Otoplasty: plastic surgery corrects fanned ears
The term otoplasty refers to plastic surgery of the ears, and may correspond to several techniques that may or may not be associated, depending on the problem being treated. In general, the term is used to indicate the protrusion of prominent (flap) ears, but other problems such as trauma sequelae, congenital absence of ears and constricted ears are also treated with otoplasty techniques.
Correction of ears in flared, of prominent ears or simply plastic of ears.
Indications of otoplasty
Children can perform otoplasty from the age of six - foto: Getty Images
Ear corrections are performed to minimize deformities , try to correct asymmetries of shape, size and angulation in the case of the flap, in malformed ears from birth or that suffered deformities after a trauma. It should be considered as reparative, when it tries to correct a defect, and at the same time aesthetic, thinking of the search for harmony of form, volume and position.
It exists from the lightest to the most severe degree of fanned ears, but the surgical indication is based on the degree of discomfort that the patient presents. There are patients with minor changes and great discomfort. The degrees are based on the amount of anatomical changes present in the ear in question. "There are also cases of macrotia, where the person has ears that are over-sized, that is, very large ears," explains the plastic surgeon Maria Carolina Coutinho.
Minimum age is between six and seven years of age. "In this age group the ears have already been finished, so surgery will not interfere with this process," explains plastic surgeon Maria Carolina Coutinho. It also coincides with school-age literacy when the child begins to bother with prominent ears.
How surgery is performed
Otoplasty should be performed in a hospital by skilled professionals - photo: Getty Images
The most commonly used anesthesia is the place with sedation. The surgery begins with an incision behind the ear, following the natural fold of the skin. The excess of skin is then removed and then the cartilage is ligated to make it more flexible. In some cases cartilage removal may be done for ear reduction. Soon afterwards, anchoring points are made to maintain a new anatomy of the ear and to close the skin. In general, the points are internal and absorbable, therefore need not be removed. The surgery lasts an average of one hour.
Professional who can perform this surgery
The surgery must be performed by a plastic surgeon member of the Brazilian Society of Plastic Surgery.
"A good pre-operative consultation, besides preparing the patient for the surgery, should make him understand his problem, understand the proposed solution, risks and benefits of the procedure, and align the ideal expectation with the possibilities of treatment and that type of result can be achieved, "recommends the plastic surgeon Claudia Ranauro Zuliani, member of the Brazilian Society of Plastic Surgery.
Otoplasty, although a simple procedure, requires that all preoperative exams recommended. Among them are the blood test, which consists of a complete blood count and coagulogram, and the electrocardiogram.
The use of any other medicine to alter blood clotting, including acetylsalicylic acid (ASA) , gingko biloba, cascara sagrada and clopidogrel. The ideal is to maintain the use of medicines regularly, especially in patients with hypertension and diabetes.
Approximately eight hours fasting of solids and liquids.
The average length of hospital stay is eight to twelve hours.
Dressings are usually performed with healing ointment and gauze. It is performed at the end of surgery and removed after a period of 24 to 48 hours of surgery in the doctor's office. If there is a need for a new dressing, the patient (or his / her caregiver) will be advised how to do it. A specific compressive band should be used in the cases of fissure correction, taken only for the bath, but used 24 hours a day for one month.
Plastic surgery Claudia Zuliani explains that when the dressing is removed, the patient should leave the area of the scar clean and dry, washing carefully in the bath and drying carefully afterwards, as directed by the physician.
Painkillers are always prescribed, but usually there is no pain, there is only a feeling of discomfort . If there is major pain, the doctor should be advised to examine and orient.
"The orientation is to avoid actually scratching the operated region, because the swelling, the sensitivity of the skin is diminished, and a simple scratch can tear the skin, cause bleeding, or lead bacteria to healing skin, causing infection, "explains plastic surgeon Claudia Zuliani. "Knowing what can be harmful helps the patient to collaborate postoperatively, not traumatizing the operated ear, even for a short period of time."
Swelling and redness
It is normal for swelling and swelling to occur. redness. Over the course of days this aspect will improve until healing is complete.
Common analgesics are routinely prescribed for the postoperative period, and patients are advised to take if they have pain.
