The Different Causes of Prominent Ears and the Different Options of Ear Pinning Surgery

Описание: A 23-year-old lady explains that her ears stick out. She wants to know the procedures that would best correct how her ears look.

Dr. Amiya Prasad is a board certified cosmetic surgeon and has been practicing in Manhattan and Long Island for over 20 years. He has encountered a lot of prominent ears of different types in his practice. He does a proper analysis in order to reach an appropriate procedure for the patient. When he looks at an ear, there are few key elements if the main concern is prominent ears. First, there may be under development or lack of development of the antihelical fold. Second, there may be conchal hypertrophy or prominent concha. And lastly, there might be a protuberant or a more outwardly pointed earlobe. In general, he has to anatomically identify 1, 2 or all 3 of these elements.

The surgery for prominent ears is called otoplasty from the greek word “oto” meaning ear and “plasty” meaning to change. This is surgery is done in a predictable and consistent way. In Dr. Prasad’s practice, if all the 3 elements are present, he’ll do a surgical otoplasty involving procedures behind the ear and inside the crease of the ear. Behind the ear, he tries to recreate the fold. If there is too much of this conchal bulge, he resects part of that and brings the conchal bulge against the mastoid fascia, and also brings in the prominent earlobe. This is somewhat in contrast to other procedures like a setback or pulling of the ear. The important thing is identifying the anatomic issues. Every surgeon who does this has their preferred technique.

In adults, Dr. Prasad has the luxury of doing this with a little cooperation. In this type of procedure, he routinely does this under local anesthesia with LITE™ IV sedation. One of the many challenges is that he has to create a nice-looking ear which is symmetric with the other side. The elements of the ear have to look good. Unfortunately, when a person heals, there may be some asymmetry. Sometimes, the surgeon has to go back and do enhancements. In his practice, he explains that if a stitch breaks or an earlobe is still a little prominent, he can always enhance those areas. For most people who are older than teenagers, this is the way he does this surgery.

With Dr. Prasad’s personal office-based surgical facilities that are certified by the Joint Commission, he always feels that patients feel more comfortable when they do procedures in an office setting versus a hospital or surgery center. Patients get more attention in a private office setting. Dr. Prasad also prefers local anesthesia with LITE™ sedation because this is the type of surgery where they don’t need general anesthesia. However, children are an exception because they cannot cooperate, therefore a general anesthesia is appropriate.

Dr. Prasad suggests that she meet qualified, experienced cosmetic surgeons to get a proper physical examination. When he looked at this lady’s photos, her antihelical folds look pretty good and it was a little bit difficult to tell whether the ears were prominent from the center part of the ear. What he does is he looks at how the ears are relative to the patient’s face. There’s a certain measurement of the ear from the bone which makes it look very good. However, procedures are customized for every patient. Once a physical exam is done, she must understand the risks and benefits of doing this surgery. This information should help guide her as she does her research in understanding where her ear fits in this scheme.

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