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Ears

Earlobe Procedures


Split earlobes and tribal earlobes as a result of the large “flesh tunnel” piercings are among the most requested procedures in Mr Fattah’s practice. Typically, a new job or relationship prompts a rethink about the suitability of the large earlobes. The procedure is quick and simple being performed in the minor ops clinic and taking under an hour using local anaesthetic. For a split earlobe, the area of scar tissue is removed and the earlobe sutured back into a natural shape, often a small refinement at the margin avoids a notch occurring once the ear heals. In the case of tribal earlobes, the procedure is more technical but is still performed in the clinic. The excess tissue is removed and the earlobe repaired into the most natural shape possible depending on the size of the piercings. After the procedure the sutures are removed at two weeks and the scar is allowed to mature until barely visible. This small procedure gives a huge amount of confidence to those whose professional appearance matters.

Ear Reshaping (Pinnaplasty/Otoplasty)


This is surgery that aims to reduce the protrusion of the ears. This is one of the most common procedures Mr Fattah undertakes in the NHS and he has applied a number of innovations to streamline the patient experience and reduce complications. In addition, Mr Fattah is often asked to revise complications from elsewhere as a consequence of previous surgery.

The surgery involves a small incision behind the ear and using a minimal access technique, the cartilage of the ear is exposed and strong sutures are used to reshape the ear into a natural shape avoiding the tell-tale postoperative appearance of the ears being flat against the head or the natural curves of the ear being squared-off. Dissolving sutures are used to close the incision and a layer of glue is used as a dressing. The procedure is performed as a day case and most patients are able to go home within an hour or so of the surgery.

Frequently Asked Questions

Will I need to wear a head bandage?

No. The glue dressing is used to stick the ears to the side of the head temporarily so a head bandage is not required. Additionally, it acts like a sealant meaning you can wash your hair from the following day and is much less conspicuous. Children that have this surgery often return to school after 48 hours. After a week, the glue is released, suture knots are trimmed (no need to remove sutures) and a sweatband is only worn at night for a further 5 weeks.

Will it hurt?

Mr Fattah uses long-acting local anaesthetic whilst the patient is asleep so that when they wake up at the end of the procedure, their ears are numb and pain-free for several hour afterwards, typically only simple pain killers such as paracetamol and ibuprofen are required.

The combination of minimal dissection, long acting local anaesthetic and glue dressings have made this procedure straightforward with rapid recovery, minimal impact on lifestyle and high patient satisfaction.

I’ve hear about implants for pinnaplasty, does Mr Fattah use them?

The “earfold” implant is a nickel-titanium alloy that is inserted under the skin on the front of the ear. The metal is bent to try and shape the ear. Mr Fattah does not use them: Firstly, the earfold implant only works well in a specific type of prominent ear. Secondly, Mr Fattah avoids placing implants under the skin where there is a risk of it wearing through the thin ear skin leaving a visible scar (rare but possible). Finally, the incision is made on the front of the ear; if you had a scar complication then it would be visible, in contrast to a scar on the back of the ear.

My child has prominent ears, shall I bring him to your clinic?

Children are usually eligible for surgery on the NHS without cost and you should ask you’re a GP for a referral. Alder Hey children’s Hospital that serves the North West carries out numerous procedures each year by experienced paediatric plastic surgeons.

Nose

Rhinoplasty


Rhinoplasty is a surgical procedure aimed to improve the appearance of the nose and improve breathing. The decision to undergo a rhinoplasty is often an emotional one and unlike many other surgeries that aim to reduce the signs of aging, a rhinoplasty can change the way you look. This can improve self-esteem and confidence. Lots of time is spent discussing your aims and assessing the balance between the nose and the rest of the face.

The Procedure


Through incisions in the nose the shape of the underlying skeleton is altered, this may involve repositioning the bones, reducing or increasing the cartilages of the nose. The soft tissues are then redraped over this reshaped framework. Goals include straightening of the nose, reducing a hump, narrowing the nose or changing the shape of the tip. It is typically performed as a day case surgery under general anaesthetic, meaning that you will be able to go home a few hours after the operation. The most important thing in rhinoplasty is to have clear aims regarding what you want to achieve.

Frequently Asked Questions

What about non-surgical rhinoplasty?

Non-surgical rhinoplasty uses facial fillers to change the profile of the nose. It is ideal for making a hump look smaller and can be offered as an alternative to the surgical procedure. It is performed in the clinic and takes only a few minutes, just like other filler injections. Although it is cheaper than surgery and the complications fewer, the results are temporary. Nonetheless, it may be a good way to see if reshaping the nose can achieve the result you want before making a big decision regarding surgery.

Is the recovery painful?

After surgery you should be relatively pain free due to the long-acting local anaesthetic that is introduced in and around the nose while you are asleep. The main sensation will be a blocked nose. Your nose will initially be swollen and this mainly resolves over 6 weeks but takes 6-12 months for the final result to appear. You must think medium to long-term with this operation so as not to be disappointed with the initial result.

Will you see my scars?

A rhinoplasty can be performed closed where the incisions are hidden in the nostrils, or open where there is an incision made across the columella, which may be visible only when looked from directly below. Open rhinoplasty is used for more complex cases or if the tip of the nose needs refinement.

I have already had a rhinoplasty performed but am unhappy with the result, am I able to have this procedure again?

Yes. Rhinoplasty revision can be performed it is technically demanding and therefore can take longer than a primary rhinoplasty. A detailed discussion about your aims will be required to ensure you are not disappointed again.

What is the recovery like and how long will I need to rest or take time off work?

If you wish to conceal the surgery, it is suggested that you take a minimum of two weeks off work to recover. As with many operations, swelling will generally increase over the first 48 hours, and then will subside over the following weeks. Expect the swelling to increase for a further 48 hours, it will then subside over the following week. To minimise the swelling, ensure you sleep propped up on 2 or 3 pillows. Conversely, bending down will increase swelling and raise the blood pressure in the face and may cause a small nose bleed in the first days after surgery. We recommend avoiding bending forward for at least 2 weeks after surgery. You may feel crusts inside the nose, these are best managed by placing Vaseline into the nostrils to soften them and ease their passage.