LASER OTOPLASTY, THE NEW FRONTIER

Author: Dott.ssa Battistella Melania

Date: 22/04/2020

The angle formed by the incidence of the hollow of the ear with the skull should not exceed 30° according to current aesthetic standards. We speak of otoplasty, or ear surgery, in the case of facial surgery aimed at restoring harmony in cases where, for example, it is the structure or any asymmetries that must be corrected, or the protrusion of the outer ears and certain deformities, such as the lack of the appropriate skin folds. Depending on the aesthetic problem presented by the patient, the surgeon will evaluate which area they will operate on and how.

A very popular surgery is the correction of prominent (so-called "sticking-out") ears. This is also recommended in children as it avoids the psychological discomforts that this issue can entail. Often as a joke, in fact, they become a reason for mockery and this leads to a drop in self-esteem in the child. Since the outer ears have been definitively developed by the age of seven, it can be subject to aesthetic changes.

In this specific case, the surgical procedure involves cutting into the back of the ear where it is closest to the head, removing the excess cartilage and skin from the hollow, the cause of the protrusion of the ears, and suturing the edges.                                                                   
When, on the other hand, the protrusion of the ears is due to insufficient formation of the anti-helix, this curvature of the cartilage is manually created and maintained by means of traction sutures.                                                                                                                                                   
Once the otoplasty is complete, an elastic bandage is applied as a support and the patient must take the prescribed medication, such as antibiotics.                                                                                             
Once this is done, the ear regains the right proportions and the result is absolutely permanent with the advantage that the scars are not visible because they are hidden in the fold behind the ear.  

Nowadays, the cosmetic surgeon has at their disposal the use of a scalpel and, more recently, the CO2 laser.                                                                   For the latter, the advantages are considerable. In fact:

it limits the swelling and possible post-operative bruising as there is a decrease in blood loss due to the ability of the laser to coagulate the incisions immediately, avoiding unnecessary bleeding

- it reduces the healing time with regard to scarring as the CO2 laser makes it possible to make very precise incisions that are so thin that they do not leave obvious scars even after suturing and therefore have improved quality

The incision site remains the same therefore, after healing, it will be very difficult to identify the residual scars.                                                                                                                                        
There have been studies conducted on mice on histological analysis "to evaluate the remodelling of cartilage in laser-assisted otoplasty which show that the partially laser-ablated cartilage grew back in the form of columns and that the regeneration process, originated by the chondroblasts as well as from the perichondrium cells, was strongly stimulated by the laser energy delivered".

It is true, however, that scarring is affected by individual characteristics.

Laser otoplasty is performed under local anaesthetic accompanied by a fairly deep sedation, does not require hospitalisation and is safe in terms of risks and complications. These are infrequent; however, to be precise, there may be infections, pain, numbness or excessive redness. Sometimes asymmetry may occur between the two ears caused by an error in the removal of the skin and cartilage and in these cases further surgery is required.

The procedure takes about twenty minutes per ear. It is important to remember the bandage used to compress the outer ears for the first few days. This also affects the sleeping position, which in the days following the operation must be lying on your back with your head slightly elevated.

The first check-up is performed the day after the operation and then after six days for the removal of the stitches and bandage and you can quickly return to everyday life.

The results described in the literature so far are positive as is the feedback from patients.

Dott.ssa Battistella Melania

Author

Dott.ssa Battistella Melania

Medico Estetico

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