The Three Primary Types of Ear Reconstructive Surgery

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Ear Reconstruction Options Photo - Mark Mitchell Jones, MDThere are three types of ear reconstruction surgery that patients who wish to restore a normal look and function to their ears can choose from. Each has its own unique benefits. The following is a brief description of each that patients can use to help decide which would be the right option for them.

Microtia/Anotia Surgery

This procedure involves partial reconstruction of the upper half of the outer ear cartilage. In more severe cases due to mild birth defects, creation of an entire external ear is necessary. The most commonly prescribed surgical option for full reconstruction involves taking the patient’s skin–usually taken from an arm or leg–and grafting it around a polyethylene-plastic frame base. Partial microtia usually involves removing the patient’s own living cartilage and grafting it to the affected area.

Otoplasty Surgery

This is a simple, highly individualized surgical procedure that is most often performed on an outpatient basis to correct oversized ears. Thousands of patients undergo this operation in the U.S. every year to correct simple anatomical types of ear deformities. Also referred to as ear pinning, recovery time from this ear reconstruction procedure often takes about a month and involves wearing an elastic headband in the evenings for a brief period as the new cartilage hardens.

Surgery Due To Trauma or Cancer

Injuries to the ear can range from common vehicle accidents to a previously unsuccessful ear procedure. Deformation can also occur if the patient has suffered from cancers such as carcinoma, squamous cell carcinoma, or melanoma. If the injury is not the result of cancer or some other health-related condition, then the corrective ear reconstruction procedure is relatively straightforward and will be similar to the ones performed for Microtia or Otoplasty. However, if the injury is due to a cancer, there are other factors that should be considered, such as if radiation therapy has occured. Your surgeon will consult with your oncologist to develop the proper plan that produces the best prognosis for full recovery.

Thanks to Menage a Moi for the photo of a man’s ear.

Finding Out If You’re A Good Candidate For Otoplasty

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Doctor And Child Otoplasty Candidate Photo - Mark Mitchell Jones, MDFor those who have oversized ears, there is a surgical option that can help you correct the appearance of prominent ears.  Otoplasty, also known as ear pinning, is a surgical procedure used to correct larger ears that many undergo each year. Candidates for this procedure can include healthy children, teenagers and adults who have no life-threatening illnesses or untreated chronic ear infections.

Generally, a normally healthy child who is five years of age or older is a good candidate for this procedure. But it is not unusual for children as young as three years of age to have Otoplasty. No matter the age, the child’s ear cartilage must be stable enough for this corrective procedure to be effective.

While more common for those ages 5-14, teenagers and adults can have their ears reshaped through Otoplasty as well. Older candidates shouldn’t have any chronic or undiagnosed health conditions that could impair healing. They should also be non-smokers. Regardless of the age of the patient, they should have a positive outlook and realistic expectations of the results the procedure will accomplish.

Rapid recovery is a characteristic of successful Otoplasty. The patient usually wears a head bandage for about a week after the procedure. And, for the next month, the patient wears a headband at night in order for the new cartilage to “set” properly.

If you are considering this procedure for yourself or your child, it’s best to speak with a doctor. A medical professional will walk you through the process and help you determine if it would be the right solution for your situation.

Diagnosing The Severity Of Microtia In Children

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Photo Of Children - Mark Mitchell Jones, MD Microtia is a congenital ear deformity that impacts the composition and appearance of the ear’s cartilage. It is most common in male children. Though it primarily appears in the right ear, about 10% of patients experience the deformity in both ears. There are four common types or “grades” of Microtia. Depending on the severity of the deformity, this condition can have little effect on a patient’s hearing, or impact it greatly. Below is a brief overview of the different grades.

Grade 1

Though there is usually firm tissue at the upper end of the ear and often normal shaping of the vertical back edge, the ear may appear to be generally smaller than normal. Any noticeable deformities will usually be found at the low end of the ear lobe.

Grade 2

This grade is identified by the fact that some of the common cartilage features of the ear are missing. There is usually a small lower ear lobe and connective posterior cartilage.

Grade 3

More commonly know as “Classic Microtia” or “peanut ear,” all anatomic ear cartilage subunits are present but are misshapen like a small peanut in this deformity. Though there is usually firm tissue at the upper end of the ear and some shaping of the vertical back edge, the earlobe is deformed at the low end. In rare cases there can be an external auditory canal. But in most cases, it is absent, which is a condition known as Atresia.

Anotia

In extreme cases, there is no ear cartilage or auditory canal present. This condition requires complete surgical construction of a new ear and opening of the auditory canal.

Whether your child has a Grade 1, 2, or 3 condition, there are options available that can restore the appearance and function of their ears. A consultation with Dr. Jones will help you determine what course of action is best.

