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LOP Ear

Ear pinning on the Gold Coast

A LOP ear, otherwise known as “bat ears” refers to the appearance of very prominent ears. Many patients don’t notice or feel self-conscious about their ears until they are beyond the age of 5 and some people may not notice the prominence of their ears until they are adults.

Treatment of LOP ears is a procedure that Dr Dan Robinson sub-specialises in. This procedure is known as an otoplasty or “ear pinning” and is used to treat the condition in both adults and children.

Causes of LOP ear

LOP ear is a congenital condition which is passed from parents to children. LOP ear is a highly variable condition between patients and commonly will be different between the left and right ear. There are 2 main structural abnormalities which cause LOP ear. Patients usually have a combination of both of these abnormalities as the cause of their LOP ear:

  • Prominence of the conchal bowl – The conchal bowl is the area of the ear which is surrounding the ear canal. If this area is prominent it will cause the whole ear to protrude
  • Lack of antihelical fold – The antihelical fold is a natural fold in the cartilage of the ear which is immediately inside the outer rim of the ear. This fold causes a crease in the skin of the ear and sets the outer rim of the ear back. In patients with LOP ears or “Bat ears” this fold is not present and the rim of the ear is very prominent.

Each patient is different and each ear is different. Some patients will have a conchal bowl dominant deformity of the ear, others will have an antihelical fold dominant deformity. Dr Robinson analyses this pre-operatively and tailors the operation appropriately for each patient. Dr Robinson understands that correcting a LOP ear is not the same procedure for everyone, rather each patient requires an individualised operative plan.

Symptoms

The most common symptom which people have associated with LOP ears or “bat ears” is a lack of self-esteem or being teased. Patients may be called “big ears” and may also modify the way they wear their hair – often choosing to have a haircut which covers the prominence of their ears.

Having a correction of the “LOP ear” or “bat ear” deformity is called an otoplasty and is very successful at correcting the deformity.

Surgical treatment of LOP ear

The only treatment available which has long term results in relation to having “LOP ears” or “bat ears” is an otoplasty. This procedure is otherwise known as “ear pinning”.

An otoplasty involves a general anaesthetic and takes approximately 2 hours. Prior to the surgery Dr Robinson individually plans the operation for each patient with the understanding that no 2 patients are the same and no 2 ears are the same.

There are 3 main corrective steps which Dr Robinson utilises in an otoplasty:

  1. Conchal setback stitches – These sutures are used to set the conchal bowl of the ear back so that it is not as prominent. This is the part of the procedure which is commonly referred to as “Ear Pinning”
  2. Anti helical fold creation – The antihelical fold sits immediately in front of the rim of the ear. In patients with LOP ear they won’t have an antihelical fold which has been developed as much as it should. Dr Robinson utilizes 2 techniques to create the antihelical fold, scoring the cartilage so that it bends appropriately as well as using sutures which are called “Mastadre” sutures to create the fold.
  3. Soft tissue – Patients with LOP ear commonly have an excessive amount of soft tissue sitting behind their conchal bowl. Addressing this excessive amount of tissue is something which is commonly neglected in correcting LOP ear. When Dr Robinson did his fellowship in facial plastic surgery he was taught to recognize the importance of this step in the procedure as well as how to best hide the suture line behind the ear and remove an appropriate amount of skin if needed.

Recovery time after ear pinning

After having an otoplasty patients wear a head bandage for between 3 – 5 days. Pain is not a big feature of this surgery and usually patients are able to return to work or school within one week. There is some bruising after the operation, but this settles down very quickly.

The result of an otoplasty is apparent immediately after the surgery and the final result is noticed at 6 weeks post operatively when all of the swelling has gone out of the ear.