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					                                                    Auriculoplasty
                                                     /Ears Surgery/

      Situated at the outer face contour, the ears are a major
factor in defining facial proportionality and its harmonious
profile. Traditionally we think of the ears just in their function to
analyse aural impressions; its form though is an important
aesthetic component. As such the ears more often bring a sense
of embarrassment, not of satisfaction. Certain ear proportions are
sociably accepted and every departure from the norm can affect
self-image and confidence.
      If you are bothered by the size or shape of your ears, then
cosmetic ear surgery, or auriculoplasty, may be right for you. It
will improve the form of the ears and will reposition the auricle,
enhancing facial harmony and self-confidence.

     This brochure presents an overview of ear surgery. The
best way to learn how surgery of the ears can help fulfill your
personal goals is a consultation with a plastic surgeon.

      When considering plastic surgery, make sure you know the
following:


      ■Your surgeon is a licensed physician to practice medicine
in the country you are having the procedure
      ■Your surgeon has completed extensive training and
examinations in plastic surgery
      ■Your surgeon is a member of a national plastic surgery
society that is recognized by the International Confederation of
Plastic, Reconstructive and Aesthetic Surgery (IPRAS)


     What is cosmetic surgery of the ears?
     Cosmetic surgery of the ears, or auriculoplasty, is a
procedure to improve the form of the ears. Specific features
addressed in cosmetic surgery of the ears include:
          Ear size doesn’t correspond with facial features
          Some parts of the ear are not proportionate to other
             ear components
          The angle between the ear and the cranium is
             bigger than usual – “drooping ears”
          An asymmetry between the ears referring to their
             size, form and position
          Traumatic or congenital absence of an ear part or
             the whole ear




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     These features are generally due to heredity, however they
can be caused by injury. In most cases, the characteristics of the
ears are not the only factors contributing to facial imbalance.
The facial structure may also contribute to imbalanced facial
proportions. Facial disharmony could be enhanced by the skull
form, the hair-style, racial and ethnic characteristics.

     Cosmetic ear surgery doesn’t improve ears functionality.
The effect is mostly cosmetic. Ear surgery is best performed
when facial growth is complete, around the age of 16-18. Good
candidates for this procedure are:

      ■Healthy individuals who do not have a life-threatening
illness or medical conditions that can impair healing
      ■Non-smokers
      ■Individuals with a positive outlook and specific goals in
mind for improvement

     Where do I begin?

     A consultation with your plastic surgeon is the first step to
learn how ear surgery can improve the appearance and
proportions of your ears and facial harmony. A consultation is
designed to fully educate you in a non-pressured environment,
and will include:

     ■A discussion of your primary concerns and an evaluation
of your individual case
     ■The options available for surgery of the ears
     ■The likely outcomes of surgery and any risks or potential
complications
     ■The course of treatment recommended by your plastic
surgeon

     Your plastic surgeon will also answer your questions.

     Evaluation


     Overall health and personal outlook can greatly impact the
outcome of ears surgery. These will be carefully evaluated in
consultation. Be candid about your desire to improve your
appearance, your medical history, prior surgeries, allergies, and
medical treatments. The success of your procedure, safety and
overall satisfaction requires that you:

      ■Honestly share your concerns
      ■Fully disclose health history, current medications, the use
of vitamins, herbal supplements, alcohol, tobacco, and drugs
      ■Commit to following all of your plastic surgeon's
instructions precisely




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      Safety
      By making the decision to consult with a plastic surgeon
and following all the instructions given, you are taking important
steps in helping to assure your safety.
      Your plastic surgeon should have completed surgical
training and examinations in plastic surgery which uniquely
qualifies them to perform cosmetic and reconstructive procedures
of the face and entire body.

     My ear surgery

      Cosmetic surgery of the ears is an individualized procedure
that takes into account all the specific characteristics that
contribute to the overall appearance of the ears and its relation to
other facial features. Your plastic surgeon will carefully evaluate
your individual case and goals for improvement to determine
specific features to address through ear surgery. Appropriate
techniques will then be defined and may include:

     ■Reducing the size of the auricle or its components
     ■Adjusting the angle between the ear and the cranium
     ■Reconstruction of the ear or of some of its components,
using surrounding skin or silicone implants

     If you desire more symmetrical ears, keep in mind that
everyone's face is asymmetric to some degree. Results may not
be completely symmetric, although the goal is to create facial
balance and correct proportion.      Facial augmentation with
implants of the chin, cheeks and jaw may further enhance your
outcome.

     Preparing for surgery

     Your plastic surgeon will carefully explain the surgical
procedure recommended for your specific case. Prior to surgery,
you will be given specific instructions that may include:

     ■ Pre-surgical considerations, diagnostic testing and
medications
     ■    Day of surgery instructions and medications
     ■    Specific information related to the use of anesthesia
     ■ Postoperative care and follow-up

      In addition, you will be asked to sign consent forms to
assure your plastic surgeon that you fully understand the
procedure you will undergo and any risks or potential
complications.
      The risks associated with ears surgery include skin or
cartilage infection, follow-up bleeding of the incision sites;
asymmetry of the auricles; low skin sensitivity in some ear parts.
Surgery of the ears is a procedure in which aesthetic outcomes
can be unpredictable, and in some cases a second procedure may
be necessary to fully achieve your goals. These risks and others as


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well as those associated with anesthesia will be discussed prior to
your consent.
      It is important that you address all your questions directly
with your plastic surgeon. It is natural to feel some anxiety,
whether excitement for the anticipated outcomes or preoperative
stress. Discuss these feelings with your plastic surgeon.

     What to expect

       Surgery of the ears may be performed in your plastic
surgeon's office-based surgical facility, an ambulatory surgical
facility or a hospital. The decision for anesthesia will be based on
the requirements of your specific procedure and considerations of
patient and surgeon preference. Your plastic surgeon and the
assisting staff will fully attend to your comfort and safety.

     Following surgery

     Once your procedure is completed, a bandage will likely be
placed around your ears to protect the ears from accidental trauma
during initial healing.     Before you are released following
surgery, you and an accompanying family member, friend or
caregiver will be given specific instructions that may include:

     ■How to care for the surgical site
     ■Medications to apply or take orally to aid healing and
reduce the potential for infection
     ■Specific concerns to look for at the surgical site or in your
general health
     ■When to follow up with your plastic surgeon

     Progress and healing

      The dressings will be removed on the following day. The
elastic bandage that protects the ears has no contribution to the
ears form. It has to be on 15 days round-the-clock and 15 more
days just during sleep.
      Healing will continue for several weeks as swelling
continues to dissipate and the improved appearance of your ears
begins to become apparent. Diligent sun protection is
recommended as you continue to heal. You must also protect
your ears from injury during any physical activity for the next 4
to 6 months.

     Results and outlook

      The outcome of your ears surgery will appear gradually
from 3 to 6 months. In general, the results of ear surgery are
permanent; however, ears must be protected from trauma and
injuries, especially from the back of the neck to face ones.
      You should be pleased with the improved balance among
your facial features resulting from surgery of the ears.
Asymmetry, if any, will be in acceptable levels. Achieving your


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personal goals for an enhanced appearance will likely increase
your self-confidence.




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