EAR SURGERY

Mr Sabbagh is one of the UK leading surgeons in reconstructive surgery of the ear. He provides a national service in the NHS at the Royal Free Hospital.

Ear Reconstruction is considered one of the most complex operations in Plastic Surgery. It is performed for patients born with an underdeveloped ear ( Microtia ) or those who have lost a normal ear through trauma.

The reconstruction process is in two stages, about 6-12 months apart. The first stage involves creating a skin pocket at the site of the ear by re-orientating the available tissue and thinning the skin to mimic the ear skin. Rib cartilage is then harvested and carved to produce a very detailed ear framework. The framework is inserted in the pocket and gentle suction is applied to enable the skin to adhere to framework. This operation takes 4-6 hours and the expected length of stay in hospital is 5-7 days.

The second stage involves releasing the ear from the head and inserting a piece of cartilage behind it to maintain projection. This takes 3-4 hours and the expected hospital stay is 2-3 days.

For more information, please visit Mr Sabbagh’s dedicated ear reconstruction website at:
www.ear-reconstruction.com

FAQ

PROMINENT EAR

How is the operation performed

Surgery is performed from behind the ear. A small ellipse of skin is removed to gain access to the ear cartilage. The fold of the cartilage visible on the front of the ear (antihelix) is recreated with several non-dissolving sutures. In some ears the conchal bowl (the deep concavity of the ear) is excessively prominent. This is repositioned with sutures or, if very stiff, some of the conchal cartilage is removed. The skin is then closed behind the ear with dissolvable sutures.

What age can the surgery be performed

Correction of prominent ears can be performed at any age after 5 years. Although it is possible to perform the surgery before the age of 5 it is not advisable as the operation requires understanding and co-operation from the patient.

Will there be scars

There will be a surgical scar behind the ear which will not be visible.

Will I need to wear a bandage

A head bandage covering the ears and forehead only will be placed at surgery. The aim of the bandage is to make healing more comfortable and minimize minor bleeding that may occur. The bandage is kept on for 3-5 days; however it can be removed earlier if uncomfortable. The patient will be advised to wear a headband at night and during sport activities for 6 weeks.

Is the operation painful

There will be some discomfort of the ears and this is alleviated by basic painkillers such as paracetamol. This usually settles after 1 week; however the ears can remain slightly tender to touch for 6 months following the surgery

Are there any risks

This is a procedure with a very high level of satisfaction. Complications are very rare and minor. There may be some bleeding from the wound which is of no consequence. Infection rate is very low at 1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}. In the majority scars heal very well and are almost invisible. In a small group of the population thicker (hypertrophic) scars may form which may need further treatment.

There is a small risk (5{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) of partial recurrence of the ear prominence. This is most likely to occur in the first six months and can be corrected if necessary.

EARFOLD

Section

Earfold is an implant created to correct prominent ears by reshaping the anti-helix. It is introduced through a small incision under the skin of the ear and grips the ear cartilage and immediately adopts a pre-set shape. The earfold is made from Nitinol alloy (titanium and nickel). The implant consists of a thin strip of metal plated with 24 carat gold to limit its visibility through the skin. No dressings are needed following correction and return to most activities is possible after one week.

How are earfolds inserted

Insertion of earfold implant is a quick and easy procedure performed under local anesthetic. A small incision (5mm) is made within the rim of the ear and the implant (which is pre-mounted on an introducer) is released to correct the prominence. One or two dissolvable sutures are needed to close the incision.

Can earfolds be used on all protruding ears

The earfold implant is designed to re-shape the antihelix. If the prominence of the ear is primarily as a result of conchal bowl prominence then the earfold will not correct this and a different surgical procedure will be required.

How long is the recovery period

No bandage is necessary following earfold insertion. There will be minor bruising and swelling following its insertion which will subside over a period of 2 weeks.

Do they have any risks

The implant itself has no associated health risks. The implant can be felt under the skin and is almost invisible.

There is a very small risk of infection and in the majority this settles with antibiotics. In rare situations (<1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) the implant may come through the skin. If this happens then the implant has to be removed and the skin heals without any problems. The ear prominence may re-occur after this, especially if this happens within 6 months of insertion, and thus a further procedure may be required.

Are there any risks

This is a procedure with a very high level of satisfaction. Complications are very rare and minor. There may be some bleeding from the wound which is of no consequence. Infection rate is very low at 1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}. In the majority scars heal very well and are almost invisible. In a small group of the population thicker (hypertrophic) scars may form which may need further treatment.

There is a small risk (5{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) of partial recurrence of the ear prominence. This is most likely to occur in the first six months and can be corrected if necessary.

GALLERY

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