Ear surgery (otoplasty)

Otoplasty is surgery to reshape the ears to improve their appearance. Ears can be surgically reshaped, reduced in size, or made more symmetric. Though there are many types of ear abnormalities, most patients seeking an otoplasty are concerned about their ears sticking out too much. For these patients, surgeons use a variety of techniques to gently reshape and reposition the ear and create a natural three-dimensional contour. All the incisions are generally hidden in the crease behind the ear.

Otoplasty is one of the most common procedures for children over the age of five. Both children and adults can potentially benefit from surgery to reposition their ears. Otoplasty will not alter hearing ability.

During the consultation, the surgeon will examine the structure of the ears and discuss possibilities for correcting the problems. The exact methods utilized and what can be expected from the procedure will vary from patient to patient, depending on the individual circumstances.

All surgery carries some uncertainty and risk

When ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and complications such as infection or a small blood clot can occur. These complications may require additional treatment. It also is possible that the individual’s problem may require a secondary procedure to be completely corrected.

Planning for surgery

Most surgeons recommend that parents stay alert to their child’s feelings about protruding ears; don’t insist on the surgery unless the child, themselves, want the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

Where the surgery will be performed

Ear surgery is usually performed as an outpatient procedure in one of the hospital’s operating rooms.

Types of anesthesia

For younger children, general anesthesia is generally used, so the child will sleep through the operation. For older children or adults, the surgeon may prefer to use local anesthesia, sometimes combined with a sedative.

The surgery

Ear surgery usually takes about two to three hours, although complicated procedures may take longer.

With one of the more common techniques for treating ears that stick out excessively, the surgeon makes a small incision in the back of the ear to expose the ear cartilage. The surgeon will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, this approach will be combined with additional techniques to make the base of the ear less prominent.

In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.

Getting back to normal

During your first postoperative visit, the bulky bandages will be generally be removed. Stitches may be removed at that time, as well, if required. A lighter head dressing, similar to a headband, is often recommended after the initial bulky dressing is removed, especially at night, after that. Specific instructions will be provided by your surgeon.

Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work very soon after surgery. Children can generally go back to school after approximately a week, if they’re careful about playground activity.

More natural-looking ears

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly. Perfect symmetry is both unlikely and unnatural in ears. If you’ve discussed the procedure and your expectations with the surgeon before the operation, chances are, you’ll be quite pleased with the result.

Other ear conditions

Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: lop ear, when the tip seems to fold down and forward; cupped ear, which is usually a very small ear; and shell ear, when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury.