Auricular Reconstruction

376 Pages·2016·872.53 MB·English

by  Francoise Firmin

33734
AURICULAR
RECONSTRUCTION
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AURICULAR
RECONSTRUCTION
Françoise Firmin, MD
Plastic and Reconstructive Surgery
Clinique Bizet
Paris, France
Joseph Dusseldorp, MBBS, MS, FRACS
Clinical Lecturer
Department of Plastic and Reconstructive Surgery
University of Sydney
Sydney, Australia
Alexandre Marchac, MD
Plastic and Reconstructive Surgery
Hôpital Européen Georges-Pompidou and Clinique Bizet
Paris, France
Illustrations by: Tiffany Slaybaugh Davanzo, MA, CMI
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Executive Editor: Sue Hodgson Important note: Medicine is an ever-changing science undergoing continual
Managing Editor: Megan Fennell development. Research and clinical experience are continually expanding
Director, Editorial Services: Mary Jo Casey our knowledge, in particular our knowledge of proper treatment and drug
Editorial Assistant: Ellen Wynne therapy. Insofar as this book mentions any dosage or application, readers
Production Editor: Glenn Floyd may rest assured that the authors, editors, and publishers have made every
International Production Director: Andreas Schabert effort to ensure that such references are in accordance with the state of
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Director of Sales, North America: Mike Roseman tions and forms of applications stated in the book. Every user is requested
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President: Brian D. Scanlan and to check, if necessary in consultation with a physician or specialist,
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and responsibility. The authors and publishers request every user to report
© 2017 Thieme Medical Publishers, Inc.
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D E D I C A T I O N
To my beloved and supportive husband, Francis,
who has always been by my side at the times I needed him most,
and to Caroline and Guillaume, our wonderful daughter and son.
F.F.
To my amazing wife, Mally, for your unwavering love and support,
for indulging my addiction, and for being my ear model.
To my boys, Charlie and Sandy, for understanding my long absences
and following me around the globe.
To my good friend and colleague, Sacha, for your invaluable guidance,
hospitality, and for helping us to assimilate into Parisian life.
Finally, to Madame, for having the courage to solve such a difficult
surgical problem, the talent to make beautiful ears, and the discipline
to document your work so that all who follow may benefit from your experience.
Thank you for inspiring me, teaching me without limits,
and for saying “Pourquoi pas?”
J.D.
To Nathalie, my lovely beacon,
and to Vadim and Rose, my two adorable little children.
To my father, who showed me the way and who would be so proud today.
To my friends and colleagues around the world who share the same
passion for plastic surgery, and especially to Joe Dusseldorp, with whom
it has been such a pleasure to work on this book.
And finally to Françoise, who tirelessly teaches her incredible art, with
a unique combination of virtuosity and humor, and who has become over
the years much more than a mentor, a mother.
A.M.
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EXECUTIVE EDITOR Sue Hodgson
SENIOR PROJECT EDITING MANAGER Carolyn Reich
SENIOR DEVELOPMENTAL EDITOR Megan Fennell
GRAPHICS MANAGER Brett Stone
DIRECTOR OF ILLUSTRATION AND DESIGN Brenda Bunch
ILLUSTRATORS Tiffany Slaybaugh Davanzo
SENIOR MANAGING EDITOR Suzanne Wakefield
PROJECT MANAGER Glenn Floyd
MANUSCRIPT EDITORS Rebecca Sweeney, Idelle Winer
PRODUCTIONISTS Debra Clark, Chris Lane
PROOFREADER Linda Maulin
INDEXER Matthew White
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F O R E W O R D
I fi rst learned of Dr. Firmin’s interest and passion for ear reconstruction through a communication
from the late, great craniofacial surgeon, Dr. Paul Tessier. In 1984, he wrote me to praise her abilities
as a talented surgeon, teacher, and sculptor, and asked if she could spend time with me to “learn about
ears.” He opened his letter with the simple, striking statement, “This is not an ordinary recommenda-
tion.” How right he was!
Total auricular reconstruction epitomizes the marrying of art and science, and remains one of the great-
est creative challenges facing the reconstructive plastic surgeon. The surgeon must produce a sculpted
ear replica and safely introduce it beneath the skin in the auricular region, but must also create the
framework from living tissue that will last a lifetime while withstanding trauma and allowing the pa-
tient to carry on with a normal, worry-free life. To meet all these goals, the armature must consist of
the patient’s own tissues and therein presents a supreme challenge. Only ears constructed from autolo-
gous tissues have withstood the test of time.
Because one must sculpt the patient’s own rib cartilage to an exact three-dimensional ear shape, a cre-
ative background honed through artistic hobbies is particularly advantageous. Of the numerous sur-
geons who have studied with me during my 40+ year career, the ones who have emerged as superb ear
reconstructionists have tended to pursue various demanding skills throughout their lives even before
entering medical training. As Dr. Tessier aptly pointed out, Dr. Firmin falls into that category—she has
long been a superb artist and sculptor.
Although a surgeon’s inherent understanding of sculpture and design will infl uence one’s surgical suc-
cess, strict adherence to basic principles of plastic surgery and tissue transfer share equal importance.
The remarkable results of Dr. Firmin’s skillful utilization of these tenets are beautifully illustrated in
this book.
Within this excellent book, Dr. Firmin describes and illustrates her surgical techniques and details her
mastery of her favored two-stage reconstruction, addresses total repair of both congenital and acquired
posttraumatic auricular deformities, deals with secondary deformities and partial ear defects, and cov-
ers the management of complications as well as addresses aesthetic otoplasty. This book is a tour de
force for the ear enthusiast and is magnifi cently illustrated with her impressive results.
Because of the inherent limitations in surgically creating detailed body parts, few surgeons have truly
been able to excel at reconstructing the missing ear. By following her passion, Dr. Françoise Firmin
has become an outstanding expert in the fi eld of ear reconstruction. This book is a must for those who
wish to pursue the ultimate challenge and learn the art of ear reconstruction.
Burt Brent, MD
Woodside, California
vii
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