The repair of prominent ears or otoplasty is one of the most frequently performed procedures in any cosmetic surgery clinic. The popularity is almost similar to other aesthetic surgery procedures such as liposuction, abdominoplasty, facelift, breast augmentation or rhinoplasty.
This procedure is equally popular in both male and female population, and the main age group of my clients requesting for this procedure is between 20 to 35 years old.
This is different from the demographic of patients coming for ear reconstruction in cases of under-developed (Microtia) or Absent (Anotia) Ears. For this type of procedure, the age group is usually younger, between 5 to 20 years old.
Anatomy of Protruding Ears
To understand how this procedure is performed, first we need to relook into the anatomy of the ear itself and what changes that happened causing the appearance of a prominent ear. Our ears, consist of structures known as the helix or the outer ear fold (refer to the diagram below). This is the outermost portion of the ear that gives it shape. Inside, we have the inner ear folds known as the antihelix and in between these 2 structures we have the conchas or the ear bowl.Behind these structures, at the portion where our ear is attach to the head, this is where the mastoid bone is located, and this area is referred to as the mastoid area. This particular area is worth mentioning as I will explained later the different suture-placement technique of otoplasty that involve the different areas, and this is one of them.
The appearance of a protruding ear is due to the changes in the proportion of these structures to one another. For example, when one may has a prominent helical rim, but a relatively small antihelix or another example is when the concha bowl is too shallow. These changes will give the illusion of a protruding ear.
Surgical Repair Techniques
The repair technique of this condition is referred to as Otoplasty. There are 2 types of otoplasty, known as Open Otoplasty and Closed Otoplasty respectively.
In Open Otoplasty, a surgical incision is done at the posterior portion of the ear, and the cartillages forming the helix, antihelix and concha are exposed. Subsequently, sutures will be placed to reshape these structures to reduce the appearance of a protruding ear.
The suture placement can be between the Helix to Antihelix or AntiHelic to Concha or Concha to the Mastoid area. I will determine which type of suturing step to use based on my pre-operative and intra-operative assessment of the deformity.
Otoplasty is one of my favourite Plastic Surgery procedures to do, as it involves a lot of artistic workmanship as does the surgeon’s skills to get the most beautiful outcome possible.
On the other hand, in Closed Otoplasty, no surgical incision will made on the ear, but rather the sutures are placed percutaneously to reshape the cartillages. Both techniques can be performed either under local anaesthesia or general anaesthesia. The average surgical time to complete this surgery is approximately 30 minutes for each ear.
Some surgeons will also do scoring of the cartillages on the opposite surface to weaken them in order to reduce the incidence of recurrence a few months after surgery. This follows the Gibson Principle which states that all cartillages have memories, meaning that they will return to their opposite shape after being moulded to the opposite side.
Therefore, the act of scoring will reduce this tendency and make the newly-shaped ear remains that way forever.
What are the risk of this procedure?
The surgical risk of this procedure is similar to other cosmetic plastic surgery procedures such as infection, hematoma and recurrence of the deformity. However, by getting this treatment done at a reputable centre by a trained Plastic Surgeon, these risks can be minimized while obtaining your desirable results.