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Ear pinning (Otoplasty)

What is ear pinning?

Ear pinning surgery in Iran, also known as an ear correction, otoplasty or pinnaplasty, is a procedure that alters the size, shape or position of the ears. The ears are a prominent feature of the face and can therefore have a large effect on its appearance. Many men, women and children can be unhappy with the way their ears look and seek to correct this.

If you have misshaped or protruding ears or you have a child who does, otoplasty may be for you. Otoplasty is the surgery to correct abnormalities in the structure of the ears. (It’s also known as “pinback otoplasty”).

In a perfect world, the surgery works best on children who are aged four to 14. But adults do undergo the surgery.

This surgery isn’t just for protruding ears, either. Otoplasty can correct:

. Abnormally large ear lobes

. Lop ear (ear tip folds down and trends forward)

. Shell ear (certain features of a normal ear are missing, such as the curve in the outer rim and other natural folds).

What can an ear pinning achieve?

Ear pinning surgery in Iran is often performed on both children and adults. The aim of an ear pinning procedure is to achieve a proportionate and symmetrical ear shape and size. The surgery involves realigning the “pinna” of the ear, so that it is in a position that is more balanced with the rest of the face.

Protruding or disproportionate ears can be a great source of self-consciousness for many people. It can affect the way that they choose to wear their hair, their lifestyle choices and even their career choices. This procedure can greatly improve the appearance of the whole face. It can help boost self-esteem, therefore reducing the psychological harm that many people may experience.

Why have ear pinning surgery?

The ears are a prominent feature of the face, and can have a major effect on its aesthetic. Many people find that they are unhappy with the shape, size or position of their ears. This can therefore cause them to feel self-conscious about their appearance. The ideal ear pinning candidates can therefore include those who have:

. Prominent or protruding ears

. Asymmetrical ears

. An ear size that is disproportionate to the head size

. Reduced self-esteem due to ear shape or size

. Unsatisfying results from a previous ear pinning

Who is a good for ear pinning surgery?

All ear pinning candidates should be:

. Over the age of 5

. Physically healthy

. Emotionally prepared for surgery

. Unhappy with the aesthetic of their ears

. Non-smokers, or have stopped smoking and using all nicotine products for a minimum of 6 weeks before surgery.

. Have no active or ongoing ear infections

When to Consider Ear pinning

. If you were born with overly large or small ears

. If your ears are disproportionate to your head or oddly placed

. If your ears protrude or stick out prominently

. If you have suffered an injury that has negatively impacted the shape or positioning of your ears.

. If your self-esteem or self-image would improve from such a procedure.

Ear pinning procedure

How is an ear pinning procedure performed?

An ear pinning procedure, or otoplasty, often lasts between 60 to 120 minutes. It may be done as a day procedure, or may have to stay in the hospital for one night. Before you go in for your ear pinning surgery, you must follow the instructions your surgeon has given you for eating, drinking and taking medications the night before surgery.

An ear pinning procedure involves the following steps:

1. Consent form

On the day of your surgery, you will meet your surgeon and anaesthetist to sign a consent form for the procedure. You may have signed the consent form in your pre-operative appointment a week before. After you have signed the form, your surgeon will draw lines around your ears and discuss the exact goals of the procedure.

2. Anaesthesia

Ear pinning surgery can be performed using general anaesthetic or local anaesthetic with or without IV (intravenous) sedation. You and your surgeon will discuss which type of anaesthetic is most suitable for you prior to your surgery. Children often have the procedure done under a general anaesthetic.

3. Incisions

Your surgeon will make the incision behind your ear, where the ear meets the head. This incision will expose the cartilage so that the surgeon is able to reshape it. Placing the incision in this area means that the scars are generally very well hidden.

4. Cartilage reshaping

The firm, but bendy part of the ear is the cartilage of the ear, and it is this part that your surgeon will reshape and resize during the procedure. Once your surgeon exposes the cartilage beneath the skin, they will reshape the ears and remove any excess skin or cartilage. The technique they choose to use depends on the goals specific to your ear pinning procedure. After your surgeon reshapes the cartilage, they will secure it into its new position with permanent sutures. These sutures prevent the ears from protruding outwards again.

5. Closing of incisions

The surgeon will close your incisions using external stitches. They will then wrap a tight bandage around your head. This helps stabilise your ears in their new position. Your surgeon will strategically place the incisions behind the natural skin creases, or along the hairline so that they are not visible.

