Otoplasty

Overview 

Otoplasty, or cosmetic ear surgery, is a procedure designed to alter the shape, position, or size of the ears. People often consider otoplasty if their ears protrude more than they’d like or if they have ear abnormalities caused by birth defects or injuries. This procedure can help enhance the appearance of the ears, providing a more balanced and natural look. 

Otoplasty is typically performed after the ears have reached their full size, which usually occurs around the age of five. However, adults can also undergo this procedure. In some cases, newborns with prominent or irregular ear shapes may benefit from ear splinting, a non-surgical method that can correct certain issues if started soon after birth. 

While otoplasty reshapes the ear’s structure to improve its appearance and boost a person’s self-confidence, it does not affect hearing. This surgery is purely cosmetic and focuses on achieving a more aesthetically pleasing result without altering auditory function.

Types   

The following are the different types of otoplasty:  

• Ear pinning: Surgeons typically recommend ear pinning (pinnaplasty) for individuals, including children, who have prominent ears that stick out. The primary goal of ear pinning surgery is to reduce the protrusion of the ears and reshape any malformed cartilage, thereby bringing the ears closer to the sides of the head.  
• Ear reduction: Individuals with large or oversized ears, a condition known as macrotia, may find ear reduction surgery beneficial. During this procedure, a surgeon carefully removes excess tissue from the ears to reduce their size and bring them into better proportion with the rest of the face.  
• Ear augmentation: People can occasionally have small ears, malformed ears, or undeveloped ears (a condition known as microtia). To improve the outer part of the ear in such circumstances, ear augmentation surgery is advised. In order to enhance and contour the ear and create a more symmetrical and natural-looking appearance, this treatment usually involves grafting cartilage or tissue. 

Reasons for undergoing the procedure  

Otoplasty may be considered in cases of: 

• Misshapen ears or ear lobes. 
• Ears that protrude prominently from the head. 
• Ears that are larger in proportion to the head. 
• Dissatisfaction with a previous ear surgery. 
• Cauliflower ears, a common condition among boxers, wrestlers, and mixed martial artists. 

Typically performed on both ears for symmetry, otoplasty does not alter the position of the ears or affect hearing capability.

Risk  

Otoplasty, like any major surgery, carries risks, such as: 

• Bleeding.  
• Infection.  
• Reaction to anesthesia.  

Other risks associated with otoplasty may include: 

• Allergic reaction: Allergic reactions to surgical tape or other materials used during or after the procedure are possible.  
• Asymmetry in ear placement: These outcomes may arise due to changes during the healing phase, and there is a possibility that surgery may not completely resolve existing asymmetry.  
• Changes in skin sensation: During otoplasty, repositioning your ears can temporarily alter skin sensation in the area. Although rare, there is a small risk that these changes could be permanent.  
• Overcorrection: Otoplasty can sometimes result in unnatural contours that give the appearance of ears being pinned back.  
• Problems with stitches: Stitches used to secure the new shape of the ear may sometimes migrate to the surface of the skin, requiring removal. This can lead to inflammation of the affected skin and potentially necessitate additional surgery.  
• Scarring: While scars resulting from otoplasty are permanent, they are typically well-hidden behind the ears or within the natural creases of the ears. 

Before the procedure  

Before undergoing otoplasty surgery, they will: 

• Review your medical history: Be prepared to provide information about your current and past medical conditions, particularly any history of ear infections. Your healthcare provider will also inquire about medications you are currently taking or have taken recently, as well as any prior surgeries you have undergone.  
• Physical examination: To assess your treatment options, your healthcare provider will examine your ears thoroughly, including their placement, size, shape, and symmetry. They may also take photographs of your ears for inclusion in your medical records.  
• Discuss your expectations. Your healthcare provider will probably inquire about your reasons for seeking otoplasty and what outcomes you hope to achieve from the procedure. It’s essential to grasp the risks associated with otoplasty, including the potential for overcorrection. 

Before otoplasty, your healthcare provider may advise you to stop smoking, avoid aspirin, anti-inflammatory drugs, and herbal supplements to reduce bleeding risks and slow healing. Arrange for a ride home and someone to stay with you after surgery. Otoplasty is usually performed in a hospital or outpatient facility with either local anesthesia and sedation or general anesthesia.

During the procedure  

The techniques used in otoplasty vary depending on the specific correction required. Your plastic surgeon will choose a technique that determines where the incisions are made and the resulting scars. Typically, incisions are placed on the backs of the ears or within the inner creases.

Your healthcare provider will administer anesthesia to ensure your comfort during the procedure. This can be done under general anesthesia, where you are completely unconscious, or under local anesthesia with sedation, where you are drowsy but able to respond to questions.

Following the incisions, your healthcare provider may remove excess cartilage and skin. They will then reshape the cartilage, positioning it correctly, and secure it with internal stitches. Additional stitches are used to close the incisions. The entire procedure typically lasts about two hours.

After the procedure  

After otoplasty, bandages will be applied to your ears for protection and support. It’s crucial to follow your healthcare provider’s instructions on keeping the dressing clean and dry during your recovery.

You may experience discomfort and itching following the procedure. It’s important to take pain medication as prescribed by your healthcare provider. If taking the medication doesn’t relieve your discomfort or if it worsens, be sure to contact your healthcare provider promptly.

Refrain from sleeping on your side and from touching or exerting too much effort on the incisions in order to release pressure from your ears. To reduce contact with the surgery area, wear loose-fitting collared garments or button-down shirts.

Several days following otoplasty, your healthcare provider will remove the bandages. Your ears may appear swollen and red at this stage. You might be advised to wear a loose headband overnight for a few weeks to prevent inadvertently pulling your ears forward while turning in bed.

Consult your healthcare provider regarding the timeline for removing stitches, as some may dissolve independently while others require removal at a follow-up appointment in the weeks following the procedure. Additionally, inquire with your healthcare provider about when it’s safe to resume regular activities, including bathing and physical activity.

Outcome 

Otoplasty provides significant advantages, such as:   

• Correction of prominent, protruding, or misshapen ears.  
• Enhanced self-confidence.  
• Safe procedure.  
• Permanent results. 

Once your bandages are removed, you will notice an immediate and permanent change in the appearance of your ears. If you are not completely satisfied with the results, discuss the option of revision surgery with your surgeon.

If you develop the following indications, you may need to immediately contact your healthcare provider.    

• Fever  
• Excessive bleeding.  
• Swelling.  
• Sustain a trauma at your incision site.