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- 1981-1985 Otology, Otolaryngology, Head and
Neck Surgery, and Facial Plastic Surgery Training at the Johns Hopkins
Hospital, Baltimore, Maryland. Worked with Dr. George Nager,
renowned Swiss Otologist.
- 1985-86 & 1987-88 Plastic and
Reconstructive Surgery at Stanford Medical Center, Stanford,
California
- 1986-76 Fulbright Fellowship to Paris,
France, worked with Dr. Paul Tessier and Dr, Francoise Fermin (the ear
reconstruction specialist for Europe)
- 1988-89 Associate of California Ear Institute
with Dr. Bert Brent and Dr. Rodney Perkins, specializing in External
Ear Reconstruction.
Although Dr. Jones is well trained in the middle ear surgery, he limits his
practice to external ear deformities. However, this previous training and
experience permits Dr. Jones to work intimately with his Otology colleagues
in planning the total reconstruction effort so that the external ear
reconstruction surgery does not compromise (and vice versa) the middle ear.
Surgery on the external ear can be one of the safest and easiest surgeries
that a patient can undergo if performed by a well trained, qualified,
experienced and careful surgeon, or it can be one of life's most
frustrating experiences if performed by an inexperienced surgeon. The
tissues of the ear are fragile and unforgiving and these fragile tissues
have to be handled carefully. It has been estimated that the average
plastic surgeon sees only (3) three Microtia patients in a lifetime. This
is why it is best for this demanding surgery to be performed by a surgeon
experienced in Microtia, and who is doing this surgery regularly.
Otoplasty - Prominent Ears
Otoplasty is a procedure to correct prominent or "big" ears that
is commonly performed in the United States on thousands of patients every
year. There are many different anatomical types of deformities and Dr.
Jones individualizes the techniques to suit the deformities. These
procedures are usually performed between 5 to 6 years of age just prior to
entering first grade but can also be performed anytime afterwards. Most
good insurance plans do cover these procedures as they are necessary to
correct disfigurement due to improper development, but this is determined
by the insurance carrier.
Otoplasty is usually performed as an outpatient either under general
anesthesia which puts the patient "asleep" through the entire
operation or under local anesthesia which numbs similarly to the way a
dentist frequently anesthetizes the teeth prior to dental work.
Most children usually are put to sleep to eliminate their anxiety and most
adults have their choice. A head bandage is worn one week followed by a
head band at night for one month.
Traumatic Deformities
Parts of the ear are frequently injured in accidents. Even the entire ear
may be lost because of its exposure in its projection from the head.
Each damaged ear has to be assessed individually by Dr. Jones before
reconstruction can be planned. Sometimes techniques are borrowed from the
classical Microtia repair which Dr. Jones is so well experienced or other
techniques which are better for regional ear defects are utilized. Staged
reconstructions are frequently employed for Traumatic Deformities because
of the fragility of the ear tissues.
Microtia - Staged Surgical Total Ear Reconstruction
(ex. 1) (ex.2)
   
What is Microtia? Microtia is a congenital deformation of one ear and
occasionally both ears where the middle ear containing the little bones of
the ossicular chain and the external ear with its cartilagenous framework
does not fully develop. This almost always results in a severe hearing loss
and an external ear structural deficit with only some rudiments remaining
that may be deformed and malpositioned.
The Different Methods of Ear Reconstruction Available
There have been many different methods to reconstruct total ears but none
have stood the test of time like a well executed sculptured rib graft.
These natural tissues have the advantage over artificial implants or
plastic glue-on or snap-on ears of being fully acceptable to the patient
under a multitude of circumstances that an artificial ear would not.
Silastic ear implants are notorious for rejections and infections. Glue-on
or snap-on artificial ears can be pulled off to the deep embarrassment of
the child. Can you see the effect on your child if the class clown yanked
on the ear and it came off in his hand and he held if up to his classmates?
Also there is no sensation in the plastic ear...it does not have feeling
nor sensation as a rib graft ear does. While a plastic ear may match the
adjacent skin color well at times, it does not blush or flush as one's face
normally does when you are excited, cold, or embarrassed. An artificial ear
does not suntan. So the plastic ear color may be matched well for
photography but may be obviously artificial in the real world due to their
inability to change color naturally. Sports participation with artificial
ears is limited because of the potential embarrassment of them coming off.
The total ear reconstruction is performed in four stages for most patients.
These are spaced apart 2-3 months to allow healing. Most patients do not
experience significant ear discomfort with any of the stages. Blood
transfusions are not required.
Sports are restricted for 4-5 weeks in children and for 6 weeks in
teenagers and adults. This is not done so much for the ear as for the chest
wound. Sufficient time to heal must be allowed before the patient is
allowed to run, jump, bicycle, or swim. Once back to sports, the patient is
allowed to play with no special protection and can participate like anyone
else in most activities. The ears constructed by Dr. Jones are made out of
the patient's own living tissues, and can tolerate bumping and trauma like
a normal ear. However unusually traumatic activities such as boxing are
discouraged. If the patient is to wear a helmet (as for motor cycling or
football) it is best to cut out an area and line it with soft foam rubber.
