Case Report: Aesthetic Pediatric Surgery

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Title: Correction of Congenital Ear Deformity in a 4-Year-Old: An Aesthetic Approach to Pediatric Otoplasty

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Author Information

• Author(s): Dr. Jane Smith, Dr. Emily Johnson

• Institutional Affiliation: Pediatric Surgery Department, Springfield Children’s Hospital, 123 Pediatric Lane, Springfield, IL, 62704

• Corresponding Author: Dr. Jane Smith, jsmith@springfieldchildrens.org

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Abstract

• Background: Otoplasty in pediatric patients is commonly performed to correct congenital ear deformities that may cause psychological distress due to aesthetic concerns. This case report discusses a 4-year-old patient with bilateral protruding ears, which led to significant social challenges and self-esteem issues.

• Case Presentation: A 4-year-old male with a history of congenital ear deformity (prominent ears) presented for surgical evaluation. The procedure aimed to reposition the ears closer to the head, improving both aesthetic appearance and psychosocial well-being.

• Conclusion: The patient underwent successful otoplasty, and post-operative evaluations revealed improved aesthetic outcomes and enhanced self-esteem. The child experienced no complications, and the family expressed satisfaction with both the functional and aesthetic results.

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Introduction

Otoplasty is one of the most commonly performed aesthetic procedures in pediatric surgery, primarily aimed at correcting protruding ears, a condition often present from birth. Although the primary goal is functional correction, aesthetic considerations are crucial for improving the child’s social interactions and psychological well-being. This case report explores the challenges and successful outcomes of a 4-year-old male patient who underwent otoplasty to correct bilateral ear prominence. The importance of early intervention and careful aesthetic planning in pediatric patients is emphasized.

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Case Presentation

• Patient Information:

  • Age: 4 years

  • Sex: Male

  • Medical History: The patient has no significant medical history. No previous surgeries or comorbid conditions were noted.

  • Presenting Symptoms: The patient’s parents expressed concerns about the child’s bilateral protruding ears, which were causing distress and occasional bullying at preschool. The child had normal developmental milestones and had no functional hearing issues.

• Diagnostic Assessment:

  • Clinical Examination: On physical examination, the patient demonstrated bilateral prominent ears with a visible 30° protrusion from the head. The pinna was structurally normal, with no signs of malformation or injury.

  • Imaging and Tests: No imaging was required as the deformity was clinically apparent. Preoperative photographs were taken for assessment and comparison post-surgery.

• Surgical Procedure:

  • Preoperative Planning: The goal was to reposition the ears, decrease the prominence, and correct the structural deformity while preserving the ear's natural shape. Discussions were held with the parents about the aesthetic goals and expected outcomes.

  • Surgical Technique: The patient underwent bilateral otoplasty under general anesthesia. A postauricular approach was chosen, with an incision made behind the ear to minimize visible scarring. The cartilage was reshaped using permanent sutures to fold the ear closer to the head.

  • Anesthesia: General anesthesia was administered for the duration of the procedure.

  • Postoperative Care: The patient was placed in a protective headband to maintain the new ear position during recovery. Pain management included acetaminophen, and antibiotics were prescribed to prevent infection.

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Results

1. Surgical Outcome:
   The surgery was completed without complications, and the patient tolerated the procedure well. Post-operative assessments revealed a significant reduction in ear prominence, with both ears positioned more symmetrically against the head. The patient’s parents reported increased self-confidence and satisfaction with the results.

   • Follow-Up: The child was monitored at 1 week, 1 month, and 6 months post-surgery. The follow-up visits revealed excellent healing with no visible scars. There was a noticeable improvement in the patient’s social interactions and the reduction of self-consciousness related to ear appearance.

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Discussion

• Review of the Literature:
  Studies show that early intervention in children with prominent ears is critical for preventing emotional distress and bullying, which can impact self-esteem. Various surgical techniques, including the Mustarde and Furnas methods, are commonly used in otoplasty for pediatric patients. Our case aligns with the findings of similar studies showing that otoplasty can lead to long-term aesthetic and psychological benefits in children.

• Aesthetic Considerations in Pediatric Surgery:
  In pediatric patients, aesthetic surgery requires careful planning to ensure that functional outcomes do not compromise the child’s development. In this case, the goal was not only to correct the ear shape but also to improve the patient’s psychological and emotional well-being by reducing the risk of peer bullying and enhancing self-confidence.

• Limitations and Challenges:
  Although the aesthetic results were excellent, there are challenges in pediatric surgery related to the natural growth of the ear and the potential for postoperative complications such as scarring or hematoma. Long-term follow-up is essential to assess the stability of the results as the child grows.

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Conclusion

This case demonstrates the positive impact of aesthetic surgery in pediatric patients with congenital ear deformities. The success of the otoplasty procedure in improving both the appearance and psychological well-being of the patient highlights the importance of early intervention in aesthetic pediatric surgery. The patient’s outcome was favorable, and the procedure was well tolerated with no complications, illustrating the value of tailored surgical approaches to address both functional and aesthetic concerns.

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