Otoplasty Procedure Explained

What is Otoplasty?

Otoplasty, also known as ear pinning, is a surgical procedure that corrects ear defects or deformities that are present from birth or are the result of an injury or previous surgery. The complexity of the surgery depends on the patient’s anatomical concerns. Some cases are simple and easy to correct while others are more complex to deal with.

The most common concerns of patients who want otoplasty include:

• Asymmetry
• The presence of creases and edges
• Overcorrection from a previous surgery
• Loss of some cartilage and/or skin
• The type of otoplasty method used is dependent on the type and degree of deformity that needs to be addressed.

Am I a Good Candidate for Otoplasty?

GOOD CANDIDATES for otoplasty are:

• Patients who feel their ears are too large
• Those who feel the size and shape of their ears distract from the face
• Patients with ears that greatly stick out/protrude from the head
• People with ears that are asymmetrical or uneven
• Children that are at least five or six years old since the ears reach 80-90% of their adult size by that age range
• Teenagers and adults that have been bothered by their ears their whole lives and want to make a change

Patients who are NOT GOOD CANDIDATES are:

• Younger children whose ears are still developing
• Patients who do not have realistic expectations about the surgery
• People with chronic ear infections that need to be treated before having surgery
• Those who think the surgery will help with any hearing problems

How is Otoplasty Performed?

An otoplasty surgery begins with the doctor making an incision behind the ear that exposes the cartilage. The surgeon then removes any excess skin before reshaping the cartilage. If necessary, the ear is repositioned so it is closer to the head before the incision is closed via stitches or sutures. Patients having otoplasty because of protruding ears will have their ears positioned so they are closer to the sides of their head.

Otoplasty techniques fall into two groups:

1. Cartilage Scoring – The surgeon makes an incision in the ear cartilage in order to add, remove or rearrange any tissue. Because of the incision, there is a greater risk of scars with this method.
2. Cartilage Sparing – A technique that uses sutures and stitches in order to change the position and shape of the ear. Many patients choose this method because it is less invasive and the results tend to be smoother in appearance.

Otoplasty after Previous Ear Surgery

Otoplasty cannot be performed right after a prior ear surgery. Patients must wait at least four to six months or until the scar from the first surgery has fully healed.  However, if an obvious abnormality exists, the surgeon may elect to operate sooner. Scars from any previous surgery can alter the anatomy and make the revision surgery much more difficult.

Ear Molding

Newborns can have a procedure known as ear molding during the first few weeks of their life. Ear molding is for patients who are young and their ears have not really unrolled. Some people are born with the rim of their ears scrunched in or unraveled. These patients can have moldings taken to push the ear into an ideal shape. If this process is started during the first few days of life for a baby, the patient may not need surgery later in life.

What is the Cost of Otoplasty?

The price of otoplasty varies according to the amount of work that needs to be performed on the ears, the technique used by the surgeon, the area of the country where it is performed and any fees charged by the surgeon or the facility. In general, the cost is anywhere from $3000-$7000.

Recovery and Downtime

The length of RECOVERY after otoplasty depends on factors such as the patient’s general health and the severity of the surgery. Once the surgery is done, the head of the patient will be wrapped with cotton bandages that are heavily padded to help with the healing process. After a few days, the patient can remove these bandages but he/she will still need to wear a lighter bandage for another few days.   A week after the procedure, all bandages can be removed. A soft headband will then be worn that covers the ears and holds them in their new position.  The ears will also be bruised and swollen after the surgery, but these conditions will subside over time. Patients will need to keep their head elevated to minimize any swelling. They also need to avoid sleeping on their side as the new position of the ear can be damaged in this manner.

In terms of DOWNTIME after surgery, adults and children can return to work after a week. The surgeon will determine how long it will take before the patient can go back to his or her daily activities. After the operation, some post-surgical instructions will be given which the patient should follow closely. Full recovery takes around four to six weeks and patients should avoid overexerting themselves during this time period.

Results

The results of otoplasty can be seen as early as two weeks after the surgery once some of the swelling and bruising goes away. Further improvements continue for six to twelve months. The results of otoplasty are permanent. However, there are rare instances where the ears revert to their previous shape if the patient does not properly follow the post-op instructions. If this happens, it is important for patients to visit their surgeon to address the problem as soon as possible. In general, follow-up visits are recommended to monitor the results.

Limitations of Otoplasty

The main limitation of otoplasty is the ability of the surgeon to create perfectly symmetrical ears. Not only is perfect symmetry difficult to obtain, it is also unnecessary to create aesthetically pleasing ears.  Because the position of the ears are on either side of the head, the average eye travels farther to view the ears and is less likely to notice any asymmetry.  The goal of otoplasty is to make the ears look natural. Asymmetry of both the left and right ear is natural.  

Another limitation is the age of younger patients. Children that are no longer newborns, and still have ears that are developing, are limited from having the surgery until their ears have finished developing. 

Risks of Otoplasty

Risks of otoplasty include:

• Bleeding
• Infection
• Pain or discomfort
• Scarring
• Swelling
• Tingling sensation
• Numbness
• Hematoma 

Make a Desired Change in the Appearance of the Ears

Otoplasty can change the appearance of the ears for children, teens and adults. Patients who have spent their lives unhappy with the appearance of their ears are able to make the change they desire through otoplasty. Patients interested in addressing the size and shape of their ears should schedule a consultation with a board-certified surgeon. The doctor will conduct an examination and determine which otoplasty technique is the best choice to achieve the desired results. Find a board-certified surgeon near you.

Written by Cosmetic Town Editorial Team – MA

Based on an exclusive interview with Dr. Robert Troell, MD in Las Vegas, NV