Saturday, 18 May 2013

Ear lobe reconstruction

Split ear Lobe-Repair under operating microscope

Since ancient times, men and women in all civilization have been adorning their ears with earrings for ornamental ad cultural reasons…

Over the years, the tradition of earrings in India has strengthened and today it is customary for women in most communities to have their ears pierced from an early age.

Torn earlobes are one of the most common problems effecting people with pierced ears. Earlobes may have enlarged holes or be split as a result of heavy earrings or pulled earrings. The increasing practice of ear piercing has resulted in more and more requests for ear lobe repairs.

Methods of reconstruction

Split ear lobe repair under an operating microscope

Depending on the deformity, reconstruction can take different forms. In all methods, the skin lining the slot is removed creating a raw edge to rebuild. Lost tissue complicates matters and reconstruction centers around reestablishing normal proportions in a somewhat smaller ear.

Layered closure using fine suture materials under local anesthetic is performed. Either straight line closure or z pasty can be done to reduce the scar line.

Scar formation and keloid tendency is to be born in mind before embarking on the procedure. An informed consent in this regard is taken before surgery.

Most patients should be explained about the possible scar line, and delay before wearing another ear ring or re piercing (minimum six weeks).They should be told to take extra care not to get the wound infected, avoid UV light while going out.

A cosmetic make up with UV sunscreen will camouflage the scar for the six weeks period. Or start wearing a clip on ear stud after 3-4 weeks before re piercing.

Postoperative Care

A thin layer of antibiotic ointment (Neosporin®) is the only dressing needed in most cases. You may wash your hair after putting the ointment.

The sutures are removed in 7 days.

Re piercing

Wait minimum of six weeks, No compromise on this, even if the patient becomes “impatient”

Clip on earrings may be worn 3-4 weeks after surgery.

How to avoid scar and keloid-Scar care

After sutures are removed, one can start rubbing Contratubex® gel twice a day for a month or two. It will prevent thickened scar formation to a great extent.

The active ingredients in Contratubex® are cepae extract, heparin and allantoin.

•Cepae extract is obtained from onions. It generates an anti-inflammatory, bactericidal effect. And it reduces swelling while preventing excessive growth of the connective tissue.

•Heparin loosens the tissue structure. It has an anti-inflammatory effect and helps to bind water to the scar tissue.

•Allantoin encourages wound healing and has a soothing effect. In older scars its most important effect is to replenish and regulate the extreme lack of water in the scar tissue – and to promote blood flow

Using Operating microscope for Split ear lobe repair

Occasionally I use operating microscope to repair the split ear lobe, in “costomers” who are very demanding and want perfect result, often coming from the upper class.

But I must admit, the results are much better when I used the operating microscope,although takes more time , and  not always easy when I  have got a tight schedule, with other more important surgical procedures waiting.