What is Otoplasty?
Otoplasty is a procedure used to pin the ears nearer to the head or diminish the appearance of ears that are larger than average. Surgical techniques like cartilage removal and reshaping through an incision done on the back of the ear can be carried out in order to re-establish normal ear shape. Otoplasty may be done on one ear or both ears as needed.
The specifics of otoplasty are dependent on the requirements of the patient. Certain factors may lead to ear deformities. Common deformities consist of:
Cup Ear: Parts of the external ear develop unevenly which causes it to stick out hence having a cup-shaped ear.
Lop Ear or Bat Ear: The inner part of the ear known as the concha grows perpendicular or at a right angle instead of parallel to it.
Cauliflower Ear: This is caused by injury and inflammation.
Effects of Otoplasty
Undergoing otoplasty leads to more natural-looking ears. Most of those who go through with the procedure are extremely pleased with the results of surgery. However, it is important to remember that what is achieved here is improvement and not perfection. It is important to discuss the procedure and expectations with your surgeon before undergoing surgery.
Candidates for Otoplasty
Children between the ages of 4 to 14 are good candidates for otoplasty. Adults who want to go through with the procedure must be in good health and have no medical restrictions to surgery, as with any cosmetic surgical procedure. It is essential that the patients are aware of the possibilities and limitations of surgery, as well as be realistic in their expectations after undergoing surgery.
Some deformities mentioned above such as protruding ear, lop ear (the tip of the ear seems to fold down and forward), cupped ear (a very small ear), and shell ear (curve in the outer rim and natural folds and creases are absent) can benefit from Otoplasty. Those with large or stretched ear lobes, lobes with large creases and wrinkles are also candidates for this procedure. It is also possible for surgeons to create new ears for those who have none either congenitally or through an injury or trauma.
Your surgeon will assess your condition and suggest the most appropriate technique needed for your condition. Specific instructions are also given to prepare the patient for surgery.
For parents whose child will undergo the procedure, it is advised that they be watchful of their child’s feelings concerning his/her condition and about undergoing surgery. Children who feel awkward about their ears usually are more accommodating and more open about surgery and end up pleased with the outcome.
The Otoplasty Procedure
Otoplasty generally takes about two to three hours, depending on how complicated the procedure is. The use of anesthesia may vary among patients. General anesthesia is used mostly on children under 12 years of age. On the other hand, adults receive local anesthesia most of the time. The technique used by the surgeon will depend on the condition or problem of the patient.
Otoplasty in patients with protruding ears usually involves an elliptical-shaped incision that is done in the cartilage behind the ear. The surgeon will shave, flatten, fold, or manipulate the cartilage after making the incision in order to attain desired position of the ear and achieve a new shape for it. An exceedingly long or uneven ear lobe may be trimmed in order to attain a balanced appearance of the ears.
Fine sutures are made in order to maintain the ears’ new position while it is healing. Compressive dressings are utilized in order to protect and care for the surgical site and to maintain the ears’ new shape at the time of recovery. Scars will not be noticeable as they are situated behind the ear.
One of the more common techniques includes exposing the ear cartilage. This is done by making a small incision behind the ear. The cartilage will then be sculpted and bent back toward the head. On occasion, the surgeon may remove a larger part of cartilage in order to achieve a more natural-looking fold after surgery is done. To help preserve the new shape of the ears, non-removable stitches are used.
A different technique utilizes a similar incision done behind the ear. However, the skin is removed and stitches are used to fold the cartilage back on itself. This is done without having to remove the cartilage. There are cases wherein surgery is performed on both ears even if only one ear appears to protrude. This is done in order to achieve better balance for both ears.
The patient's head will be wrapped with a bulky bandage right after otoplasty to encourage molding and healing. The ears are held in place with the use of an elastic bandage or a headband after undergoing the procedure. Pain and swelling in the ears are to be expected, as well as some throbbing. For this reason, pain medications may be prescribed to relieve discomfort. Patients are advised to sleep with their heads elevated the first night after the procedure. Two weeks after surgery, the stitches may be removed. At this time, the ears may appear too close to the head or overcorrected; however, the will adjust to the final correct position after several weeks.
Patients, both adults and children, are usually up and about within a few hours post-surgery. On the other hand, children may stay overnight in the hospital until effects of the general anesthesia wears off.
Stitches will be removed or will dissolve in about one week. For about a month or so, it is important that the patient should avoid any activity that may cause the ears to bend. Usually, adults can resume work five days post-surgery. Children, on the other hand, may go back to school after a week or so but caution should be taken on playground activities. It is also advisable to have someone keep watch over your child, say your child’s teacher, for a few weeks.
Complications are rare, uncommon, and usually minor when this procedure is done by a competent and experienced surgeon. All the same, like any other operation, risks and complications are associated with surgery.
Common side effects of otoplasty are temporary throbbing, some aching and swelling, erythema (redness) and numbness. Some patients who have undergone this procedure may develop a blood clot in the ear. This could dissolve spontaneously or can be drawn out via a needle.
Infection in the cartilage may also occur in patients after undergoing the procedure which can result in scar tissue formation. Surgery to drain the infected area is rare. Use of antibiotics is the most common way of treating this.
Other risks include getting keloids (thick scars that develop especially among African-American patients), loosening or breakage of the sutures that allows the ear to come back to its original position, and hypercorrected ears or overcorrection of the ears, making them too close to the head.
Frequently Asked Questions
Q: If only one ear is protruding, will only one ear be treated?
A: Otoplasty is done on both ears even if only one ear is affected in order to attain balance.
Q: Will the Otoplasty procedure hurt?
A: Some aching and throbbing of the ears may be expected during the first few days after the procedure. Pain medication may be prescribed for pain control and to ease any discomfort that one may feel.
Q: Will there be scar formation after undergoing the procedure?
A: Scars will be present but since they are located behind the ears, the resulting scars are well hidden.
Q: How much time is needed to take off from work or school after surgery?
A: Children may go back to school within a week after surgery. Adults, on the other hand, may resume work within a few days. For at least one or two months, more caution should be taken with strenuous and physical activities in order to avoid risks of injury to the ear.
Q: What is recovery like after Otoplasty?
A: Aching, throbbing, and a little discomfort may be expected but with only a little downtime. The head is likely to be wrapped with bandage and the stitches could be removed or may dissolve on their own within a week.
Q: When can I start exercising after undergoing the procedure?
A: Exercising, strenuous activities, contact sports, or any activity which increases the risk of injury to the ear should be avoided for at least one to two months.
Q: Does insurance cover Otoplasty?
A: Insurance does not usually cover procedures for cosmetic purposes although there may be some coverage available for the repair of abnormal body structure. It is advised that patients verify first the availability of coverage with their own insurance company.
Q: Is it possible to get the Otoplasty procedure financed?
A: Many plastic surgery procedures can be financed. Your surgeon may be able to present you with more information regarding this.