One of the benefits of lockdown for me has been spending some time looking back and reflecting on the case notes of my patients who have undergone ear surgery this year.
While I have been keeping you up to date with advances in Microtia reconstruction such as custom 3D printed implants, I have also been seeing some amazing transformations in other ways, for people with ear differences either from birth or from trauma.
This young Ecuadorian boy was born with lobular type Microtia. Using a classical two stage autologous technique which I learned from master surgeon, Françoise Firmin, I was able to reconstruct the outer part of his ear using his rib cartilage. A few days after surgery his chest is still a little sore but he is happy to have a new ear.
Before surgery : Immediately after surgery
One week after surgery
This young boy also from Ecuador had another form of Microtia known as conchal type, where he has an ear canal and has a deep bowl still present. What was missing was the correct shape of the ear. We remade his ear shape from rib cartilage using the skin he already had, meaning he needed only one operation.
Before surgery : Immediately after surgery
One week after surgery
These older men from Haiti had suffered injuries to their ears. This meant that the position and size was ok, they were just missing specific pieces. I used rib cartilage to sculpt the missing pieces and was able to camouflage the junction between the old ear and the new ear!
Before surgery : One year after surgery
Before surgery : One year after surgery
Many people have heard the term “Keloid Scarring” yet I wonder how many would imagine that this is how ear keloids can look. Keloid scarring means that the scar has grown outside the boundaries of the original injury, in these cases the keloids started from ear piercings.
They are usually quite itchy, often form on the skin of the ear, shoulder or sternum and are characterised by their tendency to regrow once they are removed. There are dozens of treatments for keloids, but the most effective are surgery to reduce the size of the lump and simple steroid injections provided regularly.
Before surgery : Six months after surgery
Before surgery : Eight months after surgery
This young girl had both a prominent ear on her left (where one of her ears stuck our more that the other) and also a “lop ear” where the top of the ear was folded forward. In one surgery we were able to address both issues. And her smile says it all!!
Left top and bottom : before surgery. Top right : immediately after surgery. Bottom right : three months later.
These images are from a young professional woman who was self conscious about her big earlobes. She always wore her hair long to cover her ears and would be embarrassed if the wind blew her hair back.
I was able to remove the excess skin and fat of her lobes in a minor office based procedure under local anaesthetic. Even I was amazed that something so simple can make such a big difference. She told me weeks later, “Having this procedure has changed my life!”
This hopefully serves as a reminder that elective surgeries cannot be judged by the size of the problem that others might see. It is the magnitude of the effect the issue has on someone’s self confidence that matters, and everyone is different.
Just as no two individuals are alike, no two surgical results will be exactly alike.
Please always seek professional advice from a surgeon, and ensure they are FRACS qualified.
All of my patients were more than happy with us sharing their photos to help others learn from their conditions.