Otoplasty and reconstructive surgery is one of the most complex procedures in plastic surgery. The difficulty lies in the fact that the ear is an uneven, three-dimensional organ, and each concave and convex structure must be appropriately sized, and the overall concave and convex structures must be in the right proportion. Therefore, the key points in reconstructing the outer ear are: a realistic three-dimensional ear scaffold and a thin skin-covered scaffold, so that the shape of the ear is perfectly reflected. If the scaffold is too thin, deformation can easily occur, and if it is too thick, it is not conducive to the expression of the ear shape; if the skin is too thick, it is also not conducive to the ear shape, and if it is too thin, skin necrosis can easily occur and the cartilage of the ear scaffold can be exposed. This type of surgery requires a surgeon with mature surgical skills, as well as a certain level of artistic skills and proficiency in surgery. Post-operative care is also very important to avoid skin and cartilage infections and hematoma formation in order to finally obtain a good external ear shape. In clinical work, I often encounter parents with specious post-operative care concepts, and even medical professionals who are mainly influenced by the experience of taking things for granted and do not have the correct modern medical concepts. Here I will introduce the common problems to you. 1.When can I get out of bed after surgery? Surgery to remove rib cartilage to reconstruct the outer ear (expanded flap phase II surgery and Brent phase I surgery) allows you to get out of bed the next day; general anesthesia surgery allows you to move around after you are fully awake, and other surgeries, after they are finished. There are many benefits for patients to get out of bed as soon as possible after surgery: it promotes gastrointestinal motility and increases feeding; activity increases lung capacity and the change in position facilitates sputum excretion and reduces intrapulmonary infections; more importantly, it prevents the formation of venous thrombosis in the lower extremities. Only a few types of post-surgery require bed rest, and even bed-ridden patients still need to turn over in bed, pat their backs, and massage and stretch activities of their limbs to get the benefits of similar activities. 2.Do I need to avoid eating after surgery? There is no need to abstain from eating after surgery. We believe that comprehensive nutrition is beneficial to the recovery of the wound. Any food that you are not normally allergic to can be eaten. We do not agree with the so-called taboo in Chinese medicine, seafood, onion, ginger, garlic and soy sauce can be eaten. Practice also proves that comprehensive nutrition is more conducive to the recovery of the disease. 3.How to take care of dilated skin? The main thing is to keep the skin clean and avoid sharp trauma. Dilated skin is thin in appearance, but in fact it has a certain degree of toughness and can be subjected to pressure. In fact, you can not wear earmuffs at home, or in a less crowded environment, and you can not use them when you sleep. The incorrect way of wearing earmuffs can easily crush the skin. You can shower once the gauze is removed, even if the sutures are not removed. Patients or parents can wash the dilated skin, the folds of the small ears, and the wounds with soapy water to keep them clean to avoid skin infections, such as acne growth. Running tap water is very clean and can be used perfectly to clean the surgical area. And soapy water is disinfecting and cleans the skin well. 4.How to do daily care after patients go home? (1) You can take a shower 1~2 days after the removal of the stitches, and the ears should also be showered, either with soap or bathing solution. After the shower, use a wet alcohol cotton ball to clean the incision and each concave and convex structure of the ear again. (2) After about 1~2 weeks, apply topical scar removal medication after the scabs fall off (3) As long as your chest is not painful, you can participate in appropriate physical exercise, such as running, table tennis, and other activities. However, there should be no intense confrontation sports and you need to protect your ears. However, after 3 months, you can participate in normal sports activities. 5.When can I wear water after the stitches are removed? You can shower 1~2 days after the stitches are removed. All ear reconstruction surgeries of all phases are completely allowed to take a shower 1~2 days after the stitches are removed (in case of patients with complications, the doctor will deal with them directly). So many doctors, nurses, and even more parents of patients think that the incision after surgery should not be exposed to water. In fact, 4~8 hours after surgery, the incision is completely filled with the body’s serum, white blood cells, and platelets, and the incision at this time is completely protected from bacteria and, of course, from bath water. At this time, the wound is not healed, which means that it needs to be closed under the pull of sutures. 7~10 days later, the serum and other components from the incision are transformed into fibroblastic tissue, which can pull the incision instead of sutures and complete clinical healing. 2~3 months later, the fibroblastic tissue is transformed into mature scar tissue and the incision is physiologically healed. With the above description, we believe that patients can shower 8 hours after surgery. However, we leave a drainage tube and gauze dressing after the surgery, so it is perfectly fine to take a shower 1~2 days after the removal of the sutures. Of course, if the wound heals poorly, the doctor will tell you directly that you need a long-term change of medication, and the wound may have secretions at this time, so avoiding water is the right thing to do. 6. How do I deal with the hair on my ears? There is often hair left on the ear whorl of the reconstructed ear. The best way is to pluck it directly or remove it by laser. The reconstructed ear does not feel very sensitive in the short term, so it is perfectly fine to pluck the hairs from the ear whorl with tweezers about 1 week after surgery. If the patient, especially children, cannot tolerate it, laser hair removal can be used. 7. When can the reconstructed ear resist pressure? The reconstructed ear is ready for pressure after 3 months. That is, it includes the expansion flap phase II, Brent phase I, and phase II. The rib cartilage sculpted into the form of an ear scaffold needs to be fixed using wire or titanium wire. This fixation may form a cutting effect with external forces and deform the scaffold, and only the formation of physiological healing between the cartilage branches can achieve a stable outer ear structure. The healing time of the cartilage stent is about 2~3 months, so the outer ear can withstand the proper pressure only after 3 months. 8. What can I do with the threads that are not removed? Just go to the ENT department of your local hospital and disinfect the threads with iodine and alcohol and remove them. After ear surgery there may be blood scabs in the incision and implant area, and the threads under the scabs may not be visible when the stitches are removed and are not removed. As the scabs fall off and the threads are exposed, the incision is completely healed at this time, so there is no need to panic, just remove it at the hospital. 9.When can I apply topical scar removal medication? Apply topically after the scab has completely fallen off. The method of topical application is: once a day in the morning and once in the evening, or once in the morning and once in the evening, wipe off the last medication with water or alcohol before applying the medication, and apply the medication after the skin is dry. After the drug with the fingertips in situ massage for a few minutes to promote drug absorption. 10.What time can I take physical education class? When the chest pain disappears, you can participate in appropriate physical exercise, and after 3 months, you can attend physical education classes normally. 11.Do I need a four-stage surgery? Depending on the condition of the ear repair, a fourth stage of surgery can be performed. Generally after three stages of ear reconstruction, most patients do not need the fourth stage surgery, not because the ears are perfect, but because there is no more room for repair. If a patient comes to the hospital six months after the three-stage surgery, depending on the condition of the ear and the patient’s request, a fourth stage can be performed.