Otoplasty is the surgery carried out either to reposition prominent or protruding ears to a more natural position closer to the head, or to reduce the size of big ears. Generally, this surgery is performed on children between the ages of 4 and 14. At the age of 4, your ears have grown almost completely, so the sooner the surgery is carried out, the easier it will be for the child to get through their school years without having a hard time. Adults can also undergo an otoplasty without it involving a higher risk because of the age.
If you or your child are thinking of undergoing an otoplasty, you will be informed about the basic details of the procedure, about when it is indicated, how it is carried out and what results to expect. However, it is unlikely that you get answers to all your questions, as they mostly depend both on personal factors and the plastic surgeon’s preferences. Should you have any doubt, talk to your plastic surgeon.
Most plastic surgeons recommend the parents to observe the attitude of their kid in relation to their prominent ears; it is not advisable to insist on the surgery until the kid wishes to have it done. Those kids who do not feel at ease with their ears and wish to undergo the surgery are more cooperative during the procedure and are happier with the result.
Many patients, be it children or adults, may feel insecure about the result of the otoplasty. Bear in mind that we aim to obtain some improvement, not complete perfection. Do not expect exact symmetry, which would not look natural. If you discuss with your plastic surgeon both the procedure and your expectations and opinions, the results will be very satisfactory.
In the first appointment, the plastic surgeon will assess the problem and recommend the most effective procedure for your case. You will also be given instructions on how to prepare for the surgery.
The procedures covered by the National Health Care do not include otoplasty for aesthetic reasons, except on those cases where there is a serious psychological disorder associated to it or when there is a big deformity, as long as it happens in school-aged children.
Otoplasties is perfomed in an operating room in a clinic or hospital. Depending on the type of anaesthetics, the procedure will be carried out either on an outpatient basis or the patient will need to stay in hospital overnight.
If the child is young, your surgeon will recommend to undergo the procedure under general anaesthetics. For older children and adults, local anaesthetics will be used, combined or not with sedation, so that the patient will be awake during the procedure, but relaxed.
An otoplasty normally lasts about 2 or 3 hours, although in some complex cases it can last longer. The technique used will depend on the specific problem. Generally, a small incision is made on the back of the ear to reveal the auricular cartilage. The cartilage is then sculpted and bent backwards; some internal stitches might be necessary to maintain the new shape. Occasionally, it might be necessary to remove part of the cartilage in order to provide the ear with a more natural shape. Finally, a wedge-shaped strip of skin is removed from the back of the ear. The scar resulting form the otoplasty is concealed behind the ear. Most times, even if only one of the ears looks abnormal, both of them are operated on in order to get a better symmetry.
Most patients, both children and adults, feel well within a few hours after the procedure, although it might be advisable to spend a night in hospital until the effects of the general anaesthetics wear off. A bandage is placed around the head immediately after the procedure. You might feel a little pain in your ears during the first days, but it can be easily relieved with some medication. After a few days, a lighter bandage similar to a headband is applied replacing the first bandage. It is important to follow your plastic surgeon’s instructions regarding the use of the bandage, especially at night. Any activity that might involve the bending of the ears must be avoided during the first month.
Most adults go back to work within 5 days after the surgery; children go back to school after about a week, provided they are extremely careful during physical activities.
When the otoplasty is performed by a qualified plastic surgeon, complications are rare and minor. However, like in any other procedure, there are certain risks and complications normally associated to this type of surgery. A small number of patients may present bruising, which will naturally disappear or might require drainage. Occasionally, there might be an infection in the cartilage, which may result in an increase of the scar tissue of the ear; the treatment involves the administration of antibiotics; rarely is surgical drainage required.