OTOPLASTY (PINNAPLASTY) Otoplasty, also known as pinnaplasty, is a surgical procedure designed to reshape or reposition the ears. It’s commonly performed to correct prominent or protruding ears but can also address other ear deformities. The goal is to produce a more natural appearance and to improve the balance and proportion of the ears in relation to the face. Here are some key points about Otoplasty: INDICATIONS The most common reason people seek Pinnaplasty is for prominent ears, but it can also be used to correct other ear deformities or to repair damage from injuries. WHAT IS THE BEST TIME TO HAVE OTOPLASTY? The best time for surgery can depend on several factors: RECOMMENDED AGE FOR SURGERY While the procedure can be performed on adults, it’s often done on children between the ages of 5 and 14. By age 5, the ear is typically fully grown, so the results of the surgery will be long-lasting. Performing the surgery at a younger age before starting formal schooling can also prevent potential teasing or self-consciousness. It is recommended to perform the procedure before the child starts school although it can be done in later years. With age the ear cartilage often undergoes calcification and becomes rigid. In certain older individuals, the extent of this calcification can make otoplasty more difficult and less effective, with a higher risk of the ear reverting to its original protruding state. EMOTIONAL READINESS It is important for the client, whether a child or an adult, to be emotionally prepared for the surgery and to have realistic expectations about the results. PHYSICAL HEALTH Good overall health is important for any surgical procedure, including Otoplasty. Clients should be free from any major health issues that could affect surgery or recovery. TIMING IN LIFE For adults, scheduling the surgery may depend on personal and professional commitments. They need to consider the recovery period and whether they can take time off from work or social activities. SEASONAL CONSIDERATIONS Some clients may prefer to schedule the surgery during cooler months when it’s easier to wear headbands or dressings without discomfort, or when they have a break from school or work, such as during the winter or summer holidays. Ultimately, the best time for Pinnaplasty is a personal decision that should be made in consultation with a qualified surgeon like Dr Sandeep, considering the client’s unique circumstances, including their physical and emotional readiness, as well as practical considerations for recovery. OTOPLASTY PROCEDURE The specific techniques used can vary based on the individual’s needs. The procedure may be performed by making an incision either behind or in front of the ear. The cartilage is then reshaped, and sometimes non-removable stitches are used to help maintain the new shape. Excess skin or cartilage may be removed if necessary. Here is a general outline of how the Otoplasty procedure is typically performed: PREOPERATIVE EVALUATION CONSULTATION An initial consultation with Dr Sandeep will give you ample time to discuss your goals, expectations, potential outcomes, recovery and potential risks in detail. MEDICAL EVALUATION Dr Sandeep and his team will carry out a thorough assessment of your medical history. He will then examine the ears to characterize the deformity and suggest a personalized surgical plan. Pre-operative photographs will be taken for documentation and discussion. ANAESTHESIA Dr Sandeep and his team ensure that their client is comfortable throughout the procedure. Local anaesthesia with sedation is often used for adults, allowing the patient to be relaxed and pain-free. General anaesthesia administered by an experienced Senior Consultant anaesthetist is the default option in children to ensure they remain asleep throughout the procedure. Many adults prefer to have a general anaesthesia as well. POSTERIOR TECHNIQUES FOR OTOPLASTY MUSTARDÉ TECHNIQUE OBJECTIVE The primary goal of the Mustardé technique is to recreate or enhance the antihelical fold, which is often underdeveloped or absent in people with prominent ears. The antihelical fold is the inner ridge of the ear that runs parallel to the outer rim (helix). By enhancing this fold, the ear can be positioned closer to the head, reducing its prominence. PROCEDURE An incision is made behind the ear to expose the cartilage. Permanent, non-absorbable sutures are placed through the cartilage to create or enhance the antihelical fold. The sutures are strategically positioned to reshape the cartilage without removing any part of it. If needed a part of the conchal bowl cartilage may be excised or repositioned if it is also contributing to the prominent ear deformity. Once the desired shape is achieved, the incision is closed. ADVANTAGES The Mustardé technique is less invasive than some other methods because it doesn’t involve removing cartilage. The use of permanent sutures provides lasting results. POTENTIAL RISKS AND COMPLICATIONS The Mustardé technique, while effective for correcting prominent ears, does come with potential risks, as does any surgical procedure. Here are some of the potential risks and complications associated with the Mustardé technique: Asymmetry: One ear may appear differently than the other in terms of shape, size, or position. Recurrence: The ear might gradually return to its previous position or shape over time, especially if the cartilage is resistant to reshaping or if the sutures fail. Unsatisfactory Cosmetic Result: Despite the surgery, the client might not be satisfied with the appearance of the ears. Over-correction: The ear might be pinned back too closely to the head, resulting in an unnatural appearance. Under-correction: The desired correction might not be achieved, and the ear may still appear more prominent than desired. Correction may require further surgery. Suture Visibility or Extrusion: The permanent sutures used to reshape the cartilage might be visible through the thin skin of the pinna and may work their way to the surface and become exposed. This can require removal or replacement of the suture. Infection: As with any surgical procedure, there’s a risk of infection at the incision site or deeper within the ear. Infection of the ear cartilage has the potential to distort the ear (cauliflower ear) permanently. Antibiotics used at the time of surgery