MOST of the time, parents know what is best, and what is right for you. However I don't think this applies when it comes to deciding whether to go forward with ear reconstruction. The reason is that the ear is a big part of who you are, and what you look like.
If a parent choses a method of creating an ear (medpor, prosthetic or rib cartilage) the child may be very unhappy with the result and resent the parent. Also, both the medpor and rib cartilage involves a large amount of theatre time as well as a fairly lengthy recovery.
I think parents can help to guide a child in their decision, and can help by doing research on the various methods, as well as giv their opinion as to what will suit their child best, but the child should be allowed to choose. I also think that families should only start thinking about reconstruction after the child turns 9, as the rib cartilage procedure can only be done after age 9.
I first heard about reconstruction at age 5 while watching carte blanche. I think it was the first ear reconstruction done in South Africa. At the time, I didn't want to have the op because the girl shown had to have her entire face and head covered in bandages for 3 weeks. About 10 years later, I decided that I did want an ear, and we went to see the Doc featured on the program, Prof Anil Madaree. He explained that the ear featured on the program was a medpor ear, and he stopped doing them because he was unhappy with the results, and the risk of infection is quite high. He said that he did not do the rib cartilage procedure, but he felt that that was the way to go, and he recommended four doctors and said Dr Firmin was the best, so off we went to see her in April 2009.
I was very happy with her work and felt confident that she would do a great job............. until a plastic surgeon mentioned prosthetic ears. Which just involved a little operation to insert magnets under the skin to secure the ear. I then decided that this might be a better option as I had already had 21 ops and the big ear op scared me. I was stuck on wanting a prosthesis for a few months, but after a lot of soul searching, deciding I had enough foreign objects attached to my skull (baha implant and V.P. shunt) and also a lot of research, I decided I wanted an ear that was part of my body. So back to Dr Firmin in April 2011 where I asked a lot more questions and also got her to explain the procedures............ rib cartilage it will be!! I am happy with the decision I made and am positive I will be very happy with the results. My parents did give me some input, but the decision was ultimately mine.
Tuesday, March 27, 2012
Monday, March 12, 2012
No-one makes ears like Françoise Firmin!!
There are a few ways to make an ear. One could go the prosthetic route; this involves having a prosthetist making an ear, and then having magnets surgically implanted for the ear to clip on to. I considered this, but decided I wanted an ear that was part of my body and that I did not have to clip on every day. You can also make an ear using medpor (which is a synthetic material) or you can have an ear made from your rib cartilage, which is what I am having done.
Why I dont like medpor: It is a hard material, and doesn't feel like an ear. Medpor is most commonly used as a bone graft, and I in fact have a medpor implant in my jaw, and it works very well as a substitute for bone. When people get an ear reconstruction, they do so for aesthetic reasons. In my opinion, it does not look like an ear. To me it looks like something that was made outside the body by a human and then inserted under the skin, which is exactly what a medpor ear is.
On to using rib cartilage. This involves a number of ops. Some doctors do this reconstruction using 4 ops, while others use 2. My surgeon does it using 2. In the first op, cartilage is harvested from the bottom 3 ribs (if the microtia is on the left she uses the ribs from the left side, and if it's on the right, she uses the ribs on the right). Before the op she would have drawn the good ear onto a transparency. This becomes her framework. She flips the transparency, so that it looks like a good ear would look on the side of the microtia. She then carves the cartilage according to her transparency. This is then placed under a pocket of skin on the microtia side. The skin is then suctioned, and 2 special drains are inserted inder the skin. This creates a vacuum. At this point in time the ear looks like an ear but it is flat as it has not been raised. In the first op, a piece of cartilage would have been harvested then put back in the body for use during op number 2. In the second op, that piece of cartilage is removed from the rib cage then placed under the ear. Then Dr Firmin removes a thin layer of skin from above where the ear sits. This skin is then used to cover that little piece of cartilage. Then as the French would say: Voila a new ear!! This ear looks like it is part of the body, and feels like an ear. Also if you would like it pierced, Dr Firmin will do that for you while you're in theatre :-D
There are a few good doctors in the world that make these ears, but in MY opinion Dr Firmin is the BEST!! I have looked at quite a few other doctors' work, but they dont come close to Dr Firmin's work. I think this has to do with her training, as well as her determination to make good ears. First she went to Dr Burt Brent in California, who makes good ears, but does the reconstruction in 4 ops. Dr Firmin didn't like the fact that reconstruction was done in 4 ops and so went to train with Dr Satoru Nagata in Japan who does reconstruction in 2 ops. Personally I think his ears look a bit dodgy, but Dr Firmin had the technique from Dr Brent, and just went to learn what to do in each op. Now Dr Firmin does it in 2 ops and uses some of Dr Brent's techniques that she came up with herself, after practising on many potatoes (yes REALLY!!)
