All types of ear surgery for microtia are technically difficult to perform. Most plastic surgeons would agree that ear reconstruction is one of the most challenging operations we do. It truly requires an artistic microtia surgeon whose career is dedicated to this condition to get consistent results with the fewest complications. The reason for this is related to the very complex shape that must be created for the ear to look natural.
Anatomy of the Ear
Since there is no natural substitute for the thin, bendable cartilage supporting the natural ear, reconstructed ears cannot bend. The framework (whether made from Rib Cartilage or Medpor) needs to be able to withstand the forces of scar tissue that would distort a more pliable framework.
Currently, microtia surgeons use two techniques to create an ear, Rib Cartilage Ear Surgery and Medpor Ear Surgery. An extensive review of these two techniques is explained in the 5 topics listed on the left under Treatment – Microtia Ear Surgery. These pages will explain how these two techniques are performed through visual presentations, a comparison of both techniques, commonly held misconceptions and new techniques.
An ear Prosthesis is a non-surgical alternative to the two methods of microtia ear surgery described above. It is custom made by a specialist in prosthetics, called an Anaplastologist, to match the normal ear. The ear prosthesis is usually made of silicone from a mold of the normal ear and hand painted to match the patient’s skin tones. If a patient has bilateral microtia, the molds may be made from the parent’s ears. The prosthesis can be attached to the head by an adhesive, or by clips or magnets which require a surgical procedure to implant these into the scalp.
The advantages of an ear prosthesis are:
- A good anaplastologist can create a very realistic appearing ear
- No surgery is required if the adhesive method is used
- Only a small surgery is required if clips or magnets are used
Some disadvantages include:
- There is a visible transition between normal skin and the prosthesis.
- Skin color cannot match the other ear because the prosthesis cannot adapt to natural changes in skin color from sun exposure
- Normal wear and tear will require replacement every few years, which may not be covered by insurance
- The prosthesis requires daily cleaning and removal/application, reminding a patient that it is not part of their body
- An artificial ear does not have the sensation that develops with a reconstructed ear.