'I could never hear on my left side - until I got a prosthetic ear'

Imagine being born without an ear and spending your entire life without being able to hear on one side.

Stephen Gilbert, 74, from Aghalee, was born with unilateral microtia, a rare condition in which the external ear is underdeveloped or missing on one side.

But he was recently fitted with a newly-designed prosthesis that accommodates a hearing aid, allowing him to hear on his left side for the first time.

That's thanks to oral and maxillofacial surgery at the Ulster Hospital; the only service of its kind in Northern Ireland, providing bespoke prostheses for people affected by birth defects, traumatic injuries and cancer surgery.

"To be able to hear someone on my left that I could never do before is just very special," Gilbert said.

"It's a huge thing to be able to have a prosthetic part of your face."

"In my case with an ear, it's not just as visual as someone maybe needing a prosthetic for the front part of their face, maybe through injury or through cancer," he added.

"I'm very conscious of that, but I'm very grateful for what has happened to me."

Growing up during the 1960s, when boys commonly wore their hair long, Gilbert could cover the area where his ear should have been.

But he became increasingly conscious of his condition as he grew older, particularly as hairstyles changed and his hair became thinner.

Gilbert first attended the Ulster Hospital in October 1997 for a prosthetic ear and over the past 29 years has had artificial ears made, repaired and adapted.

Previously, plastic surgery had attempted to reconstruct "some semblance of an ear" using skin and tissue taken from other parts of his body, but the results could not replicate the shape of a natural ear.

But after his wife read a magazine article about advances in prosthetics, describing how they had progressed from basic skin grafts to realistic artificial ears, Gilbert went to his GP.

"I'd managed for so long, but I suppose I knew that the hair wasn't always going to be there and something needed to be done," he said.

The previous grafted tissue was then removed and small implants were inserted to support the artificial ear.

A mould of his right ear was then used to create a matching left ear, before getting the colour and fit right.

"Amazing, that I had something that I didn't have there before.

"That was just remarkable," he said.

His new prosthetic ear holds a hearing aid which transmits sounds from his left side to his functioning ear.

The prosthesis has helped Gilbert feel less self-conscious when his ear is exposed, while advances in hearing aids have also made a "huge difference" to his life.

Consultant maxillofacial prosthetist Brian Bigmore has made about 4,000 prostheses and devices for more than 250 patients at the Ulster Hospital.

These include artificial ears, eyes and noses, as well as fingers, thumbs and nipples.

Each prosthesis is individually made, from the initial impression of the defect through to the final fitting of a life-like silicone device.

Bigmore said the impact of a facial defect often goes far beyond appearance and can affect confidence, social interaction and quality of life.

The aim is to help restore appearance and function, but also to help patients regain confidence following what can be a life-changing diagnosis, injury or surgery.

He said he has seen patients in a "really dark place" and even patients who have not wanted to see family members because they are afraid of their reaction and they are afraid they will look differently at them.

But he described seeing a patient's reaction when they first look in the mirror wearing their new prosthesis as one of the most emotional, but rewarding, parts of his work.

"Some of my patients say they never want to leave the house again and then after I'm finished with my prosthetic, they phone me up maybe three or four months later to say they've booked their holiday and they're going.

"They're confident to go through an airport and they're confident to lie by a swimming pool, they're confident to go for a drink with their family and not have to worry about someone staring at them because of the way they would have looked without their prosthetic," he said.

"All I can do literally is try to make them want to continue on - not to give up - because life doesn't have to finish."

While many prostheses are designed to restore appearance, some also serve a practical purpose.

Artificial fingers and thumbs, for example, can help patients feel more confident in social settings while addressing some of the challenges associated with missing digits.

Bigmore said he has seen an increase in patients coming to him with head and neck cancer, with patients having their whole nose removed or their eye taken out.

He said these patients "are literally afraid to look in the mirror anymore".

"They just see something different than was there before," he said.

"Not only are they dealing with that cancer and the prognosis of the cancer, the long-term outlook, but they're also dealing with the fact that they're now different and relationships are different.

"They don't want to face the world anymore, they just want to hide.

"In fact, a lot of my patients would say that they would rather be dead than actually look the way they now look.

"And for me, that's a big moment because I try my best to make sure that they want to live, they want to keep going."

He said after the prosthetic is fitted he hopes they regain their confidence.

"Life's never going to be the same, but it doesn't have to be over," he said.