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.

Understanding Key Differences

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.

Age and Eligibility

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.

Number of Surgeries

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.

Discomfort and Scars after Surgery

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

Durability and Longevity

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.

The Benefits of Using Living Tissue

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. 

Find the Right Treatment for You

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.

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.

The First Few Days after the Procedure

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.

Follow-Up Care

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.

Recovery Following the Second Procedure

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.

Contact Us to Learn More

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 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.

Issues from Previous Surgeries

Surgical inexperience, along with unforeseen complications, can create unsatisfactory results for microtia repair patients. Revision surgery can address a range of concerns, such as:

• Disproportionate ears
• Flat ears which sit too close to the head
• Unsuccessful integration of tissue
• Unnatural appearance

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.

Planning Revisional Surgery

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.

Immediate and Long-Term Treatment Options

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.

Rib Cartilage Frameworks

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.

MEDPOR Ear Reconstruction

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.

Silicone Prosthetic Ears

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.

Restore Your Confidence

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.

Individuals born with an ear deformity frequently undergo a physical and emotional transformation with rib cartilage ear reconstruction in New York City. Dr. Charles Thorne is on the leading edge of surgical ear reconstruction in the world and has decades of experience helping patients who were born with microtia, hemifacial microsomia, and other conditions. After a personal consultation, Dr. Thorne will provide you with an outline of the surgical timeline, as well as what to expect before, during, and after the procedure.

Dr. Thorne will assess your facial symmetry, hairline, and the anatomy of your other ear to most successfully plan your treatment.

Before and after right ear reconstruction using rib cartilage grafts, The position, angle, size and details of the ear are normal.

The Initial Consultation

During your initial appointment, which usually takes about 30 minutes, Dr. Thorne will ask about your medical and surgical history. It is important to be transparent about your medical history, as prior operations can impact this procedure. He will assess your facial symmetry, hairline, and the anatomy of your other ear to most successfully plan your treatment. In most cases, rib cartilage ear reconstruction involves two surgeries, and should not be considered until the child has enough rib cartilage to construct an adult ear. Childrenare usually ready for this surgery once they reach the age of ten years.

Understanding the Procedure

Dr. Thorne will make an incision in the patient’s chest to gain access to the ribcage. He will carefully and precisely remove a certain amount of rib cartilage which will serve as the framework for the new ear. Once enough cartilage has been harvested from the ribs, Dr. Thorne will close the incision site, and begin to create the new ear. Once he has completed the framework of the ear, he will carefully place it under a strategically formed pocket of skin on the side of the head.

During the next operation, Dr. Thorne will elevate the ear, wedge a piece of cartilage behind it, and place a skin graft to recreate the depth behind the ear.

Secondary Reconstruction

The patient underwent microtia repair in childhood but was not satisfied (Left). Dr. Thorne performed redo reconstruction (Right).

Risks and Benefits of Surgery

Perhaps the key benefit of rib cartilage ear reconstruction is the final, natural-looking results that most patients experience, and the fact that the patient’s own tissue will heal normally if ever injured. There are, however, certain risks that should be considered when pursuing this surgical procedure:

• Removing rib cartilage is uncomfortable for a few days
• Removing the cartilage in very thin patients can result in an indentation in the chest contour
• There is a permanent scar on the chest

The advantages of the new ear consisting of the patient’s own tissues, rather than a foreign body that is more prone to exposure and infection, far outweigh the disadvantages listed above.

Begin Your Treatment Plan

Dr. Charles Thorne wants to help you achieve a more natural-looking facial appearance. Contactour practice today to learn more about rib cartilage ear reconstruction, or to schedule an initial consultation.