Otoplasty

Ear plastic surgery – when otoplasty surgery is needed

Ear correction surgery, or otoplasty, is usually needed to move prominent ears closer to the head or reduce the size of large ears. Very small ears, stretched earlobes or lobes with large creases and wrinkles may also be altered.

Other names for otoplasty

Ear plastic surgery is also known as:

• Ear pinning surgery
• Otoplasty surgery

Protruding and drooping ears or torn earlobes can be surgically corrected. Exceptionally large ears or those that stick out make children vulnerable to teasing. These procedures do not alter the patient’s hearing, but they may improve appearance and self-confidence. Corrective ear surgery, called otoplasty, should be considered on ears that stick out more than 2 cm from the back of the head

From what age can otoplasty be performed?

• Otoplasty can be performed at any age after the ears have reached full size, usually at five or six years of age
• Having the surgery at a young age has two benefits: the cartilage is more pliable, making it easier to reshape, and the child will experience the psychological benefits of the cosmetic improvement
• However, a patient may have ear surgery at any age after the ears have reached full size

What Is Involved in “Pinning Back” the Ears?

Typically otoplasty surgery takes about two hours. The surgery begins with an incision behind the ear, in the fold where the ear joins the head. The surgeon may remove skin and cartilage or trim and reshape the cartilage. In addition to correcting protrusion, ears may also be reshaped, reduced in size, or made more symmetrical. The cartilage is then secured in the new position with permanent stitches which will anchor the ear while healing occurs. The soft dressings over the ears will be used for a few weeks as protection, and the patient usually experiences only mild discomfort. After otoplasty headbands are sometimes recommended to hold the ears in place for a month following surgery or may be prescribed for nighttime wear only.

Ear pinning cost

• Insurance usually does not cover surgery solely for cosmetic reasons.
• However, insurance may cover, in whole or in part, the cost of otoplasty surgery to correct a congenital or traumatic defect.
• Before cosmetic ear surgery, discuss the procedure with your insurance company to determine what coverage you can expect

Can Ear Deformities Be Corrected?

The “fold” of hard, raised cartilage that gives shape to the upper portion of the ear does not form in all people – this is called “lop-ear deformity,” and it is inherited – the absence of the fold can cause the ear to stick out or flop down.

To correct this problem, the surgeon places permanent stitches in the upper ear cartilage and ties them in a way that creates a fold and props the ear up – scar tissue will form later, holding the fold in place.

Some infants are born without an opening in their middle ear – these ears can be surgically opened, and the outer ear reshaped to look like the other ear – this procedure will restore hearing if the inner ear is intact.

Those who are born without an ear, or lose an ear due to injury, can have an artificial ear surgically attached for cosmetic reasons – these are custom formed to match the patient’s other ear – alternatively, rib cartilage or a biomedical implant, in addition to the patient’s own soft tissue, can be used to construct a new ear.

Other ear problems that can be helped with surgery include:

• ‘Lop ear’ – when the tip seems to fold down and forward
• ‘Cupped ear’ – which is a very small ear
• ‘Shell ear’ – when the curve in the outer rim, as well as the natural folds and creases, are missing.

What can be done for severe ear deformity?

• Those who are born without an ear, or lose an ear due to injury, can have an artificial ear surgically attached for cosmetic reasons
• These are custom-formed to match the patient’s other ear
• Alternatively, rib cartilage or a biomedical implant, in addition to the patient’s own soft tissue, can be used to construct a new ear

What can be done for torn earlobes?

Many mothers have had their earlobes torn by a baby’s tug on their earrings. Earrings also catch on clothing and other objects, resulting in torn earlobes. These tears can be easily repaired surgically, usually as a day surgery procedure, done under local anaesthesia. In severe cases, the surgeon may cut a small triangular notch at the bottom of the lobe. A matching flap is then created from tissue on the other side of the tear, and the two wedges are fitted together and stitched. Earlobes usually heal quickly with minimal scarring. In most cases, the earlobe can be pierced again four to six weeks after surgery to receive light-weight earrings.

How long does the surgery take

Otoplasty surgery takes around one to three hours, depending on the complexity. You will usually have a combination of general and local anaesthesia. After the procedure you will be taken to the recovery ward and then back to your room.

What to expect

After the operation, you may expect:

• Dressings and bandages
• Nausea
• Mild pain or discomfort
• Swelling and bruising
• Numbness

Over time, any swelling will disappear. In most cases, otoplasty will leave a faint scar on the back of the ear that will fade over 6-12 months or so. Once you’ve had otoplasty surgery, the results are permanent. However, ear cartilage is very elastic, so there may be some forward movement of the ears after the operation.

Ear pinning by an ENT – head and neck surgeon

• ENT – head and neck surgeons can provide a complete evaluation and treatment options regarding otoplasty
• An otolaryngologist can receive up to 15 years of university and post-graduate training in plastic surgery, concentrating on ear, nose and throat procedures
• Because they study the complex anatomy, physiology, and pathology of the entire head and neck,  ENT specialists are uniquely qualified to perform the procedures that affect the ear

If you have questions about otoplasty contact your local doctor who will arrange for you to see an ear nose throat specialist.