Ear Surgery (Otoplasty)
If you're considering ear surgery...
or otoplasty, is usually done to set prominent ears back closer
to the head or to reduce the size of large ears.
Ears that appear to stick out or are
overly large can be helped by ear surgery.
For the most part, the operation is done on children between the ages of
four and 14. Ears are almost fully grown by age four, and the earlier the
surgery, the less teasing and ridicule the child will have to endure. Ear
surgery on adults is also possible, and there are generally no additional
risks associated with ear surgery on an older patient.
If you're considering ear surgery for yourself or your child, this information
will give you a basic understanding of the procedure-when it can help, how
it's performed, and what results you can expect. It can't answer all of
your questions, since a lot depends on your individual circumstances. Please
be sure to ask your doctor if there is anything you don't understand about
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 specific complications associated
with this procedure.
A small percentage of patients may develop a blood clot on the ear. It
may dissolve naturally or can be drawn out with a needle.
Occasionally, patients develop an infection in the cartilage, which can
cause scar tissue to form. Such infections are usually treated with antibiotics;
rarely, surgery may be required to drain the infected area.
Planning for surgery
Most surgeons recommend that parents stay alert to their child's feelings
about protruding ears; don't insist on the surgery until your child wants
the change. Children who feel uncomfortable about their ears and want the
surgery are generally more cooperative during the process and happier with
In the initial meeting, your surgeon will evaluate your child's condition,
or yours if you are considering surgery for yourself, and recommend the
most effective technique. He or she will also give you specific instructions
on how to prepare for surgery.
Where the surgery will be performed
Ear surgery is usually performed as an outpatient procedure in a hospital,
a doctor's office-based surgical facility, or a freestanding surgery center.
Occasionally, your doctor may recommend that the procedure be done as an
inpatient procedure, in which case you can plan on staying overnight in
Types of anesthesia
If your child is young, your surgeon may recommend general anesthesia, so
the child will sleep through the operation. For older children or adults,
the surgeon may prefer to use local anesthesia, combined with a sedative,
so you or your child will be awake but relaxed.
Ear surgery usually takes about two to three hours, although complicated
procedures may take longer. The technique will depend on the problem.
With one of the more common techniques, the surgeon makes a small incision
in the back of the ear to expose the ear cartilage. He or she 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, the surgeon will
remove a larger piece of cartilage to provide a more natural-looking fold
when the surgery is complete.
An incision is made in the back of
the ear so cartilage can be sculpted
or folded. Stitches are used to
close the incision and help
maintain the new shape.
Another technique involves a similar incision in the back of the ear. Skin
is removed and stitches are used to fold the cartilage back on itself to
reshape the ear without removing cartilage.
Creating a fold in the cartilage makes
the ear lie flatter against the head and
appear more normal.
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
Adults and children are usually up and around within a few hours of surgery,
although you may prefer to stay overnight in the hospital with a child until
all the effects of general anesthesia wear off.
The patient's head will be wrapped in a bulky bandage immediately following
surgery to promote the best molding and healing. The ears may throb or
ache a little for a few days, but this can be relieved by medication.
Within a few days, the bulky bandages will be replaced by a lighter head
dressing similar to a headband. Be sure to follow your surgeon's directions
for wearing this dressing, especially at night.
Stitches are usually removed, or will dissolve, in about a week.
Any activity in which the ear might be bent should be avoided for a month
or so. Most adults can go back to work about five days after surgery.
Children can go back to school after seven days or so, if they're careful
about playground activity. You may want to ask your child's teacher to
keep an eye on the child for a few weeks.
Other ear problems
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.
Sometimes, however, the correction can leave a scar that's worse than the
original problem. Ask your surgeon about the effectiveness of surgery for
your specific case.
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.