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Ear Reconstruction


Ear Reconstruction

Just like noses, eyes and lips, ears can look quite a bit different from one person to the next, but our minds will see almost all of them as normal. There are some key features that our minds look for when determining if an ear appears normal or not. Ear reconstruction is performed to restore missing parts of the ear or completely replace missing ears. Partial reconstruction of the ear is commonly performed for some congenital ear shape differences and loss of parts of the ear after trauma or after Mohs surgery or cancer surgery. Reasons to create an entirely new ear include for congenital absence of the ear (microtia) or surgical or traumatic amputation of the ear. For more information on ear reconstruction for microtia visit Dr. Derderian’s pediatric website drderderian.com.

Ear Reconstruction of Part of the Ear

There are many options for treating each partial ear deformity. The considerations include the parts that are missing, the condition of the surrounding tissues and the desires of the patient with regard to the time and number of steps to the reconstruction and the degree of refinement they desire in the outcome. Below is a case example showing a patient with a traumatic injury to the helical rim and after a 2-stage reconstruction using skin from behind the ear to replace the missing soft tissue.

Total Ear Reconstruction

There are three main approaches to reconstruction of the external ear. The first method uses an implant called Medpor to create a normal appearing ear. The second, also the oldest approach to ear reconstruction, uses the patient’s rib cartilage. The rib cartilage is harvested from the chest and carved and assembled into a framework with a shape similar to the Medpor framework. The third method is to use a prosthetic ear that is glued to the skin with adhesive or anchored to implants in the bone. This prosthesis can be removed.

Rib Cartilage Ear Reconstruction

This approach is the oldest and most widely performed technique for ear reconstruction. It has been used for over 50 years. This approach is usually performed at age 10 years of age or older. The general idea is to harvest the strong cartilage from the rib cage, carve this cartilage and assemble it into a framework using wires or suture material. The framework is placed under a skin pocket in the location of the microtia to create a new external ear.

Dr. Derderian does not favor the rib cartilage approach for total ear reconstruction. Deformity and pain in the chest donor site, the number of surgeries required and the poor quality of the average result are all reasons why he favors a Medpor-based approach to ear reconstruction.

Am I a Candidate for Ear Reconstruction?

If you have an ear deformity you may be a candidate for any number of approaches to ear reconstruction. The nature of your ear deformity and previous surgeries will be important considerations. The quality of the surrounding soft tissues impacts the available options for ear reconstruction. Dr. Derderian will perform a history and examination and will discuss the available options with you in detail. He will customize options for treatment based upon your goals and the anatomy of your ear and the surrounding tissues. It is important to have realistic expectations for what ear reconstruction can provide.

What is the Recovery?

The recovery depends on the nature of the ear deformity. For most patients the surgeries are ambulatory, meaning you come in and go home the same day. Total ear reconstruction patients will often stay one night in the hospital. The recovery period varies based upon the number of stages to the reconstruction and what donor tissues are used for the reconstruction. In general the reconstructions are not painful.

When is the final result appreciable?

There may be 1-3 stages to your ear reconstruction based upon the nature of the deformity. Regardless of the number of steps, the ear will have normal contour and coloration within 2-3 months of the last stage of reconstruction. It usually takes 6-12 months for the skin to completely normalize in coloration.

What is the Cost of Surgery?

Ear reconstruction surgery is covered by most insurance providers. Out of pocket expenses for those without insurance include:
  • Anesthesia Fee
  • Facility fee
  • Surgeon’s fee

Why Choose Dr. Derderian?

Dr. Derderian developed a passion for ear reconstruction early in his training. During his plastic surgery residency at New York University he had extensive training in ear reconstruction with Dr. Charles Thorne, a world-renowned expert in ear surgery. After completing his residency, Dr. Derderian did a fellowship in craniofacial surgery at the University of Pennsylvania and Children’s Hospital of Philadelphia where he received further dedicated training in ear reconstruction with Dr. Scott Bartlett. Dr. Derderian is board certified by the American Board of Plastic Surgery. He is a well-recognized expert in ear reconstruction for acquired and congenital anomalies such as microtia and constricted ears and he regularly performs ear reconstruction in both his pediatric and adult practices. Dr. Derderian is frequently asked to give lectures about ear reconstruction and has multiple publications detailing his approach to ear reconstruction.

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