Otoplasty Orange County Otoplasty Ear Pin Back
Protruding ears can be an embarrassing feature for anyone to live with and can be the source of ridicule. Names such as Dumbo and Mickey Mouse add injury to insult. Relief can be as simple as an outpatient procedure called an otoplasty! This information has been assembled to familiarize you with the facts regarding ear pin back surgery. You are requested to read the following information thoroughly and to discuss any questions, which might arise with your surgeon before you proceed with the surgical procedure known as otoplasty. You are also requested to keep this information as a reference during your post- operative period. Ear pin back surgery is a common aesthetic surgical procedure performed by your surgeons at Orange County Plastic Surgery. A normal ear rarely attracts attention – yet one
that protrudes does attract attention and can be the source of ridicule or hurtful jokes. Protruding ears can be a source of diminished self esteem in children and adults alike. Often, correction of even a minor deformity can give the affected person and enormous boost in self esteem. Protruding ears may be present on only one side or both. Some asymmetry is always present, before and even after the most successful surgical procedure.
OTOPLASTY PREOPERATIVE PREPARATION
You may visit your surgeon as many times as you wish to have all of your questions answered. At your final preoperative visit, your final questions will be answered and you will confirm that you have understand the procedure to be performed, that this material has been explained to you, that you have read and understand these information sheets, and that you accept the risks by signing the informed consent forms. This is an elective procedure and is only performed on a patient desiring the operation. This procedure is frequently performed on children – even though a parent must sign the consent forms, the child must have an understanding of the procedure to be performed, must desire the procedure and be able to verbalize that they do indeed wish to have the operation performed.
Most children get by with Tylenol® to control any discomfort after surgery. You will be given prescriptions for antibiotics along with instructions for their use. Certain laboratory tests will also be required within two weeks of surgery. If you are over the age of 50, you will have to obtain a cardiogram at your doctor’s office or any licensed laboratory. You may have blood drawn by our office nurse during your final preoperative visit, or, if you prefer, at your family doctor's office or any laboratory (e.g. Kaiser Hospital, etc.). All patients will be asked to stop smoking at least a month prior to surgery in an effort to maximize your body's ability to heal the incisions following the operation.
Patients should shampoo their hair the morning of or the night prior to surgery and cleanse their face with an MD Performance® cleanser. Absolutely nothing may be taken by mouth after midnight prior to the day of surgery (except medications prescribed by your family doctor, but please mention these to the anesthesiologist in advance.)
Ordinarily, your anesthesiologist will call you the night before surgery to discuss the anesthetic care plan. But if you miss the call or your anesthesiologist does not call you, do not worry as you will be able to discuss your anesthesia and have all your questions answered in the morning, at the Surgery Center prior to your procedure (Orange County Surgery Center in Newport Beach, Southern California or Tracey Surgery Center in Northern California). It is absolutely imperative that you make arrangements in advance to have someone drive you to the surgery center on the day of your operation and to drive you home when you are discharged from the recovery room – you will typically be at the surgery center for about four or five hours.
A set back otoplasty is an elective, cosmetic surgical operation designed to correct the position of protruding ears. An incision is made behind the ear, the cartilage scored to allow it to be reshaped, and the incisions closed with absorbable sutures. A bulky cotton dressing will be applied at the end of the procedure, and you will leave this in place until your return visit with your surgeon. This operation requires approximately one and a half hours. The surgery will usually be performed under a light general anesthesia or deep sedation plus local anesthesia. An anesthesiologist will be present to administer the medications and assist in monitoring all patients to ensure their safety.
OTOPLASTY POST-OPERATIVE CARE
The patient can expect swelling of the ears and some discoloration. Patients are to leave the dressing in place until returning to the office for the first post operative visit. One may sit in a bath tub but it is best not to try to shower before the dressing is removed. Once the dressing has been removed, you may wish to apply Vaseline ointment to the suture lines to inhibit further crust formation. You may begin walking as soon as you feel able, but all lifting, straining and other vigorous activity is to be avoided until all bruises have faded. The best rule of thumb is to avoid any activity that causes you discomfort and to enjoy those that do not. Most patients are pleasantly surprised to discover the relatively mild degree of post-operative discomfort. The patient is requested to call the office if the discomfort
is not readily quelled by the pain pills, or if significant bleeding appears around the incisions. Some drainage, particularly behind the ears, is normal for a few weeks. Sutures are usually removed four to ten days post-operatively, but can be left in place, as they are absorbable, if a patient is particularly squeamish about suture removal.
Once the dressing has been removed, it is advisable to wear a sweat band around the ears, the type of band over the forehead and ears that tennis players frequently wear. This will protect the ears from inadvertently being pulled away from the head, particularly by a pillow while sleeping.
