Ear plastics: indications and contraindications for otoplasty
Congenital malformations and acquired defects of the auricle are found in a large number of individuals.
However, they negatively affect the psychological health of their owner due to the presence of a significant flaw in appearance.
Correction of such changes is the primary task of one of the areas of plastic surgery, the so-called otoplasty.
Types of otoplasty
Methods of correction or restoration of the auricle are divided into 2 large groups:
- aesthetic (imply correction of the shape, size, protrusion);
- reconstructive (reconstruction of the whole or partially missing outer ear).
Each of these groups has a huge number of methods and techniques of surgical correction. The plastics of the ears consist in affecting the soft tissues, cartilage, stitching, where necessary, using musculoskeletal flaps, temporal fascia, cartilaginous rib part to close the defect and form the outer ear carcass.
Most often use a combination of resection and suture methods. Surgical intervention can take place in one or in several stages, be one- or two-way.
Ear plastics are shown in the following cases:
- Lop-eared - excessive protrusion of the ears, due to the high location of the conchial fossa, hypoplasia protivozavitka;
- other defects of the development of the outer ear (folding ears, macrotia, microtia, Stahl ear, absence or lobe hypertrophy);
- increasing the angle between the occipital region and the auricle;
- deformation of the outer ear, due to cicatricial, tumor, traumatic, burn injuries;
- cryptopy;
- asymmetry of auricles;
- the absence of a whole or part of the auricle as a result of a congenital condition, injury or frostbite.
Otoplasty is not carried out for persons with the following contraindications:
- age up to
6 years; - violations of blood coagulation;
- malignant neoplasms;
- acute infectious diseases;
- progressive diseases of the nervous system;
- severe renal and hepatic insufficiency;
- pathology of the skin of the face;
- severe diabetes;
- stage of decompensation of diseases of the cardiovascular and respiratory systems;
- period of pregnancy and feeding.
Required tests
Like other surgical operations, ear plastic surgery requires a preliminary examination of the patient.
Mandatory laboratory testing includes:
- clinical analysis of blood and urine (indicating the level of platelets in the blood plasma);
- biochemical analysis (hepatic transaminases, bilirubin, cholesterol, total protein, creatinine, urea);
- fasting blood glucose, coagulogram (prothrombin index, blood clotting time, thrombin time, activated partial thromboplastin time).
As a rule, the doctor sends the patient to the diagnosis of syphilis (Wasserman reaction), viral hepatitis (Hbs-antigen), HIV infection. Before surgery, determine the blood group and Rh factor. Then they proceed to a general examination of the body using instrumental methods, namely fluorography / radiography of the chest organs, ECG.
If there is a concomitant pathology, consultation and the conclusion of a narrow specialist of the appropriate profile is necessary. Interpretation of tests and the search for possible contraindications are carried out by a general practitioner. To choose the tactics of surgical correction, you may need to anthropometric measurement of a healthy and affected auricle, namely the length from the lateral angle of the eye to the point where the curl crosses into the face, the location of the upper curl point and the lower contour of the lobe. In some cases, the structure and blood flow in the temporal vessels are additionally examined by ultrasound scanning.
Ear plastics surgery and methods
The choice of treatment method is carried out individually, taking into account all the features of the task.
The most commonly used approaches are:
- correction of incorrect proportions;
- Correction of pronounced deformations of the curl and anti-wrap;
- getting smooth and smooth edges of the anti-wrap fold;
- maximum possible and natural preservation of the shape and depth of the ear gap;
- compliance with the principles of symmetry of both ears;
- ensuring close but incomplete pressing of the outer ear to the head.
How is the operation?
After all tests have been taken and there are no contraindications, the date of surgical intervention is set. The procedure of ear plastic surgery is performed under general anesthesia, in rare cases with small amounts of intervention, under local anesthesia.
Since, in most cases, patients are children aged
Access for incision can be front or rear (in 90% of cases).
The skin, cartilaginous tissue, in the case of lop - earedness , are dissected - unnecessary parts of the cartilage are removed and it is given the desired size and shape. At the next stage, the result is fixed with several seams and auxiliary material. In modern centers with the latest equipment it is possible to use a laser scalpel, which is more preferable for the patient. The new position of the auricle is supported by a special bandage, bandage.
The average duration of the operation is 45-60 minutes. Ways to reconstruct the missing part of the auricle consist in taking autotransplant from the patient's body.
They can be the skin area from the supraclavicular region, the temporal fascia, part of the cartilage of the rib, or in the case of injury, the amputated area of the external ear itself. For the convenience of the surgeon, the defects are divided into segmental, subtotal and total. The surgeon should strive as much as possible to reconstruct the damaged auricle in one step. Cryptotia is eliminated by surgically detaching the upper pole of the auricle from the skin of the temple.
The earlobe in its absence is formed by two triangular subcutaneous fat grafts. Reducing the appearance of otoplasty reduces ear size.
This removes excess parts of cartilage tissue, skin folds. After forming the contours of the new form of the ear. There are three methods of reduction: according to Joseph, according to Trendelenburg and according to Gerzuni. With rare types of congenital defects of development, the creative abilities of the surgeon and the choice of combined methods of intervention are important.
Rehabilitation and recovery
The recovery period is not very long. The stitches after the operation are removed on the 8-10th day. The patient is wearing a bandage that supports a bandage or a special elastic band for a longer period, up to 2-4 weeks. However, they should not be too tight so as not to disrupt the process of wound healing and scar formation.
There are no general strict restrictions and recommendations, except for the avoidance of heavy physical exertion and proper lifestyle. Ligation and medical supervision can be carried out on an outpatient basis, and most of the time patients will spend at home.
It is important for the first days to keep the dressing dry, to take water procedures with caution, to try not to injure the auricles, as there is a danger of seam divergence.
Complications after otoplasty, adverse effects of surgery
Surgery on the plastic ear can lead to a small percentage of postoperative complications. The most common of these are hematomas at the access site, soft tissue swelling, bleeding, infectious complications of a wound.
All these adverse effects are excluded with laser heating, which allows for exact and practically no injuries to be corrected or reconstructed.
A complication is the patient's dissatisfaction with the results of the surgeon's work, non-compliance with the principles of anatomical proportions and symmetry. Then the patient is subjected to repeated surgical intervention in this regard. The negative outcome of the operation can be affected by the incorrect choice of suture material, instruments, the lack of an optical zoom system.
Prices
Services to perform plastic surgery on the ears provide most plastic clinics or specialized centers, due to the fact that this is one of the most popular types of intervention. Prices vary and vary within different boundaries.
The minimum cost of plastic in the classical way is
You can choose a clinic in all major cities of Russia: Moscow, St. Petersburg, Krasnodar, Novosibirsk, Yekaterinburg, Kazan, Kursk, Voronezh, Samara, Vladivostok.
The presence of an anomaly of the structure of the auricle, independent of its severity and degree, creates a feeling of inferiority in the patient and forces him to look for ways to eliminate deviations, starting from the selection of the hairstyle and ending with seeking surgical help. Therefore, the implementation of any operational manipulations aimed at the reconstruction and correction of congenital or acquired defects must meet high standards and requirements.
