Pre-Operative Marking Prior to your surgery, you will have the opportunity to speak with Dr Motykie about any part of your surgical procedure and/or recovery process. You will be asked to change into a surgical gown and Dr Motykie will place surgical markings on your ears. Lastly, make sure to wear loose fitting clothing the day of your surgery that is easy to get in and out of such as sweat pants and a shirt that zippers in the front.
Anesthesia and Operating Facility For almost all otoplasty techniques you most likely receive general anesthesia (you are asleep) for your own personal comfort, safety and surgical ease. It is Dr Motykie’s opinion that the safest and most effective way to perform otoplasty surgery is under general anesthesia. Dr. Motykie uses only Board Certified Anesthesiologists to administer anesthesia and monitor your safety during your surgery. You may be given medication before reaching the operating room so you will feel relaxed before surgery. The surgery takes approximately two to three hours to perform in its entirety. Every surgery is performed in a fully accredited, state of the art (AAAASF) surgical facility where your safety, comfort and privacy are of the utmost importance. Deep vein thrombosis (blood clots) precautions are taken with every patient and include a minimum of anti-embolic stockings and sequential compression devices (SCDs) on the lower extremities during the entire length of your procedure.
After appropriate anesthesia is obtained, an incision is made along the previously made markings that were drawn by Dr Motykie prior to your surgery. Because every ear is unique in its form and projection from the side of the head, there is no absolute standard technique for every otoplasty that is performed. It takes a skilled surgeon with an adaptable armamentarium of techniques to properly reshape and achieve symmetry when correcting prominent ears. Recognizing and understanding the multitude of Otoplasty techniques currently available is critical in order to analyze each deformity individually. In addition, the various techniques often need to be modified or combined in order to obtain the best possible aesthetic result. A surgeon most importantly must remain flexible during the procedure because no single procedure will be effective in all cases since modifying one portion of the ear may affect another in on ongoing manner. Lastly, symmetry must be obtained between the two ears and each surgeon must determine which technique will be most effective in each individual case. However, a poorly defined or “unfolded” ear and an abnormally large bowl at the base of the ear are the two most common problems seen when correcting prominent ear deformities. Both of the structures must be addressed pre-operatively and intra-operatively in order to obtain an aesthetically pleasing result and symmetry after the procedure. In general proper folding of the top of the ear must be created and the height of a large bowl at the base of the ear must be shortened and/or sutured closer to the side of the head. Strong permanent sutures are used to maintain the new shape of the ears as well as placed behind the ear in order to hold the corrected position of the ears in place after surgery. Excessively protruding ear lobes are addressed last and they can be corrected by excising a piece of skin behind the ear lobe in order to shorten and “tuck” a large lobule. The incision in the crease behind the ear is closed with a dissolvable suture that does not need to be removed after surgery. A non-stick dressing is placed over the posterior suture line followed by gauze pads. The patient is given a protective headband and compressive wrap that is to be worn for 2-3 weeks after surgery.
Recovery Room After surgery you will be brought to the recovery area where you will be allowed to rest and completely recover from anesthesia. Nurses will be on staff by your bedside to make sure you are recovering properly as well as being able to provide you with pain medications and small amounts of water and/or ice chips while you are becoming more awake and alert. After you have fully recovered from anesthesia, you may be released to home with a responsible adult or you may choose to stay overnight in an outpatient recovery retreat where there are nurses on staff 24hrs to assist you with post-operative care and medications.
The most comfortable position to recover in after surgery is a reclining chair with your head elevated. Over the first night you will most likely find yourself having to use the bathroom frequently. This is normal and is due to the intravenous fluids you received during your surgical procedure. Leave all dressings intact until the next morning when you will return to Dr Motykie’s office to have your dressings changed and receive further instruction for the rest of the week. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication.