What is otoplasty

Otoplasty is a cosmetic ear surgery, a procedure to change the shape, position or size of your ears. You might choose to have otoplasty or surgery to pin back ears (pinnaplasty) that stick out if you’re bothered by how far your ears stick out from your head. You might also consider otoplasty if your ear or ears are misshapen due to an injury or birth defect. Otoplasty won’t change the location of your ears or alter your ability to hear.

An otoplasty isn’t suitable for children younger than five as their ears will still be growing and developing. Otoplasty can be done at any age after the ears have reached their full size — usually after age 5 — through adulthood. In some cases, the surgery is done as early as age 3.

If a child is born with prominent ears and certain other ear-shape problems, splinting may successfully correct these issues if started immediately after birth.

You might consider otoplasty if:

• Your ear or ears stick out too far from your head
• Your ears are large in proportion to your head
• You’re dissatisfied with a previous ear surgery

Otoplasty is typically done on both ears to optimize symmetry.

Most people are happy with the results of an otoplasty, and generally it’s a safe procedure. But it can be expensive and there are still risks to consider.

Otoplasty procedure

Otoplasty can be done in a hospital or an outpatient surgical facility by either a plastic surgeon or an ear, nose and throat (ENT) surgeon.

Sometimes the otoplasty procedure is done with sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia — which renders you unconscious — may be given before your procedure.

Otoplasty preparation

Initially, you’ll talk to a plastic surgeon about otoplasty. During your first visit, your plastic surgeon will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions, especially any ear infections. Talk about any medications you’re taking or you’ve taken recently, as well as any surgeries you’ve had.
• Do a physical exam. To determine your treatment options, the doctor will examine your ears — including their placement, size, shape and symmetry. The doctor might also take pictures of your ears for your medical record.
• Discuss your expectations. Explain why you want otoplasty and what you’re hoping for in terms of appearance after the procedure. Make sure you understand the risks, such as possible overcorrection.

Women should tell the surgeon if they are or think they are pregnant.

If you’re a good candidate for otoplasty, your doctor may recommend that you take some steps to prepare beforehand.

For the one week before surgery, you may be asked to stop taking blood thinners. These medicines may cause increased bleeding during the surgery.

• Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
• If you are taking warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs.

Other precautions

Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.

During the days before your surgery:

• Ask which medicines you should still take on the day of your surgery.
• Always let your health care provider know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery.

On the day of your surgery:

• You will likely be asked not to drink or eat anything after midnight the night before your surgery. This includes using chewing gum and breath mints. Rinse your mouth with water if it feels dry. Be careful not to swallow.
• Take the medicines you have been told to take with a small sip of water.
• Arrive on time for the surgery.

Also, be sure to make plans for someone to drive you home after surgery and stay with you for the first night of your recovery.

Be sure to follow any other specific instructions from your surgeon.

During the otoplasty procedure

Otoplasty techniques vary based on what kind of correction is needed. The specific technique your plastic surgeon chooses will determine the location of the incisions and the resulting scars.

Otoplasty surgery generally involves:

• Making one small cut (incision) behind the ear within the inner creases of your ears to expose the ear cartilage
• Removing small pieces of cartilage if necessary
• Scoring and stitching the remaining structure into the desired shape and position
• Or, you may be offered a newer technique that involves scoring the cartilage through the ear skin using a needle. No incision is made, but there’s not much good evidence about the long-term quality or safety of this method.

After making incisions, your doctor might remove excess cartilage and skin. He or she will then fold the cartilage into the proper position and secure it with internal stitches. Additional stitches will be used to close the incisions.

An otoplasty usually takes one to two hours. If local anesthetic is used, you are able to go home the same day.

After otoplasty procedure

After otoplasty, your ears will be covered in bandages for protection and support.

You’ll likely feel some discomfort and itching. Take pain medication as recommended by your doctor. If you take pain medication and your discomfort increases, contact your doctor immediately.

To keep pressure off your ears, avoid sleeping on your side. Also try not to rub or place excessive force on the incisions. Consider wearing button-down shirts or shirts with loosefitting collars.

A few days after otoplasty, your doctor will remove your bandages. Your ears will likely be swollen and red. You’ll need to wear a loose headband that covers your ears at night for two to six weeks. This will help keep you from pulling your ears forward when rolling over in bed.