Return to normal activities and physical exercises
In children, depending on the type of correction in the ear and if there is more swelling, it is recommended to wait a week to return to school, to avoid the risk of trauma in the newly operated ears. In the simplest cases, one can return to class in three days. In adults, usually in two days. Physical activity should be light at the beginning, avoiding trauma at the operated site.
The use of glasses is released over the dressing, stuck with tape in the strip, as long as it does not overtighten the head . When removing the dressing, care should be taken with glasses tightened to the head, or behind the ear, which should be readjusted to the face. Some patients learn to attach the eyeglass rods above the ear-to-head insertion, using the same range they should use for 30 days.
Return to the doctor's office
The first return is in 24-48 hours, for removal of the dressing and medical evaluation, and then the next returns will be combined.
Scars and keloids
In scouring surgery, scars are hidden in the back of the ear, at the junction of the ear to the skull. There are cases that require incisions in the front of the ear, but it is sought to hide them in the natural folds of the skin. Scarring called a keloid scar, aesthetically unfavorable, may occur in some patients.
Contraindications to otoplasty
Ear infection contraindicates surgery, because the proximity to the site that will be operated causes a greater risk of infection in the or in the cartilage of the ear, which can seriously compromise the final result and, in more severe cases of condrich (cartilage infection), new deformities of difficult correction may occur.
Infections in other places are also contraindicated. indications for the procedure, such as more severe flu, urinary tract infections, tonsillitis. The presence of poorly controlled baseline diseases, such as hypertension and diabetes, are contraindications to any plastic procedure, and these diseases should be controlled prior to otoplasty.Smoking is a relative contraindication, the patient is advised to stop smoking for two weeks before and 30 days after surgery, due to the risk of affecting healing.
In order to perform any plastic surgery it is necessary that the patient is
There are inherent risks to any surgery or anesthesia, minimized with a good pre-operative preparation. , and doing the surgery with a specialist in plastic surgery and in place with adequate resources. There may be bleeding, bruising, pain, swelling than expected, infection, or even an asymmetry, especially in the ears of adults, who have the hardest cartilage, tending to lose the angle of correction and return to the waddle. These situations can be avoided in the majority of cases, but if they happen, they can be corrected by a specialist who can analyze each one and explain the treatment to the patient.
Six months after surgery, the result "When the bandage is removed, about 60% of the final result can be observed, since there is redness and swelling considered normal for the immediate postoperative period," explains plastic surgeon Claudia Zuliani. In the fixation of the flap, the position of the ears is corrected immediately and the difference with the preoperative one after the surgery is perceptible. In 15 days it will be much more disinfected, and it will fade up to six months, when the result will be the definitive one.
The plastic surgeon Claudia Zuliani explains that the results of surgeries are not mathematical, because the healing depends on each patient. "Adequate surgical indication, precise operative technique, and good postoperative care will greatly reduce the chance of complications," he explains. "Remember also that we are not absolutely symmetrical beings, but that we try to harmonize the differences of the ears improving the facial contour". There are cases of exceptions that require a new surgical procedure to symmetry more ears, and in cases of reconstruction, as many surgeries as necessary.
Cost of surgery
The price of surgery is composed of a hospital package (hospitalization and stay in the hospital). hospital bed or apartment while in the hospital or clinic, rent of the operating room and the materials normally used for that surgery) and the price of the team (medical fees of the surgeon, the attending physician, the anesthesiologist, and the instrumentator). It is worth remembering that pre-operative exams are always necessary, the costs of which are separate.
Check before consultation
The doctor that you will consult must be registered with the Federal Council of Medicine (CFM), it is possible to do this check on the website of the institution
-The professional must be a member of the Brazilian Society of Plastic Surgery. Other institutions do not evaluate the training and experience of the professional of this area
- -The surgery must be done in a hospital that has credit for performing medium-sized surgeries. Contact the hospital to check
- - Talk to someone who has had surgery with the same doctor and find out about the procedure and the results.
- Plastic Surgeon Claudia Ranauro Zuliani (CRM /
- Plastic surgeon Maria Carolina Coutinho (CRM / SP: 113491), member of the Brazilian Society of Plastic Surgery
- , member of the Brazilian Society of Plastic Surgery.
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