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DONALD J. CAPUANO, M.D.
Plastic Surgeon

You are interested in information regarding surgery to correct a "deformity" of the ears.

 

CONSULTATION

Dr. Capuano will discuss with you the various methods of therapy that might be appropriate in your particular case. If the edge of the ear 'sticks out' then the cartilage at the edge is molded so that it curls backward. The technique does not use sutures and the chance of a permanent result is very likely. Further 'pinning' back of the ear can be achieved by removing a portion of the ear cartilage in the 'cup' area of the ear.

In some cases there are small areas that are pointed on the edge of the ear. These areas can be treated by contouring the cartilage.

The ear lobe can stick out or can be larger than desirable. Portions of the lobe can be removed it this is the case. In some cases the lobe is too small. Fat transfer can be helpful in such cases.

The number of 'deformities' or little problems are many and all can not be described. Usually most problems involving protruding ears or ears that 'stick out' can be improved.

Problems after surgery are rare. Bleeding and infection are very rare. The final 'look' of the ear is usually quite acceptable and secondary surgery is not too frequent.

 

INSURANCE COVERAGE

Insurance coverage is rare. In cases where severe psychological injury has occurred then certain insurance companies have paid for surgery. The patient must be seen by a psychologist or psychiatrist and there must be documentation of the psychological problem. Also the ears must protrude at least 1.8 cm (slightly less than 3/4") to qualify in certain plans. The total cost of ear surgery varies from fifteen hundred to three thousand dollars Some 'simpler' problems might cost less. Many people benefit throughout their lives and are relieved of many embarrassments when their ear problems are treated early on.

ANESTHESIA FOR SURGERY

Surgery is usually done under sedation and local anesthesia (Novacaine-like) anesthesia. Check the web page on local anesthesia and sedation. Other times when the individual does not want to be aware of anything or the child is four or five years old then a general anesthetic (totally asleep) can be used. Please see our web page about general anesthesia.

Dr. Capuano will discuss the anesthesia options with you. If you decide to have surgery under general anesthesia, or if the patient is very young, there is an extra fee which is usually not paid for by insurance. You will be given an estimated cost for these services.

Surgery is performed at the Ambulatory Surgery Center. You will be given a time to arrive at the Center. Do not eat or drink anything from midnight the night before your surgery, or your surgery may be canceled.

 

BEFORE SURGERY CARE

We ask that you shower and shampoo every day for at least three days before surgery using Dial or Safeguard soap. Pay particular attention to the ear area. Do not apply creams or lotions for one day before surgery. Do not take aspirin or products containing aspirin for at least three weeks before surgery. Do not eat apples, as they contain an aspirin-like substance. Garlic also has an aspirin-like substance, so do not eat a lot of garlic before surgery. Aspirin "thins" the blood, which may cause more bleeding during or after surgery, and can increase problems following surgery. If you are presently taking aspirin on the advice of a physician, let us know prior to your surgery.

Dr. Capuano will see you just before your surgery, and mark the incisions using a marking pen. You will be awake, so you will know where the incisions will be. SOMETIMES INCISIONS OTHER THAN THOSE OUTLINED TO YOU HAVE TO BE MADE.

 

AFTER SURGERY CARE

Following surgery, you will have a large bulky dressing wrapped around your head. This should remain clean, dry and on until you are seen in the office. Do not shower or wash your hair. You will be given prescriptions, or asked to buy over-the-counter medicines following surgery. These medicines are for swelling, pain and infection. Take these medications as directed, and finish all medications unless advised otherwise. If you have a problem, CALL THE OFFICE. You will be asked to call the office to make an appointment to be seen following surgery. Call as soon as possible. Dr. Capuano will tell you after surgery when this appointment should be. It is usually between five and seven days following surgery.

You should rest and relax at home. Do not do any stressful or straining activities, i.e no heavy lifting, no bending over, etc. If you have questions, please ask.

At the time of your first office visit after surgery, the large bulky dressing will be removed, and you will be advised regarding wound care. You may be asked to wear a smaller dressing or an ace bandage, depending upon the extent of wound healing. Many patients can wear ski bands or other types of compressive bands as a dressing. Sutures may be removed, or you may have dissolvable sutures. Usually you can resume showers and shampooing after this first visit. Following the dressing removal, you should wear an "ear cap" while sleeping. This prevents pulling on the ear while asleep. This can be made from any soft material, for example a ski cap or ace bandage, etc.

 

ACTIVITY AFTER SURGERY

Regarding return to work following surgery: Your return to work and/or usual activity depends to a great extent upon your job. Many patients are able to return to usual activity within one to two weeks following surgery, however this varies from person to person. Please discuss your job with Dr. Capuano, who will be better able to give you an estimate as to return to work. Please remember that any estimates given are only estimates.

If the patient is a child, participation in school physical education classes should be avoided until Dr. Capuano gives his OK. The office will provide an excuse should one be required from the school.

Vigorous activity after surgery should be avoided. Each person and surgery is different, but generally six weeks is needed for healing. After this time, vigorous activity can be resumed, but a head band or compressive bandage should be worn for at least six months to avoid unanticipated injury to healing tissues. Cartilage is one of the slowest healing tissues in the body, which is why prolonged "banding" is needed.

You will be seen in the office periodically for follow up care. Photographs will be taken before, possibly during and after surgery. If photos have not been taken, please let us know. You will not be identified except for our office records. Photographs taken are the property of Dr. Capuano, and may be used for teaching and/or lecturing.

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Dr Capuano does not do the following operations
- Hair Transplants - - Scalp reduction - - Sex change operations - - Breast augmentation by fat injection - penile enlargement +/- fat injections

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This information is provided for your general information. How such information exactly applies to an individual would depend on a face to face history, examination, perhaps laboratory exams and individual treatment plan. Further because of the nature of electronic media and information - there is no doctor - patient relationship but merely a general information display - THANK YOU.

INFORMATION REGARDING
OTOPLASTY (EAR SURGERY)

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