Talk to your doctor about when — or if — your stitches will be removed. Some stitches dissolve on their own. Others must be removed in the doctor’s office in the weeks after the procedure.

Ask your doctor when it’s OK to resume daily activities, such as bathing and physical activity.

Otoplasty recovery

During the first few days after otoplasty surgery, your ears may be sore and tender or numb. You may have a slight tingling sensation for a few weeks.

You may need to wear a bandage around your head for the first few days to protect your ears from infection. You won’t be able to wash your hair during this time. The ear bandages are removed after 2 to 4 days. A head wrap or headband needs to be worn for 2 to 3 weeks to help the area heal.

Some surgeons recommend wearing a head band at night for several weeks to protect the ears while you sleep.

There may be some slight bruising, which can last about two weeks. You may want to delay returning to work or school until the bruising has disappeared.

Sometimes the stitches may come to the surface of the skin or cause the ear to feel tender. Pain and discomfort can be treated with over-the-counter painkillers, such as paracetamol or ibuprofen.

Be sure to call your surgeon if you have severe ear pain. This can be due to infection of the ear cartilage.

Otoplasty recovery time

You need to avoid swimming and activities that put your ears at risk of injury – such as judo or rugby – for several weeks.

• Within 5 to 10 days: Stitches are removed (unless they were dissolvable stitches) and any bandage would probably come off.
• After a week or two: Most children would be able to return to school.
• After eight weeks: Swimming should be OK.
• After 12 weeks: Contact sports should be OK.

Otoplasty results

After your bandages are removed, you’ll notice an immediate change in the appearance of your ears. These changes are permanent.

If you’re not satisfied with your results, check with your surgeon about the possibility of revision surgery.

Otoplasty side effects to expect

After ear correction surgery, it’s common to have:

• a small scar behind each ear
• slight bruising around the ears
• soreness, numbness or tingling in the ears

These symptoms should fade over time.

Otoplasty risks

Any type of surgery also carries a small risk of:

• excessive bleeding
• infection where the cut was made
• an allergic reaction to the anesthetic

Like any other type of major surgery, otoplasty poses a risk of bleeding, infection and an adverse reaction to anesthesia. It’s also possible to have an allergic reaction to the surgical tape or other materials used during or after the procedure.

Otoplasty surgery can occasionally result in:

• Inflammation of the ear cartilage
• A blood clot (hematoma) forming in the skin of the ear
• The surgery not being successful and the ears starting to protrude again
• Scarring. Keloids and other scars. While scars are permanent, they’ll likely be hidden behind your ears or within the creases of your ears.
• Asymmetry in ear placement. This could occur as a result of changes during the healing process. Also, surgery might not successfully correct pre-existing asymmetry.
• Changes in skin sensation (numbness). During otoplasty, the repositioning of your ears can temporarily affect skin sensation in the area. Rarely, changes are permanent.
• Problems with stitches. Stitches used to secure the ear’s new shape might work their way to the surface of the skin and need to be removed. This can cause inflammation of the affected skin. As a result, you might need additional surgery.
• Overcorrection. Otoplasty can create unnatural contours that make ears appear to be pinned back.
• Stiff ears – it can take several months for them to become flexible again
• Increased feeling of cold
• Recurrence of the ear deformity

The surgeon should explain how likely these risks and complications are and how they would be treated if they occurred.

What to do if you have problems

Cosmetic surgery can sometimes go wrong, and the results may not be what you expected.

You should contact the clinic where the operation was carried out as soon as possible if you have severe pain or any unexpected symptoms. The surgeon who treated you is best placed to deal with any complications.

If you’ve had ear correction surgery and you’re not happy with the results or think the procedure wasn’t carried out properly, you should take up the matter with your surgeon through the hospital or clinic where you were treated.

What to do if you have problems

Cosmetic surgery can sometimes go wrong, and the results may not be what you expected.

You should contact the clinic where the operation was carried out as soon as possible if you have severe pain or any unexpected symptoms. The surgeon who treated you is best placed to deal with any complications.

If you’ve had ear correction surgery and you’re not happy with the results or think the procedure wasn’t carried out properly, you should take up the matter with your surgeon through the hospital or clinic where you were treated.