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Blog / Ear Surgery / Ear Surgery & Its Many Forms...

Ear Surgery & Its Many Forms

January 7th, 2016 Share

Have you heard of ear rejuvenation?

Pun intended.

Ear surgery, or otoplasty, refers to all types of aesthetic plastic surgery for the ears, popular for patients of many ages in Toronto.

Most people are familiar with the “pinning” technique for large and outstanding ears. I learned my skills in ear pinning from the great pediatric plastic surgeon Dr. Hugh Thompson — fondly called Dr. T — at the Hospital for Sick Children in Toronto. Dr. T. was also a wood carver and sculptor and very astute. The technique I have been using for more than 14 years has been very effective with stable results.

Most commonly performed using general anesthesia, otoplasty can also be done using local anesthesia, with or without intravenous sedation. My incision is always behind the ears, and I then create a passage to the front with a small incision in the ear cartilage. With this now anterior approach, I score the cartilage to weaken it and to allow it to rotate posteriorly (similar to scoring wood to curve it). I secure this rotation (i.e. pinning) with permanent sutures from the ear cartilage to a strong fascia behind the ear. I can also supplement this with cartilage-to-cartilage permanent sutures. I excise skin in the back, too, as needed. Finally, I apply a special bolster-type dressing that also maintains the rotation during the first phase of healing. This technique does require finesse, artistry, and time to perform, but recurrences of any problems are almost zero, and my patients are very happy with the stable results.

That being said, otoplasty encompasses many other ear conditions, as well, all being common requests in my Toronto office.

  • Lobe repairs: Common requests include repair of elongated ear piercings, repair of complete tears in the earlobes (called “clefting”), and repair of gauged — or stretched — earlobes, a popular practice now with teenagers and young adults. All these procedures and repairs are performed using local anesthesia with no downtime. Fine stitches are used and removed one week later. Patients can return to work immediately, and pain is nil or very minimal.
  • Keloid removal: Keloid scar removal is also common. A keloid is a genetically determined overproduction of collagen, and the earlobes are common areas for keloids to occur after piercing. Excision can be challenging, and recurrence is very possible, hence the requirement of post-surgery steroid injections and silicone pressure dressing.
  • Darwin’s tubercle removal: Darwin’s tubercle is a thickening of the ear cartilage (the helix part) and is quite common, likely a vestige of our mammal development. This excess cartilage can also be repaired relatively easily using local anesthesia.
  • Shape issues: Other contour deformities of the ear cartilage can often be augmented with fillers such as Restylane® and JUVÉDERM®. This also applies to aging and atrophic earlobes. It is so common to have women come to my office with earrings and beautiful diamonds, but we can’t see them because the earlobe is so weak and the stone “looks down.” Here I come with JUVÉDERM, and I restore the perkiness of the lobe — and voilà! The stone can brightly shine again!
  • With a facelift: Finally, it is common in my facelift procedures to rejuvenate the earlobe by excising the atrophic areas and excess lobe tissue and reposition the new lobe prior to the facelift closure. As with aging hands, non-repaired aging earlobes with a fresh, taut face is a telltale sign of a facelift procedure! Always best to “renovate” all at once!

If you’re interested in any kind of ear surgery, contact my practice to learn what techniques may be right for you.