Ear surgery (Otoplasty)

Ear surgery solves a problem of undesirable position, size or shape of ear auricle. Such problems can be solved by so-called otoplasty.

What is ear surgery (otoplasty)

Ear auricles are very complicated in terms of shapes and anatomy. Otoplasty can solve abnormalities from normal position of ear auricles, their size and shape. Shape abnormalities or deformities can be either genetically predisposed or gained (result of injury, previous operation, etc). The most often requested surgery is to set prominent ears back closer to the head with possible ear shaping or modification of size of large ears. It is most often children from age 5 to 10 who undergo the otoplasty.

The ears are fully grown by age four. It is recommended to undergo the surgery in earlier age as less teasing and ridicule the child will have to endure. There is no reason for adults not to carry the surgery. There are lot of partial abnormalities from desirable position, size or shape of an ear that can be solved with the otoplasty. It can be for example an auricle without the curve in the outer rim as well as without natural folds and creases, sometimes even twisted.

The surgical procedure can help also with disproportional large ear as a whole or just some parts (e.g. very large earlobe), with stretched auricles or auricles with large creases and wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury. In these cases either own cartilage (e.g. costicartilage) or specially shaped artificial implants are used. After otoplasty, like after other surgeries, permanent scars remain, however your surgeon will make the best to conceal them as much as possible. For example after bringing the ear closer to the head the little scar is hidden behind the ear auricle.

The process of ear surgery (otoplasty)

Anesthesia

Depending on the surgeon’s and your preferences, he or she will use general anesthesia (mainly for younger children) or local anesthesia that is used most often. By the general anesthesia patients are requested not to drink, eat and smoke for about 6 hours before the surgery. In this case the patient usually stays overnight in the hospital.

In most cases ear surgery is performed under local anesthesia which numbs the auricle and its vicinity area. You’ll be awake during the surgery, but relaxed and insensitive to pain. This method surgeon more often uses on older children or adults.

The process of otoplasty

Usual surgery (such as bringig the auricle closer to the head) takes in average around one hour. Although complicated procedures (such as deformities solution) may take much longer. By the most performed procedure, setting the auricles back to the head, the incision is made through the fold behind the ear. The final scar is very faint and hidden from normal look. First the fat excess from the back of the ear area is removed ad than the cartilage of the auricle is preparated and separated.

If the wrong position of the ear auricles is connected with shape deformities, the cartilage must be shaped. It can be made by small incisions, sometimes even by removal of extra cartilage but in most cases by refinement (thinning) of the cartilage with grinding machine. After reshaping and bringing the auricle closer to the head the incision is sewn up in the skin with absorbable or non-absorbable material.

Even when only one ear appears to protrude, surgery is very often performed on both ears for a better balance.

Are you the best candidate for ear surgery – otoplasty?

Before the surgery

In the initial meeting, your surgeon will evaluate your child’s condition, or yours if you are considering surgery for yourself, and he/she will recommend the most effective technique. He or she will also give you specific instructions on how to prepare for surgery.

Than discuss frankly with your surgeon your goals and expectations from the ears surgery. The surgeon will explain you the process of the surgery, anesthesia that he or she will use and the risks and costs involved. Don’t hesitate to ask your surgeon any questions you may have, especially those regarding your expectations and results. 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 the outcome.

After your surgery

If the surgery is made under local anesthesia, the patient goes directly after the procedure home for home treatment. The surgery under general anesthesia requests usually to stay overnight in hospital.

The patient’s head will be wrapped in a bulky bandage immediately after the surgery. Sometimes also special elastic bandage is used.
The ears may ache a lot for a few days after the surgery (especially adults), this can be relieved by medication that your doctor will prescribe you. Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband or by already mentioned elastic bandage. Be sure to follow your surgeon’s directions for wearing this dressing, especially at night.

If the non-absorbable stitched are used, they are removed mostly after ten to fourteen days. After the bandage removal any activity in which the ear might be bent should be avoided. Most adults can go back to work about one week after the surgery. Also children can go back to school after seven days or so, if they’re freed from physical training.

How long will the effect of ear surgery last?

Results of otoplasty are usually permanent. If you are realistic in your expectations, so you are looking for improvement not ideal, you will be pleased with your surgery results. Therefore discuss with your surgeon frankly the surgery possibilities and results that can be achieved by this operation.