For most patients, recovery after rib cartilage ear reconstruction is relatively short. In general, patients are able to return to light activities after about three days. Dr. Charles Thorne routinely performs rib cartilage ear reconstruction for patients in the New York, NY, area. Two surgeries are typically required to achieve the final result for this type of surgery. Generally, Dr. Thorne recommends a six month healing period between the two procedures. Patients can return to normal activities about three weeks after the final surgery and contact sports six weeks after. Carefully following post-operative instructions can help ensure the best results for you or your child.
Knowing what to expect throughout the recovery process is an important aspect of your treatment.
Most patients have pain in the chest donor site for several days. In addition, they may feel sleepy or groggy after their ear reconstruction surgery due to the anesthesia. Patients generally spend two nights in the hospital and are then discharged. We may attach drains and drainage tubes (like the ones used when you have blood drawn) to the site and leave them in place for a few days.
Dr. Thorne recommends not placing any dressings or headbands on the newly constructed ear. Simply leave it open to the air and apply a small amount of Bacitracin ointment. You can shower normally after about a week, as long as Dr. Thorne believes the healing is progressing adequately.
You will need to attend regular follow-up appointments with Dr. Thorne so he can monitor your progress and provide any additional care. Patients are usually seen about five days after surgery for drain removal and again about two weeks after the procedure for suture removal.
As a general rule, patients may shower after one week, participate in normal activities after three weeks and return to full contact sports about six weeks after surgery.
Most rib cartilage ear reconstruction patients require an additional procedure to elevate the ear and achieve a normal, balanced effect. During the second surgery, Dr. Thorne will use skin and cartilage grafts to lift the ear away from the head, so it properly matches the other ear.
Patients only require about another four to six weeks to heal from this procedure. Once the ear is fully reconstructed and the grafts heal, patients can resume all their normal activities, including sports, swimming, and physical education classes. Since rib cartilage ear reconstruction uses the patient’s own natural tissue, the healing process should be relatively comfortable and result in a lifelike, symmetrical appearance.
Recovery after rib cartilage ear reconstruction requires careful supervision. With proper care and regular visits to Dr. Thorne, this procedure can transform an ear affected by microtia or another ear deformity and create a natural-looking, balanced result. To learn more about recovering from ear reconstruction, contact our office online or call (212) 794-0044 today.
If you are considering ear reconstruction surgery for microtia, injury, or another deformity, it is important to weigh the different treatment options available and determine, with the help of the surgeon, which option is best for you and your situation. Choosing between a rib cartilage framework and a polyethylene framework (MEDPOR®) is an important decision. Dr. Charles Thorne will explain the advantages and disadvantages of each treatment during your appointment at his New York, NY, office and recommend a treatment plan based on a careful evaluation of your needs. In most cases, Dr. Thorne prefers to use the patient’s own tissue. However, there are some cases in which using the artificial material is the best choice.
Dr. Thorne can help patients weigh benefits of the two techniques to arrive at an informed decision.
The main differentiating factors between these two treatment options is the material used to fashion the framework and the need for scalp tissue. With rib cartilage ear reconstruction, Dr. Thorne uses the patient’s own cartilage tissue from the rib cage to sculpt a new ear framework. Because the framework is made from the patient’s own tissue, it can be covered with the skin in the area and does not require tissue from the scalp.
The MEDPOR technique uses high-density polyethylene to create the framework. Because the framework is a hard form of plastic, it must be covered with a thin layer of tissue from the scalp called a fascial flap and a skin graft on the surface of the fascia.
Dr. Thorne can perform MEDPOR ear reconstruction on children as young as three years old but prefers to wait until age eight to 10. For the rib cartilage technique, there is no choice but to wait until age eight to 10 because the cartilage must be large enough to create the framework.
A typical ear reconstruction with rib cartilage framework or polyethylene (MEDPOR) framework requires at least two surgical procedures separated by several months.
Dr. Thorne believes the best option is to use the patient’s natural tissue whenever possible. However, he recommends MEDPOR reconstruction if the patient’s rib cartilage has already been harvested in previous attempts at ear reconstruction.
Rib cartilage reconstruction is associated with discomfort in the chest donor site for several days. The MEDPOR technique, on the other hand, does not involve as much pain. However, it does result in scarring on the scalp from the fascial flap and scars behind the other ear to obtain the skin graft. So, each technique carries its own disadvantages
When it comes to ear reconstruction, the most durable and lasting results come from using natural, living tissue. Rib cartilage frameworks are more resistant to trauma, feel more lifelike, and can last a lifetime. The long-term lifespan of MEDPOR is unknown, as the product has only been used for ear reconstruction since 1991.
