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Ear surgery
(otoplasty)
Ear surgery can reduce large ears, or ?pin back? protruding ears by setting the ears back closer to the head. Otoplasty also molds, shapes and/or removes cartilage to correct "lop ear," where the tip seems to fold down and forward; "cupped ear," a very small ear, and "shell ear," where the curve in the outer rim, the natural folds and creases, are missing. Otoplasty is usually performed on children between 5 and 14 years of age. Surgery can also reduce large or stretched earlobes, or large creases and wrinkles in the ear. Ear surgery can even involve reconstructing new ears for patients born without lobes or after an injury.
Not all corrections are successful, however, and the resulting scarring can be worse than the original condition. Be sure to get a second opinion about the effectiveness of surgery for your specific case before going ahead.
What does it cost?
The average cost for otoplasty in the US is $2,500; the cost varies from surgeon to surgeon and according to where they practice. In Canadan, the procedure costs around $4,000 but may be covered by medicare for children. There may be additional costs such as anesthesia, operating room facility, prescription medicines, etc.
What happens during the procedure?
The procedure is usually performed in an outpatient surgical center, either operated by your surgeon or a hospital facility, and takes 60 to 90 minutes per ear. Adult otoplasty patients typically receive local anesthesia plus a sedative. Usually, children are put under general anesthesia. Depending on the child?s feelings about surgery, local anesthesia with sedation can be used.
Incisions are made just behind the ear, in the natural fold where the ear meets the side of the head. The surgeon then removes the necessary amounts of cartilage and skin and permanent stitches are placed in order to pin the ear back into a normal position. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form, while in others, he or she will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. These permanent stitches are made of nylon, polypropylene, or another non-absorbable material.
After correcting one ear, the patient is turned and the procedure is repeated on the other ear. Because the incisions are well concealed on the back of the ear, the resulting scars are not normally visible.
Are there risks or potential side effects?
As with all surgeries, there is always a possibility of complications following otoplasty, including infection, a reaction to the anesthesia, hematoma, seroma, nerve damage and the occurrence of asymmetries or irregularities. Should infection occur in the cartilage, which can cause scar tissue to form, your surgeon will prescribe a treatment with antibiotics. In rare cases, surgery may be required to drain the infected area.
A small percentage of patients may develop a blood clot on the ear, which either dissolves naturally or can be drawn out with a needle. There is also a small risk that the permanent stitches eventually erode through the ear cartilage, which usually requires a repeat otoplasty.
Another risk is ending up with asymmetrical ears. If the asymmetry is readily apparent, touch-up surgery can often correct the problem. Going into surgery, patients should realize that most people's ears are not perfectly symmetrical to begin with. Although the results are usually permanent, there is always some small amount of ?springing back? of the ears due to the elastic recoil of the ear cartilage.
What to expect post-procedure?
The ears may throb or ache a little for a few days, but this can be relieved by medication. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands are sometimes recommended to hold the ears in the desired position for two weeks after the surgery.
To promote the best molding and healing, the head is wrapped in a bulky bandage immediately following surgery. A lighter head dressing, similar to a headband, replaces these bulky bandages after a few days. This sweatband-like splint must be worn day and night for two to six weeks to protect the ears and keep them held back. You should avoid all sports and physical activity for at least 6 weeks to prevent the permanent sutures from breaking during the recovery period.
The extent of the post-operative swelling and bruising is dependent on whether you tend to bruise or swell easily. The amount you can expect varies for each individual but past surgeries or injuries should be a good indication. Keep your head elevated, above the level of your heart, when lying down.
How soon does normal life resume?
You can return to normal, light activity, like work or school, within a couple of days. Children must be reminded to not touch their ears throughout the healing process. In order to make sure that there is no infection or bleeding in the ear after the surgery, you must be very careful to protect the ears and keep them clean. In addition, bending the ears forward in the first few months after the surgery can destroy even the finest surgical result. Your surgeon will provide you with instructions to minimize risks and help speed-up your recovery.
Who performs it?
Ear surgery is usually performed by a plastic surgeon or an otolaryngologist (ENT).
Are you a good candidate?
As with all elective surgery, good health and realistic expectations are prerequisites, but if you want to change the way your ears look, then otoplasty may be appropriate, but:
- Your child is only an appropriate candidates after 5 years of age.
- Make sure your surgeon is aware of any and all medical conditions and any allergies you (or your child) may have and whether you are a smoker. Also, tell your surgeon about any medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription).
- Make sure you (or your child) are not prone to scarring problems such as keloids.
- Make sure you (or your child) have a good understanding of the healing process and the limitations of the procedure.
How to prepare for surgery?
Your doctor will give you specific instructions to prepare for surgery but here are some general guidelines:
- Wash your hair the morning of surgery, making sure to clean the area around the ears.
- Avoid aspirin, any aspirin containing medication or any other non-steroidal anti-inflammatories (NSAID), such as MotrinŽ or AdvilŽ, for two weeks prior to treatment. Because aspirin thins the blood, it can interfere with normal blood clotting and increase the risk of bleeding and bruising.
- Smoking inhibits the healing process, so stop smoking before your procedure and if you start again, make sure it is after you are completely healed.
- Avoid drinking alcohol a few days before your surgery.
- Make sure to follow any fasting instructions the night before and morning of your surgery. Your doctor may insist on an empty stomach depending on the type of anesthesia.
- Make sure that you arrange for someone to bring you home and to help you out for 24 hours after surgery.
Locate a certified physician with our Doctor Locator.
To view Personal Stories about this procedure contributed by our members, Click Here.
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