Ear Surgery (Otoplasty)
Ear Surgery (also known as Otoplasty) is an operation to pin back protruding ears. Ear reduction surgery is mostly performed on children however otoplasty in adulthood is not uncommon. Prominent ears can be caused by a number of factors: the outer curve (helix) may be too large, the fold inside the outer ear may not be properly developed or the earlobes are sticking out at an abnormal angle.
Frequently Asked Questions
No two ears are alike, which is true for even your own ears. The aim of otoplasty is to attain ‘normal’ looking ears. Surgeons suggest a normal projection is about three to four centimetres. The operation does not aim for perfectly matching ears or ones that lie flat against your head. Your surgeon will discuss the possibilities and your expectations. Digital imaging can be very useful in this regard.
Ear Surgery Operation
Most plastic surgeons and ear nose throat (ENT) specialists perform ear reduction surgery. The technique used depends on the cause.
A shallow or missing antihelix (the prominent fold of cartilage inside the outer rim) requires the surgeon to make an incision in the back of the ear. The surgeon then either removes some cartilage or uses sutures to fold the cartilage and reshape the ear. Alternatively, cartilage may be scraped at the front of the ear and stitching the back of the ear closer to the head.
The operation takes about one to five hours, depending on what’s required. For adults, the procedure may be performed under general or local anaesthetic. It’s better to use general anaesthetic for children since it’s difficult for them to remain still for such periods.
Ear surgery and Children
Parents need to weight up various considerations if they wish for their child to undertake the operation. One such consideration is the age factor. If the ears protrude excessively, the operation can be performed on children as young as four. However, surgery does not stop the ears growing. Full growth does not take place until after the age of 6 (at that age the ears will have grown to approximately 80% of their capacity).
The decision can be more difficult with young boys. Ears that appear excessively prominent now may blend in harmoniously once the child reaches puberty (when the cheekbones enlarge and shoulders broaden). Once this change takes place, you may find that ear pinning surgery is not necessary after all. In this circumstance, it may be best to leave the decision to your son.
Children can be fiercely bullied for their prominent ears. However, the entire surgery process and satisfaction rate is greatly enhanced if the child actually wants the operation themselves. Children who are against the operation are more likely to be uncooperative and dissatisfied with the outcome. This is why many surgeons refuse to operate on a child unless they are aware of the problem and request for their ears to be fixed.
Ear Surgery Recovery Process
After the operation, your head will be wrapped in thick bandages. Your face will not be covered.
You will need bed rest for two to three days. Prop your head up with one or two soft pillows to reduce swelling. Stitches can be removed approximately one week following surgery.
You will feel pain in the ears, which may be eased with pain killers as directed by your surgeon. Aspirin is prohibited. It may hurt to sleep on your ears. The pain can be reduced by using soft pillows.
It’s normal for your ears to ooze after the operation. The oozing may soak through the bandage; however it should only be temporary. If it continues, speak to your surgeon.
Bandages are removed after one to two weeks. At this stage, the ears will be swollen and red. For the first week, you will be required to wear a headband throughout the day and at night. After a week, this will be limited to night for the next two to three weeks.
Swelling and redness may continue for several months. You will also experience numbness, which can persist for weeks and even months.
Ear Surgery Risks
Sensitive ears – it’s common for ears to become sensitive to cold temperatures. You may alleviate sensitivity by keeping the ears warm with a scarf, beanie, headband or hat.
Bleeding – if bleeding or a blood clot occurs immediately following surgery, this may require further surgery.
Infection – usually treated with antibiotics. If the infection is extreme, the ear may need to be surgically drained and operated on to restore normality. Also, an infection can create scar tissue which can deform the cartilage, requiring revision otoplasty. You will know your ear is infected if it’s painful and swollen.
Scarring – otoplasty scars are usually faint and hidden behind the ear. Let your surgeon know if you are prone to problem scarring. Secondary surgery or other treatment (such as injecting steroids into the ear) may be required if the scarring is heavy.
Asymmetry – if the ears turn out uneven, you may need revision ear surgery.
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