Definition and Overview
Auroplasty is a surgical procedure used to repair the ear lobe. It is categorised under otoplasty, an umbrella term used for any cosmetic ear surgery.
Who Should Undergo and Expected Results
Auroplasty is most commonly recommended to patients with stretched or enlarged holes in the ear lobe, or have a torn or split ear lobe. These conditions are typically the result of any of the following:
- Repeatedly wearing heavy jewellery, specifically earrings
- The popularity of ear stretching or ear gauging, formerly only seen in African tribes
- Increasing use of a variety of ear ornaments, including flesh plugs and gauges
- Trauma, which in worse cases, can result in the hole tearing through the ear lobe.
Auroplasty can also be performed for aesthetic purposes and can be recommended for patients who are bothered by having large ear lobes or have lesions on this part of the ear.
With proper care and wound healing, the hole in the ear lobe eventually closes off. After approximately 3 to 6 months, the ear may be re-pierced but preferably not along the area of the operation.
How is the Procedure Performed?
Auroplasty is a simple procedure performed on an outpatient basis and on average, it takes less than an hour to complete.
After cleansing the area and placing sterile drapes, local anaesthetic is used to numb the surgical site. Once the effects of the anaesthesia have taken effect, the edges of the hole in the ear lobe are incised, making the edges raw and fresh. In some cases where the tear is incomplete, the incision may be extended in order to complete it to facilitate proper wound healing.
There are several techniques for repairing the ear lobe. The simplest kind is a straight excision. However, the problem with this repair is that the scar may eventually shorten through time, resulting in a crunched up appearance of the ear lobe. A frequently used alternative is the Z-plasty, which results in a differently shaped scar.
A suture (stay suture) is drawn through the tip of the defect to approximate its edges. The edges are then joined together, making sure that they are everted. The wound is then closed using simple interrupted sutures anteriorly and posteriorly.
For some patients, a small hole may be left behind so that the patient can still wear an earring. However, some surgeons discourage against the preservation of a hole as it can lead to improper healing and weakness of the wound. Thus, in most cases, the defect is allowed to close completely before having the ear lobe pierced at a later time.
Defects of the ear lobe are fairly simple to repair. However, large defects that involve tissues may require more extensive procedures. In some cases, cartilaginous support may have to be provided and local flaps performed. If necessary, the lower margin of the ear lobe is also reconstructed or reshaped.
Once the procedure is completed, sterile dressing is applied on the wound. The wound may then be left open to dry after about a day. Sutures are removed during a follow-up with the surgeon, usually after 3 to 5 days.
Possible Risks and Complications
Although auroplasty is a simple procedure, complications can still occur. These include:
Slight pain and inflammation at the surgical area - These can be adequately managed by anti-inflammatory medications and typically resolve after several days.
Bleeding - As with any surgical procedure, bleeding is a concern. Hematoma formation can occur after the operation, manifesting as a lump of blood with associated pain. Significant hematoma should be evacuated immediately.
Infection - Antibiotics may be given after the procedure to prevent this complication from occurring. Uncontrolled infection can lead to the formation of abscess and inflammation of the ear cartilage or perichondritis. If not treated, an infection can result in permanent disfigurement of the ear.
Wound healing complications - Complications related to wound healing are the most frequently encountered complications in ear surgery. Sensitivity or allergies to suture materials can result in granuloma formation. Most scars after the procedure heal well after some time but patients who are prone to the formation of keloids and hypertrophic scars can develop these unpleasant complications after the procedure.
Converse, John Marquis; Nigro, Anthony; Wilson, Frederick A.; Johnson, Norman (1955). "A technique for surgical correction of lop ears". Plastic and Reconstructive Surgery (1946) 15 (5): 411–8.
da Silva Freitas, R.; Sanchez, M. E. R.; Manzotti, M. S.; Baras, F.; Ono, M. C. C.; de Oliveira e Cruz, G. A. (2008). "Comparing Cephaloauricular and Scaphaconchal Angles in Prominent Ear Patients and Control Subjects". Aesthetic Plastic Surgery 32