Otoplasty – Surgery to correct the ears

Otoplasty is a surgical procedure to bring protruding ears closer to the head, or to otherwise correct deformities in the shape or placement of the ears. Sometimes called “ear pinning” because it appears to pin the ears back against the head, it may be performed on adults and on children after age 5 or 6.

Why do some people’s ears protrude?

A number of different causes may lead to ear deformities. Some common deformities include:
“Cup ear”: parts of the outer ear develop irregularly/ asymmetrically, causing a protruding, cup-shaped ear
“Lop ear,” or “bat ear”: the concha (inner part of the external ear) grows at a right angle to the head instead of parallel to it
“Cauliflower ear”: deformity caused by injury and inflammation

Who should consider otoplasty?

Adult candidates for otoplasty have often spent their lives feeling self-conscious about their appearance, sometimes camouflaging their ears with hairstyles and avoiding short or pulled-back hairstyles. As with any cosmetic surgical procedure, candidates must be in good general health, and have no medical contraindications to surgery. Patients should understand the possibilities and limitations of surgery, and be realistic about post-surgical expectations. After otoplasty it is reasonable to expect a more balanced, attractive appearance, which for many, improves self-confidence and self-esteem. Bringing the ears into balance with one’s face is realistic, while aiming for a “perfect” appearance is not.

Should I consider otoplasty for my child?

Children whose ears protrude can be the targets of cruel treatment by their peers. The effect of such experiences on self-esteem can be serious and life-long. While any surgery presents risks, the overwhelming success and safety of otoplasty make a compelling case for considering the procedure for children with deformed or protruding ears. While very young children should not have the procedure because their ears are still developing, by age 5 or 6, the auricle (the visible, cartilaginous part of the ear) is nearly adult-sized and may safely be corrected. Only the ear lobes continue to elongate after this age, which gives the appearance that a child’s ears are growing. Overall, parents who choose to have their children undergo otoplasty have found it to be a very rewarding decision.

How is otoplasty performed?

In patients with protruding ears, otoplasty usually involves an elliptical-shaped incision in the cartilage behind the ear. After making this incision, the surgeon will shave, flatten, fold, or otherwise manipulate the cartilage according to the patient’s anatomy, to achieve a new shape and/or position of the external ear. Fine sutures are placed to hold the ears’ new position during healing. Compressive dressings are then applied to both protect the surgical site and to help hold the ears’ new shape during recovery. Scar lines are located behind the ear and are not visible after recovery.

If the ear lobe is overly elongated or asymmetrical, tissue may be trimmed to achieve a more balanced appearance.

Otoplasty usually takes about an hour, and patients usually return home the same day.

What kind of anesthesia is used during otoplasty?

Children under 12 years usually receive general anesthesia. Adults usually receive local anesthesia.

Recovery after Otoplasty

After surgery, the ears are held in place by a soft elastic bandage or headband for about two weeks. The ears will be painful and swollen, and pain medication will be prescribed to alleviate discomfort. Patients should sleep with their heads elevated during the first night after surgery. Stitches will be removed at about two weeks, at which point the ears will be hypercorrected – too close to the skull. After several weeks more, they adjust to the final, correct position.

Risks of Otoplasty

Risks associated with otoplasty are highly unlikely, occurring very infrequently. They include:

Development of keloids, which are thick scars, particularly among African-American patients
Hematomas – pooling of blood at the surgical site
Infection of the cartilage
Loosening or breaking of the sutures, which allows the ear to return to its original position
Overcorrection of the ears, leaving them too close to the head.