Bilateral Microtia - Double sided ear problem
The second rib graft surgery is performed as early as six weeks after the
first rib graft surgery. After two months both ear lobes can be positioned
simultaneously at one surgical setting. Then after three months the ear can
be separated from the head, followed by the other side six weeks later.
Middle Ear Surgery - The Hearing Surgery
This is done to improve hearing and is done only after the outer ear has
first been completely connected. This is necessary because the scar from
the middle ear surgery severely compromises the chances of making a good
outer ear. Dr. Jones is unique in his field of ear reconstruction in that
he has extensive background in middle ear surgery at Johns Hopkins which
allows him to work intimately with the referring Otologist in planning the
total reconstruction effort so that the external ear reconstructive surgery
does not compromise (and vice versa) the middle ear surgery.
Other Congenital Deformities
The range of congenital ear deformities is immense-from gigantic ears to
miniature ears, from wide to narrow, from lack of folds to lack of
earlobes. The cup ear, lop ear, lidded helix, canoe ear, cockleshell ear,
constricted ear are all different variations of ear deformities. Most can
be corrected or at least improved upon with surgery. All repairs are
customized by Dr. Jones to best suit the deformity and have to be
individualized.
When to visit Dr. Jones
The optimal age for external ear surgery is usually between 5 to 6 years of
age but can be done at any age thereafter. However, it is usually
beneficial for the family to visit Atlanta as soon as it convenient in
order to ask questions and go over in detail the plans for the surgery.
Know your surgeon
Dr. Jones is a well trained and experienced Plastic Surgeon and
Otolaryngologist who has been educated at the finest institutions in the
world. Indeed, Georgia is fortunate to have one of it's native sons attend
Oxford University, England; Paris, France Stanford, California; and Johns
Hopkins Hospital to learn the most up-to-date techniques in ear
reconstruction and bring these techniques and skills to the Eastern USA.
The training that Dr. Jones has had is unusual in both quality and
quantity. There are few surgeons who have had such an extensive preparation
of 20 years. It began in Atlanta at Emory University where Dr. Jones
completed his pre-medical studies. While at Emory he received a Rotary
Scholarship from the state of Georgia because of his excellent record. On
account of the scholarship and his outstanding work at he Medical College
of Georgia, he was able to attend the University of Canterbury in New
Zealand, and the Honours School of Physiology in the Medical School at
Oxford University, England, over a 3 year period. Thereafter he completed
his medical school at the University of Georgia, earning four degrees in
four years.
Twelve years of surgical training followed: two years were spent in General
Surgery with the first at the Medical University Hospital in Charleston,
South Carolina, and the other in Baltimore Maryland, at the Union Memorial
Hospital. Four years of rigorous training followed at the world-famous
Johns Hopkins Hospital specializing in facial surgery. At Hopkins the
emphasis was on the head and neck-particularly ear surgery. The fourth year
at Hopkins, Dr. Jones became a faculty member and was active in teaching
and directing surgical residents specializing in ear, nose and throat
surgery (ENT). This was followed by 3 years at the renowned Plastic Surgery
program at Stanford in California where many pioneering events in Plastic
Surgery have taken place.
Moreover, Dr. Jones was given, as a representative of Stanford, a Fulbright
Fellowship to study in Paris, France, for a year with the genius of Plastic
Surgery, Dr. Paul Tessier, who is the "Father of Craniofacial
Surgery"; Dr. Renee Malik, who has pioneered children's cleft lip and
cleft palate surgery; and Dr. Jost, the French nose surgeon who, like Dr.
Jones has completed training in both ENT and Plastic Surgery; and also with
Dr. Francoise Fermin the specialist in ear reconstruction in France and
western Europe.
Dr. Jones returned to Stanford where he finished his formal Plastic Surgery
Training. He then became an associate of the California Ear Institute and a
member of the Clinical Faculty at Stanford. Dr. Jones became the affiliate
of Dr. Bert Brent who had pioneered many ear reconstruction techniques. He
had never trained anyone else in his ear reconstructive techniques prior to
this and because of Dr. Jones's extensive training, invited him to
participate in his practice to learn the art of ear reconstruction.
Another member of the California Ear Institute was Dr. Rodney
Perkins-famous for his discovery and founding of the injectable collagen
which is used frequently today to mask wrinkles and enhance lips. He also
pioneered the use of the YAG laser surgical "knife" and has just
completed development of the ReSound "hidden" hearing aid for
better hearing as well as greater aesthetic appeal.
In November of 1989, Dr. Jones moved to Atlanta returning to his native
Georgia to raise his family and bring to the Eastern United States the
talents obtained from his 20 years of training at the leading centers in
the Unites States and in Europe, and also his skills as a specialist in
external ear reconstruction.
Dr. Jones' professional papers have appeared in several medical journals
including "The Annals of Plastic Surgery," as well as presented
at multiple conferences including the American Society of Head and Neck
Surgery and the XIII World Congress. He has been quoted and interviewed by
such magazines as Women's Daily and for CBS television's Sixty
Minutes by Diane Sawyer as well as local television stations. He is
also a guest speaker and lecturer in the community. He has been a
participant in the nationally recognized Interplast program volunteering
his services to poor children of South America who cannot afford to have
surgery on their cleft lips or cleft palates or burn scars, or ear deformities.
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