COMPLIMENTS OF Atlanta Plastic Surgery Specialists, P.C. Dr. Mark Mitchell Jones 2001 Peachtree Road NE, St. 630 Atlanta, GA 30309 (404) 355-3566 www.atlantaear.com Age to begin Opening ear canal for hearing MR Argiogram or equivalent Anesthesia and duration Major complications Natural materials Artificial materials Time in surgery Hospitalizations (total) Outpatient Inpatient (overnight) Infection Exposure Chest scar Scar on scalp Hair cutting for surgery Skin grafting Vasc. compr. & major tissue loss Time span over surgeries Ear flexibility Sensation Convenience Longevity Ear skin color Ear skin texture Rejection Infection Implant fracture Nerve risk to frontal facial nerve Exposure/extrusion Ear detachment After Trauma resilience/durability Surgery Chest scar (Longterm) Scar on scalp Permanent hair loss Options for repair of damaged ear Worry of future complications Insect bites Playground trauma Other blunt trauma Infections Sports limitations Time post-op in town Retain normal ear components Time post op. ear swelling Time post op. to wear protective dressing Before Surgery Bibliography DRAFT 10/21/2014 Microtia Repairs Comparisons Synthetic Plastic Grafts Natural Rib Cartilage Grafts External Prosthesis Glue Attached External Prosthesis Dental Implant Attached Silicon with TP Flap Endoscopic Reduces Hairloss at Scalp Seam 5-6 No No Yes, 1-2 hours No None Yes 1-2 hours 1 1 5-6 No No Yes, 2-3 hours Infection, drainage None Yes 2-3 hours 1 1 Low risk Low risk No No No No No N/A No No Daily application 5 years Changes daily Major difference No None N/A None No Yes Falls off No No No Yes High risk Low risk No No No No No N/A No No Daily application 5 years Changes daily Major difference No Lifelong risk N/A None No Yes Falls off No No No Compromised 5-6 5-6 No Option before, not after Yes Yes Yes, 3-5 hours Yes, 3-5 hours Flap loss Flap loss None None Yes Yes 3-5 hours 3-5 hours 2 2 1 1 1 1 High risk Medium risk High risk Medium risk No No Yes Yes, usually Yes Yes, usually Yes, in front of/over ear Yes, in front of/over ear High risk Medium risk 6 months 6 months Some Stiff Decreased to numb Decreased to numb Normal bathing Normal bathing All removed eventually Unknown Some difference Some difference Shiny-like skingraft Shiny/like skingraft Lifelong risk Lifelong risk Lifelong risk Lifelong risk Unknown >3% Yes Yes Lifelong risk 7% after 12 years No No Poor resistance Moderate resistance No No Yes Yes, usually High risk High risk Compromised Compromised No Falls off Falls off None Yes 1 day Yes None None No Falls off Falls off Medium risk Yes 1 day Sometimes 1 week 1 week 1. Dr. Mark Mitchell Jones website www.atlantaear.com 2. Dr. Francoise Firmin website 3. Dr. Burt Brent. The Art of Plastic Surgery. 4. Dr. Satory Nagata website www.microtia.jp 5. Dr. John Reinisch website www.drjohnreinisch.com 6. Dr. Sheryl Lewin website www.microtiaearsurgery.com 7. Mr. Andrew Greensmith website www.microtiaexpert.com High risk High risk High risk High risk Yes 2-3 weeks No 6 months 3 weeks Medpor with TP Flap Endoscopic Reduces Hairloss at Scalp Seam Medium risk Medium risk Medium risk Medium risk Yes 2-3 weeks with cup No 6 months 3 weeks Brent/Mark M. Jones Classic 3-4 Stages Japanese Nagata/Firmin Two-Stage Griffin TP One-Stage Ribgraft/Medpor (prefers rib graft) 5-6 Option, prefer after No Yes, 3-4 hours Minimum rib loss All No 2.5-3.5 hours, 1 h, 2-3 hrs 2-4 1-3 1 Low risk Low risk One incision No No Yes, behind ear Low risk 2-8 months Some Decreased to normal Normal bathing Lifelong Same as skin Normal skin No Normal None None <1% No Normal ear One, no phys. limitations No No TP flap available 10 Option, prefer after No Yes, 4-6 hours More rib loss All No 4-6 hours, 3-5 hours 2 1 1 Low risk Medium risk (14%) Two incisions Yes, 2nd stage Yes, 2nd stage Yes, behind ear Medium risk 4-6 months Some Decreased to numb Normal bathing Lifelong Same as skin Normal skin No Normal None None Some 8% No Normal ear Two No Yes Compromised 3+ Possible in some cases Yes Yes, 10-20 hours Flap compromised Yes/No Sometimes 10-20 hours 1-3 1-2 1 Low/Medium risk Medium/High risk One incision/None Yes Yes Yes, front of/over ear Medium/High risk N/A Some Decreased to numb Normal bathing Unknown Some difference Shiny-like skingraft No/Lifelong risk Mild risk/Normal None/>3% Yes/Yes Mild risk/7% No Unknown One/No Yes High risk Compromised Normal ear Normal ear Normal ear Normal ear No 1st 7-10 days, others 1 day Yes 4-6 weeks 9-10 days Normal ear Normal ear Normal ear Normal ear No 2-3 weeks Compromised 6 months Weeks to months Normal ear/Medium risk Normal ear/Medium risk Normal ear/Medium risk Normal ear/Medium risk No/Yes 2-3 months Unknown 6 months Weeks to months 8. Dr. Arturo Banilla website www.microtia.net 9. Boston Children's Hospital website www.childrenshopsital.org 10. Reinisch J, Lewin S. Ear Reconstruction with Porous Polyethylene Implant. Facial Plastic Surgery, 2009 Aug 25 (3), pp. 181-9. 11. Bauer B. Reconstruction of Microtia. Online at Plast Reconstr Surg . 2009; 124: 14e-26e. 12. Dr. Russell Griffiths website www.earreconstructionspecialist.com 13. Shen J, Quinn F. Microtia Reconstruction. Presentation at The University of Texas Department of Otoralyncology. October 2004. Copyright 2014. Dr. Mark Mitchell Jones and www.atlantaear.com.
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