Stitch Reaction Risks or Infection After Suture Technique Otoplasty!

Chronic Suture Infection / Reaction Behind the Auricle After Prominent Ear Surgery

Video Description: The area behind the auricle of the patient who had previously undergone prominent ear surgery in a different clinic was video-recorded of the patient, who applied because of the prominent inflamed areas behind the auricle, in the area of ​​the sutures, and the occasional outflow of this inflammation. As seen in this video, it was thought that there was probably a suture reaction and a condition similar to a chronic foreign body reaction in the area of ​​the suture heads on the back of the auricle. Among the prominent ear correction surgeries, the most commonly known and applied one is the Mustardé matrix suture technique. In this method, backward rotation of the auricle is ensured with the help of matrix sutures placed on the cartilages of the auricle. In this technique, since cartilage shaping is not performed, non-absorbable (permanent) suture material is used and it is knotted several times to provide a permanent stretch. Due to the thin skin of the auricle and the development of various tissue reactions from time to time due to these suture materials, these suture materials may protrude from the skin, cause chronic infection, and in case of tooth eruption, the auricle may take its former shape and cause a unilateral asymmetrical auricle appearance. subject. For this reason, I usually apply the modified otoplasty technique, which involves the use of absorbable suture materials and shaping the cartilage, and the conchomastoid suture technique. In this way, although the operation time is prolonged; The patient is protected from the risk of suture reaction and infection. When you stretch the auricle forward, a blue color, non-absorbable suture material is visible just under the skin. Sometimes even if the auricle is accidentally stretched forward, these stitches can break and separate. Here, it was planned to remove the sutures and perform otoplasty with other techniques, since it causes infections under the skin. Otoplasty techniques, in which the cartilages are reshaped in this way, take longer than the otoplasty performed with only permanent suture materials, and sometimes 45 minutes may be required for a single messenger. For more detailed information about ear plastic surgery techniques, you can check the link group below. 

Stitch method for prominent ear correction - Stitching method for otoplasty operation - Ear plastic surgery - Correction of prominent ears - Protruding ears - Bat ear - Obtrusive ears - Unfolded ears - Infection risks - Cosmetic ear surgery

Stitch method for prominent ear correction - Stitching method for otoplasty operation - Ear plastic surgery - Correction of prominent ears - Protruding ears - Bat ear - Obtrusive ears - Unfolded ears - Infection risks - Cosmetic ear surgery

Stitch method for prominent ear correction - Stitching method for otoplasty operation - Ear plastic surgery - Correction of prominent ears - Protruding ears - Bat ear - Obtrusive ears - Unfolded ears - Infection risks - Cosmetic ear surgery
As seen in the photos above, there are patients who have infected suture materials behind the auricle and have applied local antibiotic ointment to this area for years. Removal of these sutures is possible in office conditions, but when the sutures are removed, there is a risk of outward rotation and reinstatement of the auricle. In other words, if the sutures are removed, there is a risk that the patient may need a unilateral otoplasty operation again. Therefore, there are patients who prefer to apply local antibiotic ointment for a long time.
Stitch method prominent ear correction surgery is very common application as a "minimally invasive otoplasty procedure". The stitch method for correction of protruding ears is the most frequently performed otoplasty procedure among the minimally invasive cosmetic ear surgery procedure. Using permanent suture materials, the ear folds that are normally inadequate will be rebuilt and a new curve will be created in the ear cuff by squeezing the stitches. In the technique shown here, the cartilage is not formed from scratch, and the cartilage is folded with permanent suture materials. In other words, the stitching must be robust and permanent, requiring a lot of knotting. Although it is preferred as a short-term application in the surgical treatment of buccal ears due to inadequate antihelix angle insufficiency, Due to the fact that the stitches are very close to the skin, there is a risk of stitch nodal points getting out of the skin and becoming infected.

Suture Technique Otoplasty May Not Be Appropriate For Patients With Previous Suture Reaction!

It is ideal not to opt for otoplasty with suture technique in patients who have had a suture reaction due to previous permanent sutures. Since the skin behind the auricle is very thin and adheres to the cartilage immediately, suture protrusion from the skin in this area may be due to local suture infections. Since removing the sutures carries the risk of returning to its original shape, non-dissolvable suture materials should not be used as much as possible and other techniques should be used.

Treatment of Patients With Stitch Reaction / Infection after Otoplasty

In patients with subcutaneous infection due to non-dissolvable suture material and stitche reaction, generally using local antibiotic ointment and antiseptic products, oral antibiotic therapy is not sufficient for a permanent treatment. These suture materials need to be removed. In the long term, fistula and granulation formation may occur. It is recommended to perform ear plastic surgery with other techniques, by informing the patients that there is a risk of the auricle returning to its original state after the stitches are removed.

Otoplasty Cost in Istanbul

The total cost of surgery for ear plastic surgery varies between 2500-3500 us dollars. As can be seen in the example above, the total processing fee is much cheaper when only simple sewing techniques are used and are done in office conditions. I generally prefer to perform this procedure under local anesthesia and in sterile hospital operating room conditions. Although the backward rotation of the auricle is a simple surgical intervention; As you can see above, there is a risk of infection. The suture infections in the skin area behind the auricle of the patient I shared with you here may also be a foreign body reaction (tissue response to non-dissolvable suture material like polypropylene (Prolene)). I prefer to apply other techniques that take a little longer and require permanent shaping of the cartilage.

Detailed link group where you can access the articles published on this website about otoplasty >>
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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