Ear Lobe Gauges and Surgical Repair

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Picture of Woman With Ear Lobe Gauge - Mark Mitchell Jones, MD A common question asked by many adults is can the effects of earlobe gauging be reversed? The answer is yes. In fact, even ear lobes that have been stretched by multiple gaugings can be corrected with ear lobe surgery.

Ear piercings have been popular for thousands of years. Today, it is common to see young people have multiple piercings. But what happens when a young person with single–or multiple–ear piercings or gauges decides they need them removed in order to appear more professional? While the holes created by these gauges can be large, the evidence can be completely removed in approximately a month by having ear lobe surgery.

There has been a solid increase in the number of patients seeking reconstructive ear lobe surgery to eliminate gauge openings. In order to have a successful surgical reconstruction of the ear lobe, the first step a patient must take is to remove all gauges for at least a few weeks before the procedure.

This reconstructive procedure is commonly performed in the doctor’s office. It begins with local anesthetic injected into the earlobe. Then, the excess skin around each gauge is carefully removed. As many gauges as the patient wishes to be removed can be done during the procedure. Full recovery usually takes four to six weeks.

Thanks to snakesandsailors for the image of an ear gauge.

Important Otoplasty Words to Know

If you considering ear surgery there are several important words you should learn or at least be familiar to you. Terms that relate specifically to ear surgery and general surgical terms as well.

The first word being the medical name for ear surgery to reshape the ear itself: Otoplasty. This term is commonly associated with ear pinning, improving prominent ears. Two other words that relate to conditions of the ear are Microtia (meaning small or little ear) and Macrotia (ears that are too large).

Two other words that patients considering ear surgery need to know relate to the type of sedation used for the surgical procedure. General Anesthesia refers to the drugs and gases that are used to alter consciousness. Intravenous (IV) drugs are injected in a vein to help a patient relax.

Other important words describe the structure of the ear. These include Antihelical fold (the fold just inside the rim of the ear), the Conchal cartilage which is the deepest and largest concave cavity of the outer ear. The ear axis refers to the main line of ear growth.

Standard deformities of the ear include constricted ear which is more commonly known as a cup or lop ear. A constricted ear has varying degrees of protrusion, smaller ear consultant, folding of the upper rim of the ear and a low ear position. Cryptotia is also known as a hidden ear. A hidden ear is when the upper rim of the ear is buried under a fold of scalp. Another type of deformity is known Stahl’s ear. This condition occurs when the ear is distorted due to abnormal folds in the cartilage of the ear.

If you’re considering ear surgery it’s important to learn as much as possible about your condition. Websites such as www.surgery.org, can answer a lot of questions for patients considering ear surgery.

Things You Should do to Prepare for Ear Surgery

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Preparing for otoplasty or ear surgery is not that different from preparing yourself for any other type of surgery. You will receive specific instructions from your surgeon on any lab tests, additional medical exams or other details that need to be completed prior to surgery.

Very often certain types of medication must not be taken before surgery and some must be discontinued a week or two prior to surgery. These can include herbal supplements and vitamins. Aspirin regimens and anti-inflammatories are usually stopped several days prior to surgery because they can increase bleeding.

Adults are often asked to quit smoking several months prior to surgery because smokers often take longer to heal than other patients. If you have any specific concerns you should address them with your surgeon.

Children that are having surgery have parents or other adults to follow the doctor’s instructions, but have other more emotional concerns. A little extra love and attention can go a long way of helping children through the nervous anticipation of surgery.

Your surgeon will give you instructions on exactly what to do on the day of surgery. He will also explain what type of anesthesia will be used during your procedure and how long the surgery is expected to take. You will also be given instructions for post-operative care, and when to return for your post-op follow up visit.

Your surgery may take place in a hospital, surgical facility or in the doctor’s office surgical center. No matter where your surgery is performed, you should follow your surgeon’s instructions and be sure to have someone available to drive you home following your procedure. That person could also help you by picking up any post-operative prescriptions and making sure you’re comfortably settled to recuperate at home.

Your surgeon will give you detailed instructions on everything that you need to do prior to your surgical procedure. Patients need to listen carefully to the instructions and be sure to strictly follow them.

Dr. Mark Mitchell Jones of Atlanta Plastic Surgery Associates is a dual board certified surgeon with over 20 years of experience. A first class education and world class training, Dr. Jones has brought his unique combination of aesthetic skill and technical expertise to Atlanta.

Spring Sports with a Newly Constructed Ear

Children who have undergone microtia surgery are often eager to get back into their normal athletic activities. While parents may be reluctant to allow their child to fully participate, as long as the doctor has cleared the child for physical activity, there should not be a problem.

Since microtia repair surgery with the rib graft technique is done in several phases and can take up to 18 months to complete, there will be recovery times when the child may not participate. The longest time is usually after the first surgery, when the incision area on the chest from the cartilage removal needs to heal. The surgeries in phases 2, 3 and 4 are much less invasive and require less recuperation time but the healing process must be completed for normal activities to resume.