OTOPLASTY POSSIBLE COMPLICATIONS AND SCARS
Every activity in life, whether driving automobiles or having surgery, is associated with risk. The following inherent risks must be understood and assumed by the patient if we are to proceed with this surgery. Although complications and bad results are uncommon from this type of operation, they do sometimes occur. Your doctor cannot guarantee a favorable result from any operation you are considering, but every effort will be made to provide you with the best result possible. Some of the possible complications from this operation include: recurrence of the protrusion, blistering or sloughing of the skin with the possibility of permanently noticeable scarring, infection, bleeding, unequal discoloration and swelling of the ears, abnormal contour, personality changes and mental difficulties
following the operation which may occur even when the operation has been a success, and allergic or other adverse reactions to one or more of the medications used during or after the operation.
Some of the complications associated with this operation can cause the need for further or touch-up surgery, which will result in additional fees to the patient. Some of the complications can cause prolonged healing, unsightly and painful scars, deformity and inconvenience.
Complications, particularly blistering and skin loss around the ears, without question are seen much more frequently in smokers, and you are urged not to smoke for at least a month prior and after your surgery to minimize the likelihood of such complications. (And if you can stop for that long, why not do your body a favor and quit this nasty habit permanently!)
There are also other, very rare, potential complications from this operation in addition to the ones that have been mentioned, but it is not possible to advise you of every conceivable complication.
Complications after any type of cosmetic surgery are relatively rare and most patients end up with a very satisfactory result. The purpose of this information is not to frighten you, but to insure that your decision to have this operation is not made in ignorance of the potential risks of cosmetic operations on the face.
The surgical scars are permanent; however, the incisions are placed so that they are barely discernable on normal visual observation, barring complications, which may result in thick and/or painful, disfiguring scars. If this problem occurs, treatment by excision or steroid injections may be indicated, but it may be impossible to improve an unsightly scar. It is recommended that patients begin applying MD Performance® Ultimate Scar Formula to the incision about two weeks after surgery. The Ultimate Scar Formula should be applied twice daily until the scar has finished healing and no longer contains any hint of pink or purple.
SOCIAL ACTIVITY AND MAKEUP
Social activity should be limited for as long as you feel uncomfortable with the degree of swelling and bruising that you have. Light activities such as walking may be begun as soon after surgery as the patient desires. Strenuous exercises may be resumed when it is physically comfortable to do so, usually in a few weeks when all visible swelling and bruising have subsided. Cosmetics and moisturizers may be applied over the skin of the face, as soon as the dressing has been removed. The office aesthetician will not only be able to assist you with makeup application to help hide bruising, but also to give you guidance regarding skin care after you have healed.
SHAMPOO AND COLORING, SHOWERS AND BATHS
Coiffure procedures may usually be carried out after the drainage tubes have been removed and the wounds have stopped draining. Care must be employed when drying the hair during the first few months while you do not have normal sensation; the low heat setting should be used for the first two months to avoid inadvertent damage to the skin or hair. The head must be kept dry until the dressing has been removed, usually around the fifth day after surgery. The patient will then be encouraged to begin showering and shampooing normally. By the day after surgery, you may use an MD Performance® cleanser and moisturizers on the portions of the face not covered by bandages.
All fees will be discussed freely in advance by the office staff. Financing may be arranged if desired. Your insurance company may cover a part of the fee for children. Payment of all fees, however, is the patient's responsibility; all fees are due prior to surgery and the proceeds of the insurance check will go to you when the check arrives (minus a 6% billing fee if you chose to use our billing service). If requested, the office staff will assist you with forms, but recovery of any insurance benefits is between you and your insurance company. Insurance companies never pay for the entire fee and never pay for operations which are solely designed to improve your appearance. In compliance with suggestions adopted by the American Society of Plastic Surgeons®, it is customary for the patient
to pay all fees for cosmetic surgery prior to the desired operation. This insures that the patient is sincere in her motivation and can afford the surgery, thus creating a better patient/physician relationship. A non-refundable deposit will be required to secure your desired surgery date. The remainder of the fees must be paid prior to the surgery, usually at the time of the preoperative visit, but no more than two weeks before surgery. Additional fees are also required for laboratory tests, surgical facility fees, and the anesthesiologist. If additional surgical procedures become necessary, additional facility, laboratory, anesthesia, implant costs and professional fees will be incurred. The surgical facility and anesthesiologist fees quoted will be based on our best faith estimate; the final fee may vary as these fees are based on surgical time, and it is not always possible to predict exactly how long a procedure will take to complete.