Thank you for your question.
You're asking if your doctor is wrong for not recommending that you wear a headband
after having otoplasty surgery.
And then in your research, you’ve learned that other doctors do recommend wearing a
headband.
And that you're also concerned about the swelling of your ear.
Well certainly I can assist you and guiding you about what’s going on.
I’m a board certified cosmetic surgeon and a fellowship trained oculofacial plastic and
reconstructive surgeon practicing in Manhattan and Long Island for over 20 years.
And otoplasty is a part of my practice and I do have some opinions of how I approach
prominent ears.
But certainly I can give you a perspective from what I am seeing with the photos you've
submitted.
So my first observation is of course that you also have stitches where there would be
for a facelift.
So it appears to me that you had both a facelift and an otoplasty done at the same time.
And that your concern is in less than a week’s time since your stitches are still present
at least from what I see on your photo.
So with that being said, your doctor performed this otoplasty and if you trusted your doctor
to do your facelift and your otoplasty, I can’t see why there would be that much of
a doubt that your doctor is somehow not guiding you properly in the aftercare.
You know, with the facelift most likely you already had a kind of a bandage which to some
degree could have helped support the splinting that is often a benefit after otoplasty.
Just to, kind of, give you an understanding what otoplasty means from a surgeon’s perspective
is basically when you're dealing with prominent ears, you're dealing with two types of issues.
One is called a hypertrophic or enlarged conchal bowl which is the central part of the ear.
And then there is the absence of a defined antihelical fold which is the upper part of
the ear.
So when there is a hypertrophic or thick and conchal bowl, a middle third of the ear, the
options are I think it had to do something called the setback where the – where sutures
are just used to pull the ear inward or to actually do resection of cartilage and suture
the cartilage to the fascia or the mastoid fascia against the neck towards the skull.
And then with the antihelical fold is basically what most doctors do is some variation of
something called a mastoid procedure which is weakening the cartilage and using some
type of horizontal mattress sutures which is technical term.
But basically folding from the inside the ear so it’s closer to the – to the – to
the head and it creates that fold.
Now it’s not surprising that you do have a fair amount of swelling considering you
had both the face lifting surgery and the otoplasty at the same time.
The important thing here is that your doctor’s judgment on how much support and splinting
is necessary.
It is a routine in my practice to use headbands but it is not a routine for me to do otoplasty
at the same time as a facelift.
It just doesn’t seem to be something that people want when they have face lifting.
A lot of our patients who have facelifts are women which is reflective of the norm.
And a lot of times they wear their hair long so they’re not that concerned about prominent
ears.
But as far as the reason for not wearing the headband, I would suspect your doctor may
be concerned that the headband may be putting too much pressure.
And can potentially cause a fracturing of the cartilage in a way that would be undesirable.
So it appears that at least the ears are in good position relative to the head so that
chances are your doctor probably feels comfortable with the way it looks without adding more
pressure.
It might also be related to the facelift and other concurrent procedures.
So I think it’s unfortunate for you that you feel like that you want to question that
– your doctor was right or wrong because in medicine, it’s always about judgment.
It rarely is any situation is very black and white.
It is a lot of gray and a lot of that gray comes from the experience and clinical practice
in medicine.
You know, your doctor may feel that after your sutures are removed and observing how
the ear looks, they may want to give – recommend that you wear a headband or some variation
to try to put some protection and to put some pressure on that area to maintain its appearance.
But I certainly wouldn’t abandon faith in just question the doctors do – not being
competent or not doing the right thing for you by not having you wear a headband.
Ask your doctor why and if once you hear an explanation, you might feel more satisfied
or comfortable with why the choice was made.
You know a lot of times once the person understand -- that’s why we spend so much time with
our patients and we talk.
We spend a lot of time discussing, explaining, and teaching.
I feel that adult education is basically – is based in repetition and you can’t say things
often enough.
You have to space them apart for the – for it to kind of take hold – for the information
to take hold.
So we always welcome our patients to ask as often as they need to and to call us often
as they need to.
Even no matter how many times we tell them anything because this is very important to
educate and to reinforce education.
So with that being said.
Speak to your doctor, find out the reasoning.
And I’m sure that as time goes on, you’ll get an understanding and hopefully things
will work out in the way you hoped.
So I hope that was helpful.
I wish you the best of luck.
And thank you for your question.