Prominent Ear Correction: Who Would Benefit and The Next Techniques

Hello! My name's Adrian Richards, I'm a consultant plastic and cosmetic surgeon. Today I am going to be talking about prominent ear correction which is also known by a number of other terms like Pinnaplasty, Otoplasty, prominent ear setting back, so it's got a lot of names but I am going to call it prominent ear correction. So who would benefit from surgery? Well, essentially someone who has got slightly sticky out ears. Normally the ears are in a vertical diameter, at the normal vertical height. The problem is that the fold here hasn't really formed normally and this is called the anti-helical fold. So the helix is the rim of the ear, the anti-helix is the fold here, and normally that just really hasn't formed and the ear comes outwards. It can be outwards in the upper portion, like that, or it can be outwards the whole way along, so it just really depends where the fold is not properly formed. If you have other abnormalities of the ear, and these are quite common, you can have extra ear buds in front of your ear here, the ear could, rather than just be prominent, could have unusual cartilages, unusual sort of ripples in it. You can get abnormalities with the ear lobe, the ear can be small, or in fact stuck to the head and doesn't separate normally from the head and you would probably need to see a plastic surgeon really just to discuss those particular issues. Today I am really going to concentrate on the most common abnormality, which is prominence. So prominent ears, if you do have them and you do have children it's important to know that they can be corrected early at birth. So if you can get them at birth and get a little splint called an ear buddy which you place inside the ear, that can hold the cartilage back and while it is still very sort of malleable and flexible, the ear cartilage can be held back and that holds it, that helps reform the fold and most people won't need surgery later in life. So prominent ears do tend to run in families so if you are having children so consider that option. So if you have got prominent ears what can you do about it? Well the normal age to correct them is normally about five, so that's normally just before children go to secondary school when they are likely to be teased and concerned about it. So five is a good age to do it, and then any time throughout the teenage years is fine. Normally we do like to wait until the child actually decides that they would like to have the ears corrected because it is much easier to perform surgery if the child has sort of buy-in and actually sort of volunteers for the operation, but prominent ears can be corrected at any time. The oldest patient I have treated is 70, a gentleman who decided to have his prominent ears treated late in life. So they can be treated any time and basically the technique is very similar All techniques have some similarities and some differences. The incision to access the cartilage is nearly always from behind, so the ear is basically a cartilage sandwich, so its cartilage which is gristle, it's just like normal white gristle, a sheet of it, and on either side there is skin. So it's the cartilage that is the problem, it's not the skin. So just by removing and tightening the skin at the back won't cure the problem. The normal technique is a scar in the back, operation will be formed under general anaesthetic, or twilight, or local anaesthetic. So it's really your decision as to which of those you would prefer and the incision is made in the back of the ear, not much skin is removed because as I said before, it's not the skin that's causing the problem. And then normally stitches are used to recreate the fold. So the ear is stitched backwards to create the fold and sometimes it's actually set back slightly against the skull. So these are different suture techniques which you can discuss with your plastic surgeon. Each surgeon does them slightly differently, but generally you use permanent stitches which sort of become incorporated in the ear. That's the technique I prefer which is really all done from the back. There are older techniques, which actually divide the cartilage, so although the incision is in the back, the gristle is divided and then the cartilage is scored so the surgeon makes marks on the front to weaken the front of the cartilage. We tend to move away a little bit from those techniques because they can create a slightly unnatural looking ear. Although the ear is back it doesn't look absolutely normal and also the risk of complications is much higher with the scoring techniques because the cartilage is being divided and there's a potential space for blood to collect in the front of the ear which can give sort of cauliflower ears, like the rugby players get. So there's been a real trend now to using a technique just really from the back with permanent stitches used to hold the ear backwards. I'm going to talk in another video, a little bit about recovery, bandages and those sort of issues for prominent ear correction. I hope this video has been informative. If you would like any more information about prominent ear correction or would like to arrange a complimentary consultation with one of our surgeons who specialize particularly in ears, please do so by either ringing us on 01844 214362 or email us at the website which is, aurora-clinics.co.uk Thanks for taking the time to watch the video and we look forward to seeing you soon!