Ear surgery or otoplasty is a surgical procedure to correct the deformities and defects of external ears resulting from congenital conditions or trauma. The purpose of this surgery is to create an external ear of natural proportions, contour, and appearance to the ears and face. Incisions for otoplasty are usually made behind the ears. Depending upon the deformities, the cartilaginous framework of the ear is reshaped, repositioned or reduced. Correction of even minor deformities can have profound benefits to appearance and self-esteem.
The surgical objectives of otoplasty are to set back the ears so that they appear naturally contoured, proportionate, harmoniously set back and without any evidence of surgical correction. Therefore, when the corrected ears are viewed, they should look normal, from the:
- Frontal view: When the ear is viewed from the front, the helical rim should be visible, but not set back so far (flattened) as if it is hidden behind the antihelical fold.
- Rear view: When the ear is viewed from behind, the helical rim is straight and not bent or crooked. If the helical rim is straight and the setback is harmoniously achieved, the upper-, middle-, and lower-thirds of the ear will be proportionately setback with each other.
- Side view: The contours of the ear should be soft and natural, not sharp and artificial.
Indications of otoplasty
- Overly large ears — a rare condition called macrotia
- Protruding ears occurring on one or both sides in varying degrees — not associated with hearing loss
- Adult dissatisfaction with previous ear surgery
Ideal candidates for otoplasty in children
- Preschool age, preferably five years old or older
- Able to communicate their feelings and do not object when surgery is discussed
- Cooperative and follow instructions well
- Healthy, without a life-threatening illness or untreated chronic ear infections
Ideal candidates for teen and adults
- Individuals with a positive outlook and specific goals in mind
- Healthy individuals without a life-threatening illness or medical condition
Preoperative evaluation before otoplasty
Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desired results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore a specific treatment regimen is planned to suit an individual’s need.
Preparation for otoplasty
- Preoperative medical evaluation including blood investigations
- Avoid certain medications or adjust your current medications
- Stop smoking or alcohol for about 2-3 weeks before the scheduled surgery
- Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding and bruises
The risks and safety information on otoplasty
It is essential for patients to understand that every surgical procedure has its complications and downtime. However, if a patient is appropriately assessed before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced. The risks involved in otoplasty may vary depending upon the nature of the surgical procedure.
In general, some of the risks of otoplasty include:
- Bleeding
- Blood clots
- Infection
- Poor wound healing
- Asymmetry
- Changes in skin sensation
- Skin contour irregularities
- Skin discoloration/swelling
- Anaesthesia risks
- Unfavourable scarring
- Allergy reactions to tape, suture materials, bandages or medication
- Possibility of revision surgery
Postoperative expectations for otoplasty
Discomfort immediately following ear surgery is normal and can be controlled with pain medication. There may be an itchy feeling under bandages. Compression bandages or garment are usually applied for 5-7 days to the ears to prevent swelling and blood collection. It is essential that these bandages or garment remain intact and not to be removed, for any reason during the recovery period. Failure to do so may result in loss of some of the correction and may require a secondary surgery. Stitches behind the ears are usually removed 7-10 days after the surgery. After the surgery, the ears will be permanently positioned closer to the head. The surgical scars are either hidden behind the ear or well hidden within the natural creases of the ear.
Case No. 1:
Case No. 2:
Postoperative care
- Follow the postoperative instructions given carefully
- Head elevation especially when sleeping for 1-2 weeks
- Take the prescribed medications as instructed
- Compressive bandage or garment to the ears may be used for 5-7 days
- Avoid strenuous physical activities for 2-3 weeks
How much will an otoplasty surgery cost?
Cost is always a consideration in elective surgery. The cost of otoplasty surgery can vary widely. Cost may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Medical tests (blood investigations)
- Anaesthesia fees
- Prescriptions for medication
- Post-surgery garment (garment for the ears)
When otoplasty is performed for trauma or acquired surgical conditions, this procedure is considered as reconstructive surgery and may be covered by insurance. This requires a detailed examination to verify the cause before authorisation from your insurer. Patients are advised to contact their insurance company for further verification well in advance of surgery. However, when otoplasty is performed for aesthetic reasons or deformities arising from birth, it will not be covered by medical insurance.