The complex architecture of the auricle makes it one of the most challenging structures for the reconstructive surgeon to re-create. Overlying the ear’s unique cartilage framework are layers of varied soft tissues forming a three-dimensional organ, which is distinctively positioned on the head. Arguably, the most challenging auricle to reconstruct is third-degree microtia due to a near-total absence of native tissue and a need for lifelong durability of the reconstruction. Many methods of reconstruction have been studied; autogenous costal cartilage reconstruction has been one of the more traditional methods, with favorable long-term results reported by several surgeons.
 However, this technique requires tremendous artistic and technical skill on the part of the surgeon-sculptor to construct a realistic-appearing ear. High-density porous polyethylene (Medpor) is a stable, alloplastic implant that can integrate with host tissues, is resistant to infection, and has been successfully applied to reconstruction of the head and neck. For auricular reconstruction, Medpor—enveloped in a temporoparietal fascial flap with full-thickness skin graft coverage—is a durable and aesthetically gratifying alternative in microtic patients. This alternative surgical technique reduces surgical time and morbidity, standardizes results among surgeons, and facilitates an aesthetic, natural-appearing reconstruction of the auricle.
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A former Miss UK, model Shauna Gunn, 34, from County Fermanagh, Northern Ireland, lives with her boyfriend in Westchester, Connecticut, a short commute from Manhattan
"Five years ago, I had a very important photo shoot where I was up against American girls who I could just tell had had cosmetic treatments. I had the beginnings of frown lines and a deep laughter line, so I had a Botox treatment. I was nervous but my doctor, Dr Thomas Romo, was very nice and I was very happy with the results. I now see Dr Romo for 10 minutes every six months.
"I'm not going to become a 'beauty junkie', because I'm far too down-to-earth. I'm not in favour of any major plastic surgery but I like having Botox in my frown lines and crow's feet, and Restylane in my laughter lines - all in very small measures. I look fresher, bright-eyed and bushy-tailed, and first impressions count for such a log - not just in modelling, but in any position that involves working with the public.
"Of course i know lots of models who are having jose jobs and breast implants because it makes them feel more confident. But, for me, the point about preventative procedures is that less is more. Rather than waiting until you need something more major, you take small steps earlier and, particularly if you have a good surgeon, no one will ever suspect you've had work done.
"Of course, plastic surgery is much more acceptable here; it's almost taken for granted. The UK and Ireland are catching up - like fast food and takeaway coffee, cosmetic procedures will soon be an everyday thing." |
