• 
  American Society
  of Plastic Surgery
• 
  American Society of
  Aesthetic Plastic Surgery
• 
  American Association for Accreditation
  of Ambulatory Surgery Facility

SELECT A PROCEDURE: Face Lift | Mid-Face Lift (Cheek Lift) | Cheek Augmentation | Endoscopic Brow Lift (Forehead Lift) | Neck Lift | Blepharoplasty (Eyelid Lift) | Lip Augmentation | Otoplasty | Rhinoplasty

Procedure: Otoplasty

Otoplasty is a procedure performed to set prominent ears back closer to the head or to reduce size of large ears. For the most part, the operation is done on children between the ages of four and fourteen but there are many adults who seek the same correction. Ears are almost fully grown by age 7, 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.

It is 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 the outcome.

Surgery

Ear surgery is usually performed as an outpatient procedure in a hospital, or in our office-based surgical facility. Typically a small incision is made in the back of the ear to expose the ear cartilage. The cartilage is then sculpted and bent back toward the head. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage. Permanent stitches are then placed internally on the cartilage to maintain the new shape.

Anesthesia The procedure is usually performed as an outpatient under local anesthesia. If you have other procedures performed at the same time, then general anesthesia will be necessary. If your child is young, a general anesthetic is recommended, so your child will not experience the operation. For older children or adults, the surgeon may prefer to use local anesthesia. On occasions sedation can be performed using intravenous medications. The anesthesiologist and the surgical facility will bill separately for their services.

Duration of Surgery The operating time will vary depending on the patient and the extent of the procedure, and whether any additional procedures are performed. Generally, the operative time for a bilateral otoplasty is approximately 1 ½ hours

Before Surgery Do not take aspirin and ibuprofen or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from energy drinks or any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center. 

Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken.

After Surgery

The patient's head and ears will be wrapped in a bulky head bandage to minimize the swelling and bruising, for protection and to help mold the ears. The ears may throb or ache a little for a few days, but this can be relieved by oral medication. The typical complaint is that the head will itch and you will have to refrain from sticking your fingers or other items under the dressing to scratch. This may result in an infection or hinder the normal wound healing process. A fan or hair dryer set on "cool" will help dry the sweat under the dressing that is the culprit for the itching.

The bulky bandages will be removed by the 5th day and replaced by a lighter head dressing (tennis sweat-band) similar to a headband. Be sure to follow the directions for wearing this dressing, especially at night. There is usually a moderate amount of swelling and bruising after the dressings are removed. Stitches are will dissolve in about 10 days. Antibiotic ointment will need to be applied to the back of the ears for 2 weeks.

Return to Normal Activity Any activity in which the ear might be injured or bent should be avoided for a month or so. Skiing, playing ball, wrestling, riding bikes, skateboarding or being on a trampoline should be avoided. Most adults can go back to work within five days after surgery. Children can go back to school after seven days or so if they are careful about playground activity. You may want to ask your child's teacher to keep an eye on your child for a few weeks. You should try to sleep with your head and shoulders elevated to help reduce the amount of swelling. You may shower after the dressings are removed. Strenuous sports and other activities should not be performed for 3 to 4 weeks, as this may raise your blood pressure and result in further swelling or bleeding. You may drive when you are no longer taking pain medication and when the swelling is no longer a concern.

Scars Incisions will be located behind the ears; however, occasionally a small incision is necessary on the front of the ear. These incisions usually heal very well. The scars are rarely problematic. Nevertheless, you should be aware that all scars are permanent and their height, width and final color are unpredictable. Wear a sunscreen of at least SPF 30 or greater when outside to protect the scars from sunlight during the healing process.

Swelling and Bruising Swelling and bruising of the ears or any site following surgery is normal. During the first 1 to 2 weeks your ears will feel and look swollen. The swelling will start to subside after the first postoperative week. It may take as long as 2 to 3 weeks for the last bit of swelling to recede. The bruising will also take 1-2 weeks to subside. Taking the herbal medication, Arnica Montana, as well as fresh pineapple and/or papaya will help decrease the swelling and bruising.

Complications

HEMATOMA This is the most common complication and occurs when a collection of blood forms under the areas of undermined skin. It occurs in about 1 to 2% of patients. The body will absorb minimal bleeding. Only on rare occasions will it require additional surgery. On very rare circumstances, bleeding could result in intense pain behind the ear and may lead to cartilage injury or infection.

EDEMA This is swelling, which is a normal consequence of surgery and is best treated simply by elevating the head of the bed. The application of ice packs or cold compresses is very helpful for the first 2 to 4 days.

ABNORMAL SCARS A small percentage of patients will develop scars that are unacceptable despite meticulous attention to detail, both during and after surgery. The scars may widen, remain red or raised. If the scars are problematic, a steroid ointment or injection may be used to improve their appearance. This usually corrects itself with time, massages and patience. In rare cases, the scars may need to be surgically revised.

INFECTION This complication is also rare. Prevention is the key, and antibiotics are given both before and after surgery. Occasionally, patients may develop an infection in the cartilage, which can cause scar tissue to form within the ear. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

ASYMMETRY There is usually some asymmetry of the ears; in some people this is marked and is the reason they seek surgery. All efforts are made to have the ears as symmetrical as possible but it is important to understand that perfect symmetry may be difficult to attain. A slight asymmetry may be acceptable after surgery; a greater amount of asymmetry may require additional surgery to correct.

I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be.

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