Ear pinning risks and complications

All surgeries come with potential risks. It is important to be aware of the ear pinning risks and complications before you have your procedure. These can include the following:

Scarring

Scarring after an ear pinning procedure is unavoidable. This is because your surgeon must make surgical incisions to perform the surgery. The scars however, tend to be minimal and barely visible. They are strategically placed within the natural skin creases or along the hairline to make them less visible.

The extent of the scarring depends on your skin’s ability to heal. Some patients are more prone to severe types of scarring such as keloid or hypertrophic scars. Patients are usually already aware if they are susceptible to developing these types of scars.

Re-protrusion

In some cases, an ear pinning surgery may not be successful in pinning the ears back adequately. This may lead to the ears re-protruding. This can however, be corrected with revision surgery.

Asymmetry

Asymmetry is a normal feature of all human faces. An ear pinning procedure aims to reposition the ears so that they are as proportionate and symmetrical to the rest of the face as possible. The healing process however, may result in slight discrepancies in symmetry.

Stiff ears

When your surgeon adjusts the cartilage in the ear to a different position, the ears can become less flexible and stiff. If the ears do become stiff, this is usually temporary but it may take several months before they regain their flexibility.

Aesthetic

There is always a risk that you may be unhappy with the final result of your ear pinning surgery. We therefore advise you to choose your surgeon carefully, making sure they understand your expectations.

Altered skin sensation

The surgical incisions that your surgeon makes may damage the nerves in the area that they operate on. This nerve damage can result in numbness or altered sensations (such as pins and needles) to develop in or around the ears. In most cases, the numbness will reduce over time, but this can take several months. In some rare cases, the numbness or altered sensation may persist and become permanent.

Bleeding & bruising

Minor bleeding and bruising is common after an ear pinning procedure. In some cases, a blood clot called a “haematoma”, may also form in the skin of the ear. This will often disperse naturally, but may sometimes need to remove with a small needle.

It is rare to experience severe bleeding, but if this does occur, it requires immediate medical attention.

Inflammation

After an ear pinning procedure, the permanent stitches that hold the ear in place may rise to the surface of the skin and irritate the skin in that area. This may lead to the affected part of the ear becoming inflamed. You may need to have further surgery to correct this.

Infection

Every surgery carries the risk of infection. These tend to be mild wound infections that can be treated easily with antibiotics. Infections can however, become more severe if you do not seek treatment. For this reason, it is important to be aware of the signs of infection. You must flag up any of the following symptoms to your surgeon:

. A temperature of 38° C or more

. Foul-smelling pus or discharge from the drains or incision sites

. Redness that is starting to spread away from the incision site

. Increasing pain or discomfort that is not helped by painkillers

Before surgery

In most situations, the surgery is performed as an outpatient at either the hospital or the surgicenter. In both facilities, quality care is provided without the expense and inconvenience of an overnight stay. An anesthesiologist will monitor you throughout the procedure. Usually, the anesthesiologist will call the night before surgery to review the medical history. If he or she is unable to reach you the night before surgery, they will talk with you that morning. If your doctor has ordered preoperative laboratory studies, you should arrange to have these done several days in advance.

You should not take aspirin, or any product containing aspirin, within 10 days of the date of your surgery. Non-steroidal anti-inflammatory medications (such as Advil, Naprosyn, and Nuprin) should not be taken within 4-7 days of the date of surgery depending on the preparation. Many over-the- counter products contain aspirin or anti-inflammatory drugs. So it is important to check all medications carefully. If there is any question, please call your doctor’s office or consult your pharmacist. Acetaminophen (Tylenol) is an acceptable pain reliever. Usually your doctor will give you your prescriptions at the preoperative visit. It is best to have these filled prior to the date of your surgery.

You must not eat or drink anything 6 hour prior to the time of surgery. This includes even water, candy, or chewing gum. Anything in the stomach increases the chances of an anesthetic complication. Smokers should make every effort to stop smoking, or at least reduce the number of cigarettes. This will help to reduce postoperative coughing and bleeding. If you are sick or have a fever the day before surgery, call the office. If you wake up sick the day of surgery, still proceed to the surgical facility as planned. Your doctor will decide if it is safe to proceed with surgery.

What happens on the day of surgery?

It is important that you know precisely what time you are to check in with the surgical facility, and that you allow sufficient preparation time. Bring all papers and forms with you including any preoperative orders and history sheets. You should wear comfortable loose fitting clothes which do not have to be pulled over the head. Leave all jewelry and valuables at home. Remove all make-up with a cleansing cream. Thoroughly wash your face with soap and water. Do not apply make-up or cream to your face.

