There’s a lot to know about reconstructive ear surgery or ear reconstruction, whether a functional or cosmetic facial procedure. Please take the time to review the information below to learn about your ear reconstruction procedure by Dr. Randolph C. Robinson in Denver, CO:
The external ear has a functional purpose of helping to channel sound into the ear canal in order to facilitate directional hearing. The top of the ear, known as the helix, should be at about the level of the eyebrows, and the ear lobule, or ear lobe, should be located approximately 1 to 1-1/2 inches above the angle of the jaw. The small projection in front of the ear canal toward the anterior aspect of the ear is called the tragus.
Surgery on the external ear is indicated for patients who have over-protruding ears or ears that are too large. Surgery can also be used to repair torn earlobes from traumatic injuries caused by earrings pulling through the pierced area.
It is also possible to completely reconstruct the external ear using a framework carved from rib cartilage. This total ear reconstruction of the outer ear does not provide for correction of deafness, but can be done in conjunction with other surgeries to help that problem. It was developed by Dr. Burt Brent in California and refined by Dr. Francoise Firmin in Paris. Dr. Firmin then trained Dr. Robinson in this technique during his craniofacial fellowship training there. Another procedure can reconstruct the ear using implants placed in the skull so that a prosthetic (artificial) ear can be attached.
Some ear surgery procedures may be considered an elective cosmetic procedure. Therefore, they are not covered by insurance. But in some cases, reconstructive procedures are covered by insurance. Please contact your provider for coverage details. In the meantime, learn your options for ear reconstruction by scheduling an appointment at Robinson Cosmetic Surgery:
The Ear Reconstruction Procedure
The surgery to correct over-protruding ears or torn earlobes is fairly simple with minimal scarring. To tuck the ears closer to the head, an incision is made behind the ear, the cartilage framework is scored with a scalpel, and then a suture is tied to increase the curvature and bring the ear closer to the head. To repair a torn earlobe, the torn tract is removed, and the earlobe is sewn together. The ear may be re-pierced in six weeks.
The total ear reconstruction is performed by first removing any remnant or rudimentary cartilage that is present, and then a skin pouch is developed in which a carved framework is placed. The framework is made by harvesting two ribs from the opposite side of the chest from the ear that is to be reconstructed. The framework is carved to match the size and shape of the natural ear.
Once the framework is placed, the skin is suctioned down during the healing phase, much like plastic is suctioned down over a mold, conforming to the shape. Then, second stage skin grafting and creation of the tragus is performed three months later.
In the case of a total ear reconstruction using a prosthesis, two to four implants are placed in the temporal bone, around the ear canal. After these implants have locked themselves into the bone, usually requiring four months, a framework is fashioned connecting the implants together. This metal framework then serves as a support for a prosthetic ear. The coloration and shape can be made to look very natural and a hearing aid can be added.
The recovery period for repairing earlobes is very minimal, with some minor swelling, and usually a bandage is not required. The stitches are removed in one week. When the ear is tucked closer to the head, a bandage is placed for the first 24 to 48 hours to support the ear and reduce the amount of swelling. The stitches behind the ear are removed in seven to ten days. Some minor bruising may be present for seven to fourteen days.
The recovery following total ear reconstruction using cartilage from the ribs is more prolonged. This delay is usually due not to the surgical site where the ear is placed, but to the incision located in the chest. Patients will typically have some discomfort associated with taking a deep breath for one to two weeks; however, taking deep breaths is important following the surgery in order to make sure that the lungs stay expanded to normal capacity.
A bandage is placed around the head in order to support the totally reconstructed ear for approximately five days. Suction drains come out of the skin behind the newly-reconstructed ear to create the definition in the skin over the framework. These drains are removed on the third day following surgery.
The stitches around the reconstructed ear are removed on the seventh day, and the stitches in the chest are removed in the second week following surgery. During the recovery phase of a total ear reconstruction, a moderate amount of swelling persists for up to twelve months; but 80% of the swelling will dissipate by the third week.
The recovery following the placement of implants in order to provide for the framework of a prosthetic ear is fairly straightforward. The stitches are removed in seven days, and a moderate amount of swelling and some bruising will occur in the area, but pain is typically minimal. Usually, the implants are completely buried under the skin after four months and are then uncovered and exposed so that the framework can be made, and the ear fabricated.
Nausea is not uncommon after surgery. It is sometimes caused by the anesthetics and strong pain relief medicines. It may be alleviated by eating a small amount of food (e.g. soda crackers or foods that you can see through; initially avoid dairy products) before each pill. On the first post-operative day, if you don’t feel like eating, don’t force yourself to eat. Take the pain pill with repeated sips of clear liquids that you can tolerate, e.g. ‘flat’ 7-Up, ginger ale, water, apple juice, etc. If you have persistent nausea problems, call our office.
The most common complication associated with any incision is scarring. Collections of blood or fluid under the skin may form along with residual deformities.
Total ear reconstruction has the complications of: displacement of the framework, lack of good definition, skin loss over the framework, and problems related with harvesting the rib, such as a collapsed lung or fluid collecting around the lungs.
Complications for the implants themselves involve: loss of the implant, brain damage, infection, and scarring.
- Arrange for someone to take you home and stay with your – attentive to your needs – after the operation for the first 48 hours if you are having any anesthesia.
- Do not eat or drink anything after midnight the night before the operation (or as your anesthesiologist instructs). If you are prone to be nauseated, consult with your surgeon about medications you can take before surgery.
- Wash your face and shampoo your hair the morning of surgery, but do not apply makeup to your face.
- Wear comfortable clothes that are loose and easy to put on. Leave valuables at home.
- Take medications with only a sip of water as directed by your surgeon.
- Take no aspirin, ibuprofen, blood-thinning medications, or vitamin E two weeks before surgery, unless otherwise directed by your surgeon.
- Keep head elevated for two weeks.
- Keep the pressure bandage on for three days.
- If a rib graft has been taken, cough and deep breathe, as instructed, four times a day.
- No strenuous activity for four weeks. No lifting greater than 10 pounds for four weeks.
- Eat a balanced diet as you desire but you may want to eat only lightly the first day after surgery.
- Take one multiple vitamin with iron (on a full stomach) and 1,000 mg of vitamin C, in four 250 mg doses, daily for six weeks following surgery.
- Take anti-nausea medication, as prescribed, if nausea occurs.
- Keep incisions clean with hydrogen peroxide three times daily, then apply an antibiotic ointment to the incision after each cleaning.
- You may wash your face the day after surgery and your ear(s) when the bandage comes off, but do not allow the water to hit your ear(s) directly for one week.
- Avoid sun exposure for one month as this will cause pigmentation changes.
- Call if:
- pain is not relieved with medications
- bleeding continues to saturate the cotton or gauze pads
- swelling is asymmetric (uneven) or sudden over 1-2 hours
- nausea or vomiting persists, despite taking anti-nausea medication
- temperature is greater than 101.0° F by mouth
- you experience sudden or increasing difficulty breathing
- Take medications as directed.
Talk to a Highly Experienced Surgeon About Your Reconstructive Ear Surgery Today
If you have questions about an reconstructive ear procedure, please contact the Robinson Cosmetic Surgery. We’ll schedule an appointment with Dr. Randy Robinson so you can get answers to every questions you might have.