People whose ears stick out, or have an enlarged ear lobule, sometimes push their ears back and wish that they remained in that position. This is a simple action to create permanently by surgery. Protruding, or prominent ears can cause a lot of psychological trauma to a patient due to distasteful comments or ridicule by others, and according to one statistic, it can occur in about five percent of people. Otoplasty, or ear pinning, is one cosmetic procedure that can be performed as early as age seven years old, when the ear growth has neared maturity. Typically, children may tell their parents that they are being teased at school because of their ears, and the parents seek to have correction of the ear protrusion of their child. An elongated or protruding ear lobule typically happens in older years, and can be easily addressed with a simple surgical wedge resection of the ear lobe.
Some patients have their protruding ears pinned as adults. These patients may want to improve their facial appearance or would like to wear their hair in a ponytail. This last option is difficult for them to accept because they are used to wearing their hair in a way to cover their ears. Either one ear or both can be protruding, and the level of protrusion may vary. An ear pinning operation, or Otoplasty, is done to correct this condition and improve the level of self-satisfaction that a patient has with his or her self-image.
If the patient has a protruding or elongated lobule, then a wedge of skin may be resected, thus shortening the lobule. If a crease appears in the middle of the lobule, and the lobule folds on itself, then injecting the ear with Restylane or Radiesse can solve the problem for months to years, but not permanently.
It is important to distinguish a prominent or protruding ear with other ear deformities, such as “cup” ear, or missing ear, or a traumatized ear with missing parts. These examples are addressed with other procedures tailored to those particular conditions.
We believe a well-prepared patient leads to a successful surgery and recovery. Whether you are flying in internationally or a local, our staff strives to give you a great experience. During your initial call to our office, one of our patient care coordinators will discuss the different options available to improve the areas of your concern. A consultation is scheduled with the doctor who best fits your personal situation. The doctor will review your medical history, spend the appropriate time to review all surgical and non-surgical options, and discuss whether surgery can be performed in-office under local sedation or at the hospital under general anesthesia. In sharing our before and after photos, you get a better sense in the quality of surgery our doctors offer and what outcome you can expect to achieve. We will review pre- and post-operative care so you can be prepared for what your role is in surgery. You will be asked to stop smoking two weeks prior to and post-surgery. Safety is our top priority, so we will ask you to see your primary care physician to perform a physical exam, lab work and, in some patients, an EKG 30 days prior to surgery. Next, we see you for a pre-op appointment two weeks prior to surgery to discuss any questions you may have and review surgery details, ensuring everyone is on the same page. You will then receive a courtesy call the evening before surgery to review instructions and any questions you may have.
The appearance of ears appearing to be bigger” than normal is due to one or more of the following factors:
The cartilage is formed in the ear without a fold close to the upper edge.
There is an excessive amount of cartilage formed in the middle of the ear.
The angle that the ear makes with the scalp is larger than normal, making it “stick out.”
In order to correct a protruding ear, we examine it with the patient looking in the mirror, and we observe the shape of the ear. We make a plan together to correct the aspect of the ear’s appearance that bothers the patient.
The operation is done under general anesthesia, and is typically performed on both ears, but sometimes, people have one normal ear and one protruding ear, so only the protruding ear is corrected. After a patient is given anesthesia, the previously noted three factors are addressed. If a patient does not have an upper pole fold, then a fold is created by lifting up the skin of the ear and suturing the cartilage to itself to create a fold. Next, if there is an excessive amount of cartilage in the middle of the ear, then that cartilage is trimmed appropriately. Finally, if the angle that the ear makes with the scalp is larger than normal, then a portion of skin is resected from behind the ear, and the ear is sutured –or “ pinned back” – to the scalp. Then dressings are placed to protect the ears and the patient is awakened, and discharged home when ready.
Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most facial procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure; light make-up may be used to cover bruises starting a week after surgery. We also offer scar creams at an additional cost to optimize results.
To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s and Dr. Lickstein’s cell phone numbers if you need to reach your physician after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.
MAXIMIZING POSITIVE OUTCOMES
At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.
There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.
We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Our surgeons are committed to continuing education, honing their skills and introducing new techniques always with the aim of improving safety and surgical results.
We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.
WHY CHOOSE BITAR COSMETIC SURGERY INSTITUTE?
Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar and Dr. Larry Lickstein are distinguished board certified plastic surgeons, with over 30 years of combined experience, who exclusively perform cosmetic surgery. Our doctors stay on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, they are able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.
For more information, call our office at 703-206-0506.
Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.