After all surgeries and recovery are completed, participating in most types of sports are allowed. The only exceptions to this would be boxing or wrestling. While other sports, including contact sports, carry a risk of injury, both boxing and wrestling can cause direct trauma to the ear and should be avoided.

Kids who have undergone surgery are usually anxious to get back to normal as quickly as possible. Parents, although protective, need to allow their children to participate in any activity they wish. Emotional support for parents and children can be found on websites like www.earcommunity.org.

Traditional spring sports such as baseball, tennis, track, soccer, and swimming are all great individual and team sports that can help build a kids confidence and self-image. Young kids are anxious to participate and even if parents are hesitant, they can feel secure that after microtia repair surgery their children can run and play just like any other kids

Consider Having Ear Reconstruction during School Holiday Vacation

Dr. Mark Mitchell Jones of Atlanta Plastic Surgery Associates of Atlanta, Georgia is encouraging parents of school age children with microtia to consider beginning or continuing the surgical process during the upcoming school holidays.

By starting the process during the school holiday or summer break young patients will miss less school. Dr. Jones estimates that young patients during stage 1 of the microtia reconstruction process will spend 1-2 days in the hospital, go home to recuperate and return 6-8 days later for bandage removal.

Dr. Jones uses the rib graft technique for microtia ear reconstruction. The standard rib graft technique is four-step surgical process and usually takes place over the course of a year. The first surgery where the actual rib cartilage is excised and initially attached is the most complicated and the only surgery in the process that requires overnight hospitalization. The remaining three surgical phases can be easily taken care during the holiday breaks with no lost school time.

When a baby or young child is initially diagnosed with microtia parents often don’t know where to turn. It is often difficult to find information on the condition. Several larger metropolitan areas may have local organizations, there is an online support group on Facebook, Microtia and Artesian Support Group, that has offers support to families and created communities.

To make an appointment with Dr. Jones please call our offices.

Happy Young Ear Reconstruction and Microtia Patients Bring Dr. Mark Mitchell Jones Endless Rewards

Transforming the lives of microtia patients is what it’s all about for Dr. Mark Mitchell Jones of Atlanta Plastic Surgery Consultants. Children travel from all across the country, and even internationally, to have ear reconstruction surgery with Dr. Jones.

Children who undergo the ear reconstruction process need to be about 5 or 6 years old, and the entire process can take a year or more. While there are other options to ear reconstruction with rib graft technique, these other methods do not use the patient’s own tissue and are subject to trauma, rejection, infection, and poor healing.

Dr. Jones thoroughly enjoys the work he does and all the wonderful thank-you notes he receives from parents and his young patients. The cute cards and kind words push him to continue to improve his surgical methods. Dr. Jones has made several proprietary improvements to the standard rib graft surgical technique to address specific situations.

Earlier this year, Dr. Jones reached a milestone of 300 microtia repair surgeries. This surgery is highly specialized and Dr. Jones recommends that parents consider a surgeon’s experience when deciding on ear surgery for their children.

Many parents are eager for information and support when they learn about their child’s condition. Our website features a “Guide to Microtia” that many parents have found helpful. Other resources include Ear Community, which is a group run by other parents for families.

To learn more, please call our office at (404) 355-3566.

Do Children Inherit Microtia?

After a child is born and parents are told of their child’s ear condition, they face a myriad of questions, guilt, and confusion. One of the most frequently asked questions is whether or not microtia is genetic.

The answer is not so simple. Why most experts agree that often there is a genetic component to microtia, just as often there is not. In fact, only 15% of cases have a genetic component that can be identified. Statistically, boys are more affected than girls, and certain ethnic groups (Hispanics and Asians) are more commonly affected than Caucasians and African-Americans.

For most patients, the cause of the condition is unknown and not caused by any behavior by the mother such as smoking, alcohol, or caffeine during pregnancy. An extremely rare reason for microtia can be exposure to Accutane or Thalidomide in pregnancy. These are drugs that are commonly known to cause birth defects, and are both strictly controlled and used only for specific medical conditions.

“Often patients will ask me about genetic testing for microtia. Currently there is no specific test that can be done to identify it and since the percentage of cases that are genetically transmitted as so low, a specific test may never be developed. Often microtia can be determined with prenatal ultrasound testing, although this is not always reliable,” explained Dr. Mark Mitchell Jones of Atlanta Plastic Surgery Consultants.

This issue often arises when parents of a child with microtia are considering having more children. There have been studies that suggest that parents who already have a child with this condition have a 4%-5% increased chance of having another child with the deformity. That’s a very small increase, and most parents would consider going forward with a second, third or more pregnancies.

“I tell parents that the good thing is we can fix this. Your child will not have to go through school and the rest of their life being different from any other kid. They will be able to play sports, dance or do anything their hearts desire. It’s gratifying for me to help these families move on with their lives,” said Dr. Jones.

To learn more, call our office at (404) 355-3566 for an appointment.