While MEDPOR is a good solution for some patients, Dr. Thorne believes the best option is to use the patient’s own tissue whenever possible. MEDPOR is a foreign material. The hard plastic often feels unnatural or uncomfortable and will always carry the risk of exposure, infection, or in extreme cases, complete loss of the framework. Once the rib cartilage framework is in place, it heals like any natural tissue and can provide lasting results with a lower risk of complications.
The best way to find out which type of ear construction is right for you is to schedule an appointment with Dr. Thorne. He can examine your or your child’s ear and determine which material is best suited to your unique needs. For more information about the differences between rib cartilage ear reconstruction and reconstruction with a plastic framework, contact the office online or call (212) 794-0044.
Patients with microtia usually have aural atresia, which is the absence of the external auditory canal, eardrum, and connection to the middle ear. In addition, there are usually abnormalities of the middle ear structures. These patients have hearing problems that are different from the hearing loss that occurs as part of the aging process and traditional hearing aids will not help them. For microtia patients, whose hearing problem is related to the middle ear, the hearing can often be restored with a bone-anchored hearing aid (BAHA).
This device can either be worn on a headband in a newborn or very young child or attached to a titanium implant in the skull to bypass the middle and outer ear and directly stimulate the cochlea of the inner ear. In turn, the cochlea sends neural signals to the brain which translate into sound. As part of the comprehensive ear center at Lenox Hill Hospital in New York, NY, Dr. Charles Thorne can arrange for you to obtain a BAHA. Backed by over three decades of experience in microtia surgery and the treatment of ear deformities, Dr. Thorne is a trusted expert who is passionate about improving patients' quality of life.
BAHAs owe their effectiveness to a small titanium implant.
A BAHA consists of two or three parts depending on the type: a titanium implant, a sound processor, and possibly an abutment that connects the implant and the sound processor. In some patients, the sound processor is attached to the titanium implant with a magnet. During a short surgical procedure, a colleague of Dr. Thorne will place the implant into the bone behind the non-functioning ear.
The BAHA works by using the natural transmission pathways which are available through bone vibrations. The sound processor sends vibrations through the skull to the implant which, in turn, vibrates the surrounding bone. The bone then sends the vibrations to the inner ear where they are processed by the auditory nerve as sound waves.
Ideal candidates for a bone-anchored hearing aid have issues which affect the middle ear or ear canal, such as patients with microtia. Since BAHAs bypass the middle ear, they can be especially helpful for patients who have:
Implanting a BAHA is a simple procedure which takes about an hour to complete. Local anesthesia is often sufficient although some patients might also receive general anesthesia. Some skin follicles and fat behind the deaf ear will need to be removed before treatment. A skin graft may also be placed.
BAHAs can offer an effective hearing loss solution, even for patients who may be frustrated with past treatment experiences.
Once preparation is complete, a small hole is placed in the skull and the implant is inserted. If the magnetic type of BAHA is used, then only the implant is necessary before closing the scalp. If an abutment is used to attach the BAHA, a skin graft is then placed around the abutment.
In general, it takes about two months for the implant to fully heal, at which time the sound processor can be attached to the abutment. The advantage of the magnet is that there is no bald spot or visible abutment.
BAHAs can offer an effective hearing loss solution, even for patients who may be frustrated with past treatment experiences. If you believe you or your child could benefit from this type of device, contact the office online or call (212) 794-0044 today.
If you are dissatisfied with the results of a previous microtia surgery, Dr. Charles Thorne can perform microtia surgery revision at his practice in New York, NY. Microtia is a rare condition and there are only a small number of doctors who regularly perform ear reconstruction. For over 30 years, Dr. Thorne has dedicated his practice to performing ear reconstruction and otoplasty. Whether you had a rib cartilage ear reconstruction or MEDPOR® ear reconstruction, Dr. Thorne has the experience and training to revise your previous surgery and help you achieve the results you desire.
Revision surgery can help patients feel completely satisfied with their appearance.
Surgical inexperience, along with unforeseen complications, can create unsatisfactory results for microtia repair patients. Revision surgery can address a range of concerns, such as:
In some cases, patients who undergo microtia treatment at a young age may outgrow their prosthetic or reconstructed ear. Others may experience side effects due to materials used in the reconstruction.
If you are dissatisfied with the results of a previous procedure, the first step is to schedule a consultation with Dr. Thorne.
Dr. Thorne can choose between several forms of reconstruction to improve the results of a previous microtia surgery.
