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Ear Surgery (Otoplasty)

Ear surgery, or otoplasty, is procedure that places the ears in a more aesthetically desired position. Typically, this procedure is performed to correct protruding ears. Ear surgery may also be performed to alter the shape of the ear to create balance and harmony to the head. Ear malformations, such as lop ear, when the tip of the ear folds down and forward; cupped ear, a very small ear; shell ear, when the curve in the outer rim, as well as the natural folds and creases, are missing; large or stretched earlobes; and lobes with large creases and wrinkles may be corrected through this surgical procedure. Since the average person's ears are fully developed by the age of four, this type of surgery is most commonly performed on a child or adolescent.

• How is ear surgery performed?
• How long does ear surgery take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• How do I prepare for ear surgery?
• What precautions are necessary during recovery?
• What are the possible complications after ear surgery?
• What results can I expect after ear surgery?
• Choosing the right surgeon

How is ear surgery performed?

Surgical techniques for ear surgery will vary depending on the problem you want to correct. One of the more common techniques is for surgeons to make a small incision in the back of the ear that exposes the cartilage. Your surgeon will sculpt and shape the cartilage to the desired position, and then bend it back toward your head. In most cases, non-removable stitches will be used to maintain your new shape. To provide a more natural looking ear fold, your surgeon may remove a larger piece of cartilage when the procedure is completed.

Another technique your surgeon may choose is to make a smaller incision in the back of your ear. Skin is removed, instead of cartilage, and stitches are then used to fold the cartilage on to itself. This technique pulls the ear back flat against your head and enables your surgeon to reshape the ear without removing cartilage. The technique your physician uses will depend on your ear's current condition and the result you want to achieve. In most cases, the surgery leaves a light scar on the backside of your ear that will fade over time. To create a more balanced appearance, surgeons will normally operate on both ears even if only one ear is misshapen. Your surgeon will evaluate your ears and speak with you about the results you would like to achieve and recommend the most effective technique.

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How long does ear surgery take?

Ear surgeries generally take two to three hours to perform. However, procedures that are more complicated may take longer.

What type of anesthesia is used?

For ear operations performed on young children, general anesthesia is normally used throughout the operation. For older children and grown adults, surgeons will normally use local anesthesia and a sedative, which will cause you to be awake but very relaxed.

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Where is the procedure performed?

In most cases, ear surgery is performed on an outpatient basis (no overnight hospital stay is required) in a hospital or surgical suite in your physician's office. However, for more complicated procedures, your physician may recommend that you plan to stay over night in a hospital. Surgeons also may recommend that children stay over night in a hospital even for simple procedures until all the effects from general anesthesia completely wear off.

When can I return home and resume normal activities?

You will need to avoid any physical activity that could involve the bending of your ear for about a month. The average adult should allow for about five days of recovery before returning to work. Children should plan on spending a quiet restful week away from school after ear surgery. Even with a week off, children should be very careful when returning to playground activities. It might be wise to alert teachers to your child's condition so they can provide closer supervision.

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How do I prepare for ear surgery?

During your initial consultation, your surgeon will discuss the changes that you would like to make to your appearance. Since the appearance of your ears is a matter of personal perception and preference, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives. If you are considering this surgery for a child, most surgeons recommend that parents do not insist on the surgery until the child desires the change. You also should make arrangements ahead of time for someone to drive you to and from your procedure and to assist you with your daily activities during your recovery period.

Prior to your surgical procedure, the surgeon will perform a complete health history and physical. Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical is complete. Depending on your individual health status, the instructions may include guidelines regarding your diet, alcohol intake, smoking and which medications to take or avoid. Your experience will be much smoother if you remain compliant with your surgeon's instructions.

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What precautions are necessary during recovery?

You should be able to be up and around a few hours after your ear surgery. To promote healing and help maintain the new shape your surgeon has sculpted, your head will wrapped in a bulky bandage. You may experience some pain and throbbing in your ears for a few days. However, your surgeon should be able to provide you with medication that minimizes any discomfort. For certain procedures, your surgeon may place a drain in your ear that can usually be removed after one day.

After one month, your head bandage will be replaced with a lighter head dressing that is similar to a headband. Your surgeon will provide you with specific directions about how long you must wear this dressing and how to manage it while you sleep. After about a week, your stitches will be removed or be dissolved, depending on the style of stitching your surgeon has chosen. Your surgeon will provide you with more specific recommendations and directions for your individual recovery.

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What are the possible complications after ear surgery?

Complications from ear surgery are infrequent and minor when performed by a qualified, experienced surgeon. However, as with any surgical procedure, there are certain potential risks and complications. One potential complication is the formation of a blood clot under the skin of the ear. Fortunately, this occurs in only a small percentage of patients. The clot may naturally dissolve or be withdrawn through a needle. Another complication is an infection that may develop in the ear cartilage. This may result in the formation of scar tissue. Antibiotics are the usual course of treatment, although surgical drainage may be required. It is always important to be informed about the possible complications before any surgery. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after ear surgery?

When you return home from your surgery, you will want to have someone with you for at least the first 12 hours as you begin your recovery period. Your ears will be somewhat sore and you may still be feeling the effects of the anesthesia, whether it is local or general. For the long term, your expectations should be realistic. The goal of your operation should be great improvement, but not perfection. The ears average of an average person are not an exact match, so don't expect the symmetry of your ears to be picture-perfect after your surgery. However, with realistic goals, you can expect your ear surgery to produce dramatic, pleasing results that last an entire lifetime.

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