COST IN LISBON?
The price of an otoplasty depends on the complexity of the problem to be treated, whether it is a unilateral or bilateral otoplasty, and whether it is performed with sedation and local anesthesia or only with local anesthesia. The exact price will be shared with you during your medical appointment, after the diagnosis.
WHAT TYPE OF ANESTHESIA IS THE USED?
Otoplasty is usually performed under local anesthesia. Sedation is usually given to children or patients who are uncomfortable being awake during surgery.
WHAT IS THE IDEAL AGE TO PERFORM AN OTOPLASTY?
This surgery can be performed once the ears are fully developed, usually after the age of 6-7. Also, cartilage is softer and more malleable at a young age, which enables an easier reshaping.
CAN OTOPLASTY BE PERFORMED ONLY ON ONE EAR?
Yes. If the ears are asymmetrical and only one is prominent, it is possible to perform a bilateral otoplasty. However, it is advisable to carry the procedure on both ears for a more symmetrical, proportional and harmonious result.
DOES OTOPLASTY DECREASE THE EARS SIZE?
The normal size of the ears is about 6 to 6.5 cm. Macrotia is a congenital malformation characterized by excessively large ears (above the size considered normal), which can have a great impact on one’s confidence and self-esteem. Reducing the size of the ears implies surgical techniques different from those used to correct prominent ears. To decrease the size of the ears, it is necessary to eliminate cartilage and excess skin at the top, bottom or both, in order to achieve a smaller and proportional size.
HOW LONG DOES RECOVERY TAKE?
The recovery time for an otoplasty is relatively short, and you can return to work 1 to 2 weeks after the procedure.It is recommended that children undergo otoplasty during school holidays. You should use the postoperative headband 24h/day for 1 to 2 weeks, and then use it while sleeping for another 2 to 4 weeks;
WHAT IS THE BEST TIME TO PERFORM AN OTOPLASTY?
Otoplasty can be performed at any time of the year, both in winter and in summer. What matters the most is to schedule it for when you can recover peacefully. It is important to bear in mind that you cannot get direct sun exposure for a month. As for children, the best time to perform the surgery is during school holidays.
WILL SCARS DISAPPEAR?
The scars of otoplasty are hidden in the back of the ears, hence not noticeable. Although all scars are permanent, over time, they become thin, discreet and practically imperceptible. During the first three months, they will be redder and more sensitive. By the end of this period, the scar will improve its appearance, and the end result is expected 12 to 18 months after the surgery.
IS THE RESULT DEFINITIVE OR CAN THE EARS GO BACK TO HOW THEY WERE BEFORE?
Surgery should only be performed after the age of 6-7, when the ears are fully developed. The results of otoplasty are permanent. Recurrence is possible, but it is a rare complication. If necessary, a follow-up surgery is performed, usually a minor one, under local anesthesia.
WHAT ARE THE RISKS OF SURGERY AND ANESTHESIA?
As with any surgical intervention, otoplasty is not without risks and complications. The most common are:
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