Do not take any medication unless instructed by your doctor or the anesthesiologist. Usually in the pre- operative holding room, a nurse will start an intravenous infusion line (IV) and you may be given a medication to help you relax.

During surgery

In the operating room, the anesthesiologist will usually use a mixture of a gas and an intravenous medication to put you to sleep and to maintain your anesthetic at a safe and comfortable level. During the procedure, you will be continuously monitored including blood pressure, pulse, oxygen saturation (pulse oximeter), and heart rhythm (EKG). The surgical team is prepared for any emergency. In addition to the surgeon and the anesthesiologist, there will be a nurse and a surgical technician in the room.

Depending on what is required and whether or not you are also undergoing additional procedures, the surgery may take several hours. Your doctor will typically come to the waiting room to talk with any family or friends once you are safely to the recovery room.

After surgery

After surgery, you will be taken to the recovery room where a nurse will monitor you. You will be able to go home the same day as the surgery once you have fully recovered from the anesthetic. This usually takes several hours. You will need a friend or family member to pick you up from the surgical facility and to take you home. He or she should spend the first night after surgery with you. When you arrive home from the surgical facility, you should go to bed and rest with your head elevated on 2-3 pillows.

By keeping your head elevated above your heart, you can minimize edema and swelling. You may get out of bed with assistance to use the bathroom. It is best to eat a light, soft, and cool diet as tolerated once you have recovered fully from the anesthetic. Avoid hot liquids for several days. Even though you may be hungry immediately after surgery, it is best to go slowly to prevent postoperative nausea and vomiting. Occasionally, you may vomit one or two times immediately after surgery; if it persists, your doctor may prescribe medication to settle the stomach. It is important to remember that a good overall diet with ample rest promotes healing.

You will be prescribed antibiotics after surgery, and should finish all the pills that have been ordered. Some form of a narcotic will also be prescribed (typically hydrocodone/Vicodin), and is to be taken as needed. If you require narcotics you are cautioned not to drive. In some situations your doctor may give you steroids to be taken either preoperatively and/or post-operatively.

 It is very important that you take this medication as prescribed, and not discontinue it prematurely. If you have nausea or vomiting post-operatively, you may be prescribed medications for nausea (anti-emesis), such as phenergan. If you have any questions or you feel that you are developing a reaction to any of these medications, you should consult your doctor. You should not take any other medication, either prescribed or over-the-counter, unless you have discussed it with your doctor.

Recovery and aftercare

When you are sent home, your head will be bandaged. It’s very important that you follow your doctor’s instructions on how to handle the bandage to ensure a smooth recovery.

You will have to wear your bandage for at least three days, if not more. Your surgeon will instruct you on how long you will be required to wear it and how to best manage it while you sleep. When you have the first bandage removed by your surgeon, he or she will provide you with a headband-type dressing. Your surgeon may want you to keep this on for up to three weeks to promote proper healing.

If you have stitches that need to be taken out, your surgeon will do this about one week after the surgery.

You will have scars at the incision site. However, these probably will fade over time.

Your otoplasty may be performed as a day case procedure or you may need a one-night stay in hospital.

You will have a dressing around your head, covering your ears. Your surgeon will advise you how long to keep this in place and if you should wear a smaller and lighter headband to protect your ears once it is removed.

You may have some pain initially and you will be prescribed painkillers that you should take regularly for the first few days. You may also have some swelling and bruising that will subside over time.

You will have a follow-up appointment with your surgeon to assess your progress and let you know when you can resume your normal activities.

You should avoid strenuous exercise, heavy lifting and swimming for six weeks following surgery.

You can expect to take at least a week off work. This will depend on your individual circumstances and your type of employment.

After your bandages are removed and the swelling has gone down, you will be able to see improvements to the contour of your newly shaped ear.

If you must be in the sun you should use a number 15 or greater sun block. You may use your usual make-up any time after surgery. Do not wear earrings or glasses (if possible) for 3 weeks.

Notify your doctor if you have:

. A fever greater than 101.5 degrees F which persists despite increasing the amount of fluid you drink and acetaminophen (Tylenol). A person with a fever should try to drink approximately one cup of fluid each waking hour.

. Persistent sharp pain or severe one- sided pain which is not relieved by the pain medication you were prescribed.

. Increased swelling or redness of the ears.

. Drainage from the wound.

Ear pinning cost

How much does Ear pinning cost in Iran?

The average cost of Ear pinning in Iran is around $1000, Otoplasty costs can widely vary. The average fee referenced above is only part of the total cost – it does not include anesthesia, operating room facilities or other related expenses.

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