Ear Reduction

Ear reduction, also known as otoplasty or ear pinning, is a cosmetic surgery procedure that changes the shape, size or position of the ears. It is performed on the external part of the ear because the ears can sometimes project too far off of the skull or they are missing the antihelix which is part of what forms the folds of the ears. A reduction can be done in the concha (the deepest part of the ear) where the internal ear is located in the opening of the ear. The antihelix can also be preformed using the existing cartilage of the patient through a small incision at the back of the ear.

Am I a Good Candidate for Ear Reduction?

Both men and women have this procedure performed on their ears. While the procedure can be done at the age of seven, when the ear is done growing, many patients typically wait until their 20s for otoplasty when they can afford to pay for it. GOOD CANDIDATES include:

• Women that complain they cannot wear their hair back in a ponytail
• People that are too embarrassed to wear their hair short because of the size of their ears
• Patients who feel their ears are too big
• People with ears that protrude too far from their head or who have ears that are asymmetrical
• Those who have ears that are oddly shaped because of an accident or because of genetics

There are patients who become good candidates when they are born. Some people are born with congenital ear abnormalities associated with genetic syndromes and they can be addressed by otoplasty. People are sometimes born with the lack of a fold or a deep concha. Ear abnormalities can be seen as soon as a baby is born. Plastic surgeons can do ear molding on these babies but it should be done within the first two months of life because the maternal estrogen is still in circulation in the baby’s blood stream and can possibly prevent them from needing an otoplasty when they are older.

There are few people that are NOT GOOD CANDIDATES for ear reduction. Children that are four years of age, or younger, are normally not good candidates since their ears are still growing. Children usually have to wait until the age of seven (or above) for their ears to develop to a size that is close to the size of an adult ear.

How is Ear Reduction Performed?

Ear reduction is typically done through an incision behind the ear or the crease behind the ear to expose the cartilage. The surgeon uses sutures in the ear to create the fold that is missing, remove any excess skin and bring the ear to the skull. The cartilage can also be reduced if necessary. All of the incisions are made on the back of the ear under the skin, or on the inside of the ear, and are hidden from view.  The ear is then repositioned closer to the head before the incision is closed with sutures or stitches. Patients with protruding ears can also have their ears positioned more closely to the sides of the head.

Ear reduction can be performed by two methods:

1. Cartilage Sparing – Stitches and sutures are used to change the position as well as the shape of the ear. Some patients prefer this method since it is less invasive and gives a smoother looking result.
2. Cartilage Scoring – Incisions are made in the cartilage so the surgeon can remove, rearrange or add any tissue. The incisions give the patient a risk of some scarring after the surgery.

Reconstructive Ear Surgery:

Patients who need otoplasty to correct injuries and deformities can have reconstructive ear surgery to treat issues caused by:

• Burns
• Torn piercings
• Birth defects

Reconstructive ear surgery uses surgical methods, such as skin grafts, and reconstructive techniques to create a natural looking ear.

What is the Cost of Ear Reduction?

Ear reduction costs depend on the technique used by the doctor, if any reconstructive surgery was also performed by the surgeon and if any of the costs are covered by insurance. Patients should check with their insurance provider to see if any of the surgery is classified as medically necessary. In general, the cost of ear reduction ranges from $2500-$9000.

Recovery and Downtime

Patients worried about RECOVERY should know there is not a long recovery period after ear reduction. Overall, there will be around 7 days of bruising and 10-14 days of swelling. Any pain following the procedure is temporary and will resolve on its own.

The patient will need to wrap his, or her, head with heavily padded cotton bandages for a few days. Once they are removed, lighter bandages will be necessary for another few days. Once all of the bandages are removed, a soft headband will need to be worn to cover, and protect, the ears while keeping them in their new position. The amount of time wearing the soft headband varies per patient but it is normally in the range of 4-6 weeks.

Results

In general, the results of ear reduction are permanent. The ears might revert back to their pre-surgery position but this rarely happens since permanent sutures help minimize the complication. If the ears have not shown any sign of returning to their old position after six months, the patient should not have to worry about the ears reverting to their original position.

Any scars are usually hidden in the fold. Since the ear has been brought back, the scars are not usually noticeable but there is a chance they might be seen after the final results are visible.

Limitations and Risks of Ear Reduction

Ear reduction has been shown to provide long lasting and aesthetically pleasing results. Regardless, there are some LIMITATIONS patients should be aware of:

• The amount the surgeon can adjust the ears and take them back is not unlimited. There is only so far the ear can be taken back before the top rim starts to stick out.
• Some patients will never have ears that are symmetric because they were not born with symmetric ears. While the surgeon will do his or her best to make the issue less noticeable, there are some patients that will always have ears that are slightly “off” from each other.
• Since ear reduction sometimes involves incisions, the surgeon is limited in the amount of scarring that can be prevented or hidden.

Ear reduction also has a few RISKS involved with the surgery:

• The ear might come back out
• Cartilage infection
• Hematoma
• Bleeding
• Numbness of the ear
• Bruising

Ear Reduction Restores Confidence

Ear reduction is an operation that gives people confidence and restores their self-esteem. This is especially true if they have been bullied for having prominent ears their whole life. The procedure can be done starting at age seven and there is no maximum age limit for a patient to have an otoplasty procedure and gain the appearance of their ears they have always desired.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Jennifer Keagle, MD in Downtown Los Angeles, CA