Disclaimer: The details in this section are for general information only. Always check with your own doctor.
What is otoplasty?
Otoplasty or pinnaplasty is an operation that is usually done to set back prominent ears
closer to the side of the head, but can also be used to correct overly large ears.
When to have surgery
Some children are born with prominent ears and it is possible in the first few months
of life to use an ear splint that may well help in remoulding the shape of the ear
thus avoiding subsequent surgery at a later stage. See the Earbuddies website.
However, the majority of otoplasty is carried out in children after the age of six.
By then the ears are almost fully grown at this stage and the cartilage relatively easy
to reshape. This also coincides with the child’s awareness that they might be slightly
“different” to their peer group, and possible experience of teasing at school.
Most surgeons who carry out otoplasty recommend that it be carried out when the
child wants the change as they will be generally more co-operative and happier
with the outcome.
The surgery : What is involved?
At the initial consultation, your surgeon will evaluate the ears and establish
what is required to produce the desired shape. There are several techniques that can be
used to reshape and set back prominent ears, so the most appropriate ones for the
individual will be discussed.
A technique that is often used involves the removal of a small ellipse of skin from behind
the ear to expose the ear cartilage and then the surgeon can reshape the ear cartilage either
using stitches alone or a combination of stitches and scoring of the cartilage to create a natural looking fold to the ear and a normal position in relation to the
head.
Otoplasty usually takes between one and two hours to perform although more complicated
procedures may take longer and your surgeon will be able to discuss with you the likely
length of the operation.
In the United Kingdom, otoplasty is usually performed under a general anaesthetic.
However, some surgeons may prefer to use local anaesthesia especially with an adult
patient. Otoplasty can be carried out as a day case procedure but occasionally your
doctor may recommend an overnight stay.
After the surgery
Most patients will be up within a few hours of surgery but you will be recommended to
stay in hospital until the effects of the anaesthesia has worn off. The patient’s head is usually
wrapped in a head bandage immediately after the surgery to promote the best moulding
and healing.
The ears may throb or ache for a few days but this operation should not be
particularly painful and only simply painkillers are usually required. The ears may feel
a little numb after the operation but this usually settles within a few weeks.
The head bandage is usually removed five to seven days after the surgery and your
surgeon will recommend using some form of head band (tennis sweat band) at night to make
sure that there is no pulling forward of the ears when asleep.
Stitches from behind the ear are usually removed at the same time as the head dressing.
Most children can go back to school about seven days after the surgery but should be
careful with playground activity and should avoid contact sport for a six weeks.
Adults can usually go back to work after seven days.
What are the risks?
When otoplasty is performed by a qualified experienced surgeon, complications are
infrequent and usually minor. However, as with any operation there are risks associated with this type of surgery.
A small percentage of patients may develop a blood clot under the skin of the ear.
This may dissolve away naturally or occasionally may need to be removed by your surgeon
with a needle. If this blood clot is large and left untreated, it can cause damage to the
underlying cartilage which will produce an unnatural shape to the ear (cauliflower ear).
A similar situation can occur if patients develop an infection in the cartilage.
Such infections are usually treated with antibiotics but again may require drainage
of the infected area.
The scar behind the ear usually heals extremely well but may in some patients
become lumpy or overgrown which would then require further correction.
Results
The vast of majority of patients who undergo this surgery are pleased with the results.
However, it should be kept in mind that the aim of surgery is an improvement in the
shape of the ear and not perfection.
It is difficult to get perfectly matched ears and it is important that you discuss
the procedure and your expectations with the surgeon before the surgery to try to
ensure that you end up with the result that you are pleased with.
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