During the appointment, you can explain your concerns in detail and discuss your medical and surgical history. Then, he will perform a full evaluation of the treatment site and assess your facial symmetry, hairline, and the anatomy of your other ear. Based on the information he gathers, Dr. Thorne can design a treatment plan suited to your unique needs.
Dr. Thorne offers several forms of ear reconstruction which can help improve the results of a previous microtia repair surgery. The best option will depend on what type of surgery you had in the past and the types of results you are hoping to achieve.
Issues resulting from rib cartilage ear reconstruction may be aesthetic or functional, or a combination of the two. If the appearance of your reconstructed ear bothers you, Dr. Thorne can replace the framework by using tissue from the other side of your rib cage. However, if your body is rejecting the harvested tissue, you may experience better results with a MEDPOR ear reconstruction. For some patients, the biocompatible material offers a safe alternative to cartilage.
Dr. Thorne can replace unsatisfactory MEDPOR frameworks with rib cartilage or a new polyethylene framework. MEDPOR ear reconstructions are prone to exposure of the polyethylene framework which requires a procedure to ensure that the entire framework is covered with healthy tissue. However, Dr. Thorne can precisely plan and perform your procedure to ensure natural-looking results.
In some cases, scar tissue from previous reconstructions can interfere with revision surgery. Dr. Thorne can use a silicone prosthetic to immediately restore the appearance of your ear without surgery. Prosthetics can be attached to the skin with adhesive or titanium posts which are embedded in the bone for added stability. Typically, prosthetics are only recommended as a temporary solution or for older patients who do not have an active lifestyle.
For some patients, ear reconstruction for microtia is a long and difficult process. Dr. Thorne recognizes that reaching the end of this process and seeing unsatisfactory results can be incredibly frustrating. Learn more about the benefits of revision surgery for microtia repair by contacting his office online or calling (212) 794-0044 today.
For patients who do not qualify for reconstructive ear surgeries such as rib cartilage ear reconstruction or MEDPOR® ear reconstruction, we can fashion customized silicone prosthetic ears to restore facial symmetry. While these prosthetics cannot improve hearing, they do offer realistic, aesthetically pleasing results for adults or adolescents.
Dr. Charles Thorne is Chairman of the Department of Plastic Surgery at Lenox Hill Hospital and the editor-in-chief of Grabb and Smith’s Plastic Surgery, the premier textbook in plastic surgery, and has designed prosthetics for many patients at his Lenox Hill, Manhattan, practice. You can view previous patient’s results in our gallery.
Silicone ears are prosthetics used to create symmetry with your healthy ear. An experienced anaplastologist can create the prosthetic from a mold of your ear so that they match in shape, size, and color.
When selecting your silicone prosthetic ear, there are two types to choose from. The first type attaches to the skin temporarily with a safe and biocompatible adhesive. The second type is known as an osseointegrated prosthesis and attaches to the head using titanium implant posts that are inserted into the bone around the ear. Although both types are removable, the osseointegrated prosthetic ear provides more durability and security.
Prosthetic silicone ears are usually recommended to patients who are unable to qualify for reconstructive surgeries
Regardless of which kind you opt for, you should remove your prosthetic ear nightly before sleeping or before any athletic activities. With attentive care, a prosthetic can last one to three years.
Prosthetic silicone ears are usually recommended to patients who are unable to qualify for reconstructive surgeries or to older patients whose health could be at risk with cosmetic ear surgery. Because the attachments are temporary, prosthetics are not ideal for children, as they could fall off during play. The ideal candidates are elderly patients or patients whose ears are so scarred from trauma or previous attempts at ear reconstruction that no further reconstruction is possible.
Since silicone prosthetic ears do not require surgery, they are often a beneficial option for patients who are looking for immediate results or who do not qualify for reconstructive surgery due to health reasons.
However, patients should be aware that silicone prosthetic ears are fashioned from realistic looking materials, rather than using your own tissue. As a result, the outcome is not as lifelike as that of MEDPOR® or rib cartilage ear reconstruction. It can also be difficult to conceal the area where the ear and head meet and may leave some patients dissatisfied or frustrated with the appearance of their ear. While initial treatment is faster and more affordable than surgical procedures, the silicone prosthetic must be replaced periodically and costs can begin to add up. Both the pros and cons of this option should be considered carefully when deciding on treatment.
If you or your teenage child suffer from microtia and have been unable to qualify for traditional ear reconstructive procedures, you may find success with a customized silicone prosthetic ear. To schedule a consultation with Dr. Thorne and discuss your options, please contact our office today online or give us a call at 212-794-0044.