I don't just like her ears, I like her as a person. As you can see, I already know what she is going to do in theatre. I don't like docs who don't tell you exactly what they are going to do in theatre. She is also a very warm person with a wonderful sense of humour, and she makes people feel at ease. I also like the fact that she admits that there can be complications sometimes, but she says thats why she keeps patients in the hospital for 3-4 days. She also assures you that she has seen every complication and knows how to overcome them. And might I add that she does 300 ear ops a year!! Oh, and she has gorgeous earrings!! :-P
Why I dont like medpor: It is a hard material, and doesn't feel like an ear. Medpor is most commonly used as a bone graft, and I in fact have a medpor implant in my jaw, and it works very well as a substitute for bone. When people get an ear reconstruction, they do so for aesthetic reasons. In my opinion, it does not look like an ear. To me it looks like something that was made outside the body by a human and then inserted under the skin, which is exactly what a medpor ear is.
On to using rib cartilage. This involves a number of ops. Some doctors do this reconstruction using 4 ops, while others use 2. My surgeon does it using 2. In the first op, cartilage is harvested from the bottom 3 ribs (if the microtia is on the left she uses the ribs from the left side, and if it's on the right, she uses the ribs on the right). Before the op she would have drawn the good ear onto a transparency. This becomes her framework. She flips the transparency, so that it looks like a good ear would look on the side of the microtia. She then carves the cartilage according to her transparency. This is then placed under a pocket of skin on the microtia side. The skin is then suctioned, and 2 special drains are inserted inder the skin. This creates a vacuum. At this point in time the ear looks like an ear but it is flat as it has not been raised. In the first op, a piece of cartilage would have been harvested then put back in the body for use during op number 2. In the second op, that piece of cartilage is removed from the rib cage then placed under the ear. Then Dr Firmin removes a thin layer of skin from above where the ear sits. This skin is then used to cover that little piece of cartilage. Then as the French would say: Voila a new ear!! This ear looks like it is part of the body, and feels like an ear. Also if you would like it pierced, Dr Firmin will do that for you while you're in theatre :-D
There are a few good doctors in the world that make these ears, but in MY opinion Dr Firmin is the BEST!! I have looked at quite a few other doctors' work, but they dont come close to Dr Firmin's work. I think this has to do with her training, as well as her determination to make good ears. First she went to Dr Burt Brent in California, who makes good ears, but does the reconstruction in 4 ops. Dr Firmin didn't like the fact that reconstruction was done in 4 ops and so went to train with Dr Satoru Nagata in Japan who does reconstruction in 2 ops. Personally I think his ears look a bit dodgy, but Dr Firmin had the technique from Dr Brent, and just went to learn what to do in each op. Now Dr Firmin does it in 2 ops and uses some of Dr Brent's techniques that she came up with herself, after practising on many potatoes (yes REALLY!!)
I don't just like her ears, I like her as a person. As you can see, I already know what she is going to do in theatre. I don't like docs who don't tell you exactly what they are going to do in theatre. She is also a very warm person with a wonderful sense of humour, and she makes people feel at ease. I also like the fact that she admits that there can be complications sometimes, but she says thats why she keeps patients in the hospital for 3-4 days. She also assures you that she has seen every complication and knows how to overcome them. And might I add that she does 300 ear ops a year!! Oh, and she has gorgeous earrings!! :-P
Saturday, March 10, 2012
Intro
My name is Aneesa, and I was born on 11 April 1993. I have a microtia on the left side due to Goldenhar Syndrome. On the 2nd of April, I will have the first of 2 reconstructive surgeries on my ear. Even though I am from South Africa, I am having my op in Paris. This is because no-one in South Africa makes good ears that actually look like ears.
I have chosen Dr Françoise Firmin in Paris (yes, FRANCE!) to do my surgeries. Dr Firmin does occasionally operate in South Africa, but she refuses to operate on me here. With Goldenhar, one side of the face (in my case the left side) is underdeveloped. The bones in my left cheek are severely underdeveloped. In order for ear reconstruction to happen, there needs to be a foundation for the ear. In my case, there was no bone in the place where the ear is going to go, and last July I had a fat graft which will provide the foundation for my new ear (it also improved my facial symmetry). Dr Firmin feels that because my case is more complicated than most, she would like her staff to look after me. I'm not complaining, I get to have a two week holiday in PARIS!!!!!!!!!!!!
I created this blog so that family and friends can follow my journey even though they are not in France. I also created this blog so that parents who are considering ear reconstruction using rib cartilage can see what what the surgery (I hope to get some pics!) and recovery is like.
what we are starting with:
I have chosen Dr Françoise Firmin in Paris (yes, FRANCE!) to do my surgeries. Dr Firmin does occasionally operate in South Africa, but she refuses to operate on me here. With Goldenhar, one side of the face (in my case the left side) is underdeveloped. The bones in my left cheek are severely underdeveloped. In order for ear reconstruction to happen, there needs to be a foundation for the ear. In my case, there was no bone in the place where the ear is going to go, and last July I had a fat graft which will provide the foundation for my new ear (it also improved my facial symmetry). Dr Firmin feels that because my case is more complicated than most, she would like her staff to look after me. I'm not complaining, I get to have a two week holiday in PARIS!!!!!!!!!!!!
I created this blog so that family and friends can follow my journey even though they are not in France. I also created this blog so that parents who are considering ear reconstruction using rib cartilage can see what what the surgery (I hope to get some pics!) and recovery is like.
what we are starting with:
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