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Ears | Otoplasty

Prominent ears / Protuberant ears

otoplasty picProminent ears are recognized as one of the most common congenital ear anomalies. Their degree of prominence is quite variable

Children with prominent ears may be teased prompting surgical correction.

This procedure is most often performed on children between the ages of four and fourteen – commonly in children prior to entering school.

The features responsible for prominent ears may include an incompletely folded or developed anti-helical fold, an excessively deep concha or a combination of both.

Procedure:

The procedure is performed via an incision placed behind the ear. The surgical techniques for the correction of prominent ears can be grouped into operations that involve:

  • molding the ear with sutures
  • molding the ear with scoring or sculpting of cartilage
  • setting back the prominent concha
  • a combination of any of the above.

Pre-operative evaluation of the prominent ears will determine which techniques to employ to achieve a natural and permanent result

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BEFORE YOUR SURGERY

Arrange to have a responsible adult over 18 years of age stay with you the first evening after surgery. The procedure will be cancelled if you do not have support.

SMOKING

Smoking increases the risks of complications significantly and should be ceased 4 weeks prior to surgery.

ALCOHOL

No alcohol 48 hours before surgery.

DIETARY REQUIREMENTS

Be well nourished, hydrated and rested before your surgery.

MEDICATIONS

A script will be issued for antibiotics and pain tablets. You will need to purchase them from a chemist and bring them with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery.

They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. These include medications containing aspirin & anti-inflammatories (Voltaren, Brufen etc) they should not be taken 2 weeks prior to your procedure. Avoid Vitamin C & E supplements and red wine 3 days before your operation.

Stop all herbal medications 1 week before surgery. These include Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John’s Wort, and Valerian. *(Please ask us for a more comprehensive list if required.)

Please consult Dr Geldenhuys before ceasing any chronic medications. Arrange to have someone fetch you on discharge & stay with you for 2 nights.

ADDITIONAL PRECAUTION & ADVICE

Report any signs of a cold or infections; skin (boils, bites scratches etc) dental etc within two weeks of your surgery. These may increase the risk of surgical infections and may require delaying your surgery for a few days/weeks.

Obtain any desired “comfort items” for after surgery e.g. music, comfortable clothing, pillows, healthy prepped meals, anything that will facilitate a pleasant environment for your recovery. Avoid sun/UV exposure for two weeks prior to surgery. Any evidence of sunburn will result in your surgery being cancelled.

Do not save questions for the morning of your surgery. This is a busy time for us and it should be a relaxing time for you. Please contact the office PRIOR to your surgery if you have any questions.

DAY OF SURGERY

On arrival at the clinic you will be offered a pre-med, this is to ensure you are relaxed & calm for the procedure. Prior to surgery, Dr. Geldenhuys & your anesthetist will see you in the ward. You should have nothing to eat or drink for 6 hours before your operation. If you are required to take chronic medication during this time please do so with a sip of water.

WHAT TO BRING WITH YOU

  • Any current medicines and those which have been prescribed.
  • Medical Aid membership card
  • ID Document
  • Credit Card or other agreed means of payment
  • Toiletries if required.

WASHING

Medicated soap will be provided to be used on the morning of your operation.

PRODUCTS

Do not apply make-up, perfume/deodorant, nail polish or hair products after washing.

JEWELRY

Remove all jewelry.

CLOTHING

Wear loose, comfortable clothing and footwear. Front opening garments with buttons or zips are ideal.

POST-OPERATIVE INSTRUCTIONS

MOBILITY

During the first week, you will sleep on your back. Get out of bed every 2-3hrs and walk a little bit, then back to resting. Avoid any strenuous movements and heavy lifting. Heavy exercise or straining can cause bleeding or swelling during the first few weeks. Return to normal activity should be a gradual process and should never cause discomfort. Stop if you are uncomfortable!

