Benefits of Otoplasty

A person who most benefits from otoplasty is someone who feels their ears are too prominent, turned too far forward, or too big. Otoplasty not only makes a change in the appearance of the ears but it can make patients more confident about their appearance. The surgery can make a meaningful improvement since otoplasty is designed to enhance or correct the appearance of the ears.

UNCOMFORTABLE EARS 

There are people with ears that are very prominent and uncomfortable because:

1. Their ears get cold easily.
2. They roll over on their side while they sleep. If the ear is really big and tilted forward too much, it is easy for that ear to get folded over. When they wake up, their folded over ear hurts.
3. Having a really big and prominent ear serves like a sound magnifier. Kids with really prominent ears will start to avoid loud environments because it is actually uncomfortable for them to be in medium to loud environments.

These patients would benefit from having an otoplasty procedure.

ONE EAR

Most people have both ears treated during an otoplasty surgery but there are times when only one ear needs to be corrected. A patient can have one ear that looks average and one ear that is foldedawkwardly.  The surgeon will only operate on the awkward ear and alter it so that  it matches up with the normal ear. That is known as a unilateral otoplasty and it happens maybe 10% of the time. The other 90% is bilateral otoplasty where both ears are operated on.

IDEAL AGES FOR OTOPLASTY 

As people grow from a baby to a young child, the ears grow to an adult size by the age of six years old. A common time to do otoplasty is when a child reaches about six years old. At six years of age, it is not too early because the ears are fully developed and their bodies can handle some minor surgery. It is also a good time because they have not gone to school at this time of their life. They have not had time to be in environments where kids are making fun of them and hurting their self-esteem.

There are two peaks in age when people tend to have their ears corrected. One is around age six because the parents notice this and they are trying to spare the kid from being bullied and low self esteem. The second peak time is people in their 20s because they wanted it done as a kid. Maybe the family could not afford it or the parents were not necessarily in favor of it. They are adults and on their own and doing it for themselves. There is no maximum age restriction. As long as the patient is in good overall health and their ears bother them, the ears can be fixed as long as the person is six years or older.

NON-SURGICAL APPROACH

There are three nonsurgical approaches to otoplasty:

1. When the patient is a few days old, it can be clear that the ear is misshapen. For example, the ear can be folded over in utero while they are still being carried. They come out and their ear is in a weird and floppy position. It has a crease or it is a weird shape. At that age, a doctor can actually put little molds or splints around the ear and tape it into position. If this is done for several weeks, the ear will actually take a new shape because the cartilage is not fully developed. It can be formed into a new shape.
2. The second nonsurgical treatment is by the use of a laser that can soften the cartilage of the ear of an adult. Before the laser is used, the patient gets a mold of their ear and the mold is sent off to a factory. A series of splints similar to  Invisalign braces are made for the patient to wear after the laser is used to soften the cartilage. The splints are worn for many weeks to progressively shape the ear towards the desired shape. However, this treatment never became popular and is rarely used.
3. The other nonsurgical option is where doctors do not make incisions. Instead, they put sutures through and under the skin to bend the ear. However, the doctor does not have as much power in reshaping the ear and there is a much higher failure rate.

LIMITATIONS

The main limitation of otoplasty is that the ears will not be symmetrical. There is no one born with two ears that are the same shape, the same angle, and the same size. This procedure is designed to take someone whose face and head is dominated by large and forward rotated ears. It takes the ears away from center stage but they will not be completely even.

Another limitation is that when the ear is shaped, the shape is subject to change. This is biological material with a healing process and a scarring process. The cartilage wants to bend back to the way it was originally formed. Changes may occur after the last stitch is placed. It is hard to predict how the tissues are going to change. The surgeon does not have perfect control over where the ear ends after the healing process.

RECOVERY 

The patient will be swollen or bruised for ten days or so after the surgery. Many surgeons have the patient wear a floppy head wrap for two days or so. They wear a little headband around their ears when they are sleeping for a couple of weeks.

People tend to bruise on their ears. Most people with prominent ears have already styled their hair so that it basically hides their ears. They can wear their hairstyle where their ears are mostly hidden until the bruising goes away. It is about a ten-day recovery period where they avoid exercise and heavy lifting.

SIDE EFFECTS

The procedure is often done by leaving permanent sutures on the inside. Once in a while, one of those permanent sutures might work its way out to the skin. If this happens, the doctor just removes the stitch. It is not a big deal but it is something patients should be aware of.

Once in a while, the cartilage will go towards the original shape more than the surgeon expected and this is known as failure or recidivism. Usually if it is going to happen, it occurs in the first couple of years and the doctor will need to redo the ear.

RESULTS

The results are immediate and can be seen on the operating table. The changes are usually permanent and last a lifetime. There is a chance that the ears can return to their original shape but it is unlikely. It is more likely that it might drift a little bit towards its original shape.

SCARRING 

The incision for this procedure is in the crease behind the ear so it is well-hidden. People with a real tendency towards true keloid scars probably should not consider otoplasty. The vast majority of people have skin that heals great so it should not be an issue.

FINAL THOUGHTS

The benefits of otoplasty are not always visible. While the correction of the shape of the ears is apparent, the change in appearance can also result in a big change in the self-image of the patient. Otoplasty should not be performed on people who are already happy with the shape and appearance of their ears.

Written by Cosmetic Town Editorial Team - MA

Based on an interview with L. Mike Nayak, MD, in St. Louis, Missouri