IN THIS ISSUE
Ear Refinement: Parent Struggle to Make the Right Call
Is a parent, you want to do what is best for your child. The process of evaluating your child’s options for improvement, including reshaping, repositioning, and reconstructing the ears depends on the nature and extent of the problem. Your physician will help you through this process in order for you to make an educated decision for your child.
How do I know what is normal? Individuals are evaluated based on proportion and harmony with their total facial features; the following guidelines cannot be applied perfunctorily to every patient. Ears generally lie close to the head and extend from the level of the brow to the base of the nose. The grown ear protrudes approximately 2.0 centimeters at its midpoint; is between 5.5 and 6.5 centimeters long; and measures 3.0 to 4.5 centimeters in width. Earlobes may be curved and hanging or straight and attached to the side of the head. With age, earlobes become longer at the base.
What causes ear abnormalities? The development of the outer ears may stop short in the womb. If the complex folds fail to form, the child is born with cup-like ears that project from the sides of the head. In other cases, excess ear cartilage develops resulting in ears that stick out too far. Occasionally, the ears just grow too large. Not all ear problems are evident at birth. As we age, the collagen fibers relax, causing creases and elongated earlobes. A traumatic injury or complications from ear piercing can also cause an abnormal appearance.
How is otoplasty performed? The surgery begins with an incision just behind the ear, in a natural fold. The surgeon removes the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, this entails trimming the cartilage, or shaping it to a more desirable form and then pinning the cartilage back with permanent sutures to secure the cartilage. In other instances, the surgeon will not remove any cartilage at all, using stitches to hold the cartilage permanently in place.
What can I do to help my child? You need to have a positive attitude with realistic expectations. Your physician will thoroughly explain your options and help you consider what is best for your child psychologically, physically, and aesthetically.
Is it too late for my child?
Six-year old George C. came to see his facial plastic surgeon. His parents were concerned that they had waited too long to fix his protruding ears. The physician explained that five to six years of age is ideal because the ears have reached their full size, yet the cartilage is still pliable, permitting greater ease of shaping. After evaluation, the physician agreed that George was an excellent candidate for otoplasty. The procedure was a success, and the parents reported that George felt more comfortable and confident as a result.