- Under correction
- Over correction
- Reprotrusion or lost correction
- Distortions of ear
- Wrong analysis of problem by prior surgeon
- Wrong structures sculpted
- Poor surgical technique
- Suture failure
- Early suture extrusion
- Healing issues
- Loss of tissue
Prevention is the best way to minimize problems with ear surgery. Complications are the risk of any operation, Dr. Bermant has a very low rate of problems with his own otoplasty sculpture, but he has seen many deformities from other surgeons. Picking the right surgical sculptor is very important.
The Natural Ear, What Looks Normal? Dr. Bermant has studied the ear in art and in people to evolve his concepts of a Natural Looking Ear. Coupling this artistic sense of this goal with his skills with sculpture techniques results in the many before / after pictures you can see of his patients and is why patients travel from around the world for his services.
Cosmetic Complications of Ear Surgery: Ear deformity can include abnormal relationships of the auricle to the scalp, auricular distortions, big ears (macrotia), unbalanced elements, and missing components. Under correction, over correction, and reversion of deformity are all issues of the relationship of the ear to the head or the balance of the various parts of the ear.
Error in Diagnose or What is Sculpted: By not selecting the appropriate feature to sculpt, an abnormal ear can look even worse. An over projecting ear from a conchal bowl deformity cannot be fixed by over bending a normal antehelix. Ears that are too big (macrotia) are not made smaller by bringing ears that project a normal distance from the head even closer. When the upper and or lower components of the problem are ignored, a Telephone Ear Deformity can occur.
Complications of Execution: Excessive correction can result in flattening the ears against the scalp. Over bending the antihelix fold results in an unnatural contracted shape. Cartilage buckling, visible edges and visible bowstringing of sutures can be the results surgical technique or the limitations of real surgery on living cartilage. Removing too much skin behind the ear can eliminate a natural retroauricular sulcas or space.
Unrealistic Expectations: There are limits of what any surgery offers. Emotional scars from stress of living with big ears can distort a natural looking ear. The abnormal body image can result in patient requests for unnatural ears (such as ears too close to the head or over reduction of ear size). Cartilage healing is fickle, the tissue just has a mind of its own and even if Dr. Bermant puts an ear right where he wants by measurement, tissues can evolve and cartilage warp.
Healing Complications: Dr. Bermant uses an attention to detail, meticulous hemostasis to minimize bruising and bleeding with his otoplasty surgery. His Formal After Ear Surgery Dressings provide a protective environment for healing. Patients can help or hurt their healing tissues. Keeping the dressings in place and permitting them to do their job is essential. Various medications and over the counter substances can thin the blood increasing chances for bleeding, bruising, and loss of hematoma or collections of blood. High blood pressure and early excessive after surgery activity can also cause bleeding. Nicotine constricts blood vessels limiting blood supply. Tissue that may have survived can die. Trauma to healing tissue can disrupt repairs.
Dr. Bermant prefers techniques to minimize scars. Wounds that heal primarily tend to have better scars. Some patients have a tendency to bad scarring. Elective cosmetic surgery or revisions may not be a reasonable option for those who tend to have keloid or hypertrophic scars elsewhere on their body as a result of injury or other surgery.
Infection can lead to disaster with ear surgery. Condritis or infected cartilage can melt away this supporting structure and result in a deformed result. Dr. Bermant asks his patients to let him know about other infections or inflamed tissue elsewhere so that elective otoplasty surgery can be rescheduled. We use an antibiotic before surgery to further minimize risks.