  • First 3 weeks: You may take a gentle walk within a few days, “short Sunday stroll”. You may drive when you are comfortable and have discontinued all medications, typically 10 days post operatively.
  • Weeks 4-6: Legs & light cardiovascular exercise only (lower body movement, no arms)
  • Week 7-12: Gradual increase in cardio exercise & light upper body training ( abdomen, biceps - no peck exercises for first 3 months )

BATHING

Please refrain from showering for the first 7 days after surgery. You will be allowed to take a shower on the morning of postoperative day 7 prior to your follow-up appointment. In the meantime you can bathe, but do not submerge your head in the water.

SWELLING

Swelling will vary patient-to-patient. Swelling may actually increase the first three to four days before subsiding. Most of your swelling should resolve over the first two to three weeks. Do expect, however, to have minor fluctuations in the remaining swelling over the course of the next two to three months. To minimize this swelling include keeping your head elevated as much as possible over the first two to three weeks, avoiding bending over or heavy lifting for the first three weeks, and avoiding prolonged sun exposure for the first two to three months.

DISCOLORATION

Bruising will vary like swelling from person to person. Most bruising and discoloration should resolve over the first two weeks.

NUMBNESS

Your ears may be numb following surgery. This is normal and will subside over the coming weeks to months. Unusual sensations, pins and needles, and occasionally mild discomfort may occur as these nerves regenerate over time.

DEPRESSION

It is not uncommon for patients to go through a period of mild depression after cosmetic surgery. This typically occurs the second week after surgery while some of the swelling and bruising still persist and yet the patient is anxious to see a final result. Realize this is a temporary condition and things will improve.

RESTRICTIONS

  • No strenuous exercise for at least two weeks.
  • No heavy lifting for three weeks.
  • No "pull-over" clothing for two weeks.
  • Avoid hard chewing foods for two weeks.
  • No contact sports for six weeks.

GARMENT & DRESSINGS

We will provide you with a headband that should be worn continuously for the first 7 days. It should only be removed to preform incision care. After 7 days, you will continue to wear it for an additional 7 days only while you sleep. This helps to hold the ears in good position and protect them. Keep your dressings dry. We will change your dressing on the first follow up appointment

ICE

Cold compresses help minimize swelling and bruising. Use a bowl of ice cubes with gauze at the bedside to soothe sore areas during the first 2 days. It is more important to sleep than to have ice on the eyelids, so don’t ‘stay up’ in order to ice. When you do awaken, apply some ice before going back to sleep.

ARNICA & LIGHT THERAPY

Optional - You may take Arnica which is a homeopathic remedy to aid in reducing your bruising and swelling post-operatively. Light Therapy can assist in the healing process.

BLEEDING

If you bleed from one of the suture lines, apply pressure with gauze for 10 – 20 minutes, and it will almost certainly stop. If dried or clotted blood is stuck in the suture line, we advise gentle cleansing with clean water using a cotton bud or gauze.

SUTURES

Removal of sutures at 5-7 days after surgery. The application of your prescribed ointment can then be applied during the day until the tube is finished.

BATHING & SHOWERING

Take care when washing your hair and face not to get any product on the area until the day after the sutures are removed.

SUN

Scars take at least one year to fade completely. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of UV radiation can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times when in the outdoors.

SCAR MANAGEMENT

The incisions will be covered with Bactroban ointment for about 2-3 weeks after surgery, then topical Vit A or Silicone for 8-12 weeks. ( this will be explained to you after surgery )

MEDICATION - Take medications as directed.

Contact Dr Geldenhuys if you develop nausea, heartburn, diarrhea, constipation or bloating. If pain persists despite pain medications please contact Dr Geldenhuys.

INFECTION

Infection is unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated.

SMOKING

Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing.

DIET

Have 3 meals a day with plenty of fiber, protein & carbohydrates. Hydrate yourself with plenty of noncarbonated drinks: water & freshly squeezed juices.

CALL ROOMS (021) 424 5218 IF YOU HAVE

  • A temperature greater than 37’C.
  • Excessive bleeding from your eyes or incision sites
  • A sudden increase in pain, or swelling.
  • Any questions regarding your care.