Ear Surgery (Otoplasty)

Otoplasty is the surgical procedure used to alter the size or shape of a person’s ears. “Children and adults with prominent or deformed ears are often the victims of teasing and unpleasantness”, says Mr. Henley, “and this can cause individuals great embarrassment and loss of their self-confidence.” Fortunately, the results from corrective ear surgery, both physically and psychologically, are immediate in children. For adults, however, the psychological trauma of being constantly teased or bullied over the years takes its toll. The effects should not be underestimated and a consultation with a clinical psychologist can be extremely beneficial. Mr Henley usually recommends that such a discussion takes place prior to any surgery as part of the overall treatment plan.

The goal of the operation is to restore the balance to the face, shifting unwanted attention away from the prominent or misshaped ears. The ear is mostly made up of cartilage, except for the ear lobe, which contains only skin and soft tissue. During the procedure, Mr Henley remodels this cartilage to correct any deformities in shape and in the case of prominent ears, close the angle of the ear to the face.

Otoplasty can be performed using either a general anaesthetic (always used for small children) or a local anaesthetic, with or without sedation. The operation takes under two hours to complete. The scar is placed behind the ear and a small dressing is sutured in place and left for a week following the surgery.

Providing all is well, you can expect to go home the same day.

Risks and Side Effects of Surgery

No surgery is without risk, although Mr Henley says “In general, no major complications are expected with this procedure.”  However, there is a 1 in 100,000 chance of death due to anaesthetic with this procedure. Parents keen to have their child’s ears corrected need to be aware of this risk, particularly when the child is not concerned about their appearance.

Blood can collect beneath the skin of the ear, which may need to be drained. Otherwise, there is a risk of developing a cauliflower ear. Infection, a risk after any operation, may also occur, although this too is rare. Scars usually fade to a negligible level, but in about two out of every hundred people, they can become thick and red. Rarely, a keloid scar may form. Further treatment may be required. The operation may occasionally fail, in that the set back ear may protrude again necessitating a further operation.

The ears will be extremely sensitive to minor trauma or contact in the first six to eight weeks. Any knocks to the ears from playing contact sports, or playful blows from brothers or sisters, can cause discomfort out of all proportion to the strength of the blow. Care needs to be taken during this time.

Reduced sensitivity and numbness can occur in the ears. This may last as long as twelve months following surgery and on occasion may be permanent. Your ears may also turn deep red or purple when you go out in cold weather during the first few months.

Asymmetry or lop-sided ears are occasionally reported, although Mr Henley does point out that “Most people’s ears are not perfectly symmetrical, or perfect to begin with. People often first notice asymmetry when they closely study their ears after the operation!”

All the risks will be discussed in detail at your consultation. You will also be provided with detailed written information to help you make an informed decision about any surgery.

Recovery

After the operation, some swelling and bruising can be expected, but this usually settles down in the first few days. Your ears may also feel sore and uncomfortable, although significant pain is very rare.

At the end of the operation, an elasticated head dressing is applied. It is there to protect the ears and helps to maintain their new shape. This is removed about seven days after surgery when all stitches are removed. A ski type headband or sweat band is then worn at night for a further six weeks to help protect the new position of ears when sleeping.

You should be ready to return to work or school about one week following surgery and after six weeks, return to any contact sports.

Ear pinning before and after surgery

Patient A

Before Surgery

Six weeks after surgery		This photograph clearly shows the position of the incision line.

 

Patient B

Before Surgery

Seven weeks after surgery See how the ears sit much more closely to the side of the head.

Scar line This photograph was taken seven weeks after surgery. The incision line can be seen as a fine, red line.

Mr Henley would like to thank these patients for allowing their photographs to be displayed for the benefit of others who may be considering cosmetic surgery.

The information provided is intended to give a brief outline of the procedure. It is not a substitute for a personal consultation with a surgeon.