*Individual results may vary
Ear surgery, or otoplasty, is a cosmetic procedure to improve the appearance of a person’s ears. Although otoplasty does not affect hearing, it can provide great psychological benefits to anyone who has been teased about the size or shape of their ears, has had a serious ear injury, or simply wants to improve their appearance. Ear surgery for children or adults can set prominent ears back closer to the head and reduce the size of large ears. Surgery may also be helpful for “lop ear,” “cupped ear” and “shell ear,” large or stretched earlobes, and lobes with creases and wrinkles. The procedure lasts from two to three hours and may be performed in a hospital, office-based facility or an outpatient surgery center under general or local anesthesia.
Otoplasty typically serves two functions: setting prominent ears back closer to the head, and reducing the size of large ears. Ear surgery may also be helpful for the following conditions:
- Large or protruding ears
- Lop ear (top of the ear folds downward or inward)
- Cupped ear (a small ear)
- Shell ear (no outer curve in the cartilage)
- Large, stretched, or torn earlobes
- Earlobes with large creases and wrinkles
Surgeons are also able to construct new ears for patients who are missing them from birth abnormalities, injury or other causes.
Candidates for Otoplasty
Individuals who feel self-conscious about their ears and want to improve their appearance may be good candidates for otoplasty. While such operations are most frequently performed on children ages 4 to 14, they can be beneficial to people of any age. Ears are almost fully grown by age 4, and early surgery can help create self-confidence as a child begins to deal with the social complexities of school. I prefer to not perform the procedure for protruding ears until a child is at least six years of age. It is also important that you are in good general health and have realistic expectations about the outcome of the procedure.
Not everyone is a good candidate for otoplasty. It is important for patients to be in good general health. Goals for the surgery should be carefully discussed with the surgeon prior to undergoing the procedure so that the patient has realistic expectations about the outcome.
The Otoplasty Procedure
The otoplasty procedure generally lasts two to three hours and is performed on an outpatient basis. The type of anesthesia used typically depends on the age of the patient. General anesthesia is recommended for very young patients, while local anesthesia and a sedative may be used for older children and adults.
The otoplasty procedure begins with a small incision made behind the ear, in the natural crease where the ear meets the head. The cartilage is then sculpted and bent into its new position to achieve the desired appearance. In some types of otoplasty, skin is removed but the cartilage is left in one piece and merely bent back on itself for a smaller-looking ear.
After sculpting the cartilage to the preferred shape, sutures and a bandage are used to hold the ear in its new position until healing is complete. To achieve a more symmetrical appearance, both ears may be operated on even if only one has a problem.
Patients usually feel back to normal within hours after an otoplasty, although the ears may ache or throb for a few days. Prescription medication will be made available to help alleviate any discomfort. A few days after the otoplasty procedure, the bandages around the head will be replaced with a surgical dressing that should be worn for about a week after which time the stitches will be removed. Otoplasty patients should avoid sleeping on their side for the first two weeks after surgery.
After about one week following otoplasty, patients are usually able to return to their normal routines, children to school and adults to work. After the ears have healed completely, there will usually be a faint scar on the back of the ears. However, because of the strategic placement of the incisions in ear surgery, the scars will be virtually invisible* and will typically fade with time.
Risks and Complications
As with all surgery, there are risks associated with otoplasty. A small percentage of patients may develop a blood clot on the ear or an infection in the cartilage. These issues may resolves themselves or be treated medically through intervention or antibiotics. Other possible complications may include changes in skin sensation at the site. While most patients are delighted with the results of the otoplasty, there is a possibility that the patient will not be totally satisfied with the appearance of the ears after surgery. Patients should not expect the new ears to match exactly, since even normal, natural ears are not entirely symmetrical.
Complications are rare and usually minor, and can be minimized by choosing a qualified and experienced surgeon and by carefully following the surgeon’s aftercare instructions.