Otoplasty

Otoplasty

Otoplasty, or ear reshaping surgery, is a procedure done to correct deformities and defects of the pinna (external ear). This surgical procedure can alter the size, shape, or position of the ears to give them a more normal appearance.

A natural appearance takes unwanted attention away from the ears. Correction of even minor irregularities in the appearance of the ears can impact on a child’s or even an adult’s self-esteem, who feel embarrassed or are concerned about their appearance. Dr. Vafaei performs otoplasty on patients depending on their anatomy and certain goals for change.

Otoplasty Benefits

Otoplasty or ear cosmetic surgery offers the following benefits:

• Increasing self-confidence
• Restoring shape and size of the ears
• Improving symmetry and positioning of the ears

Who can Benefit from Otoplasty?

Otoplasty works best on children between the ages of 4 and 14. It can also be performed on adults without any additional risks. So it’s never too late to make a change. If you have misshaped or protruding ears or you have a child who does, this cosmetic surgery that moves your ears closer to your head may be a good option for you. This surgery is not just for protruding ears. It can correct abnormally large ear lobes, lop ear, or shell ear as well.

Types of Otoplasty

There are three main types of otoplasty, which include:

• Ear augmentation: This is done when the pinna (outer part of the ear) is underdeveloped or absent, known as microtia. The surgery involves adding structural elements (cartilage tissue grafts) that are usually taken from either ear or rib to reconstruct the missing structures.
• Ear reduction: This procedure helps reduce the size of excessively large or prominent ears. When the ears are overdeveloped, this is called macrotia. Ear reduction involves reducing one or more of the components of oversized ears. To minimize the visible scarring, the surgeon makes the incisions usually in, or near, the front folds of the pinna.
• Otopexy: This procedure flattens protruding ears. Otopexy or pinning back surgery is usually performed under a local anesthesia with sedation for adults and general anesthesia for children. To begin this surgery, the surgeon makes an incision behind the ear to expose the cartilage. Then he reshapes the cartilage and removes excess skin. Finally, if necessary, he repositions the ear more closely to the head, and closes the incision with stitches.

How is Otoplasty Performed?

Adults commonly undergo otoplasty under local anesthesia with intravenous sedation. In children, general anesthesia is used. The procedure takes approximately one to two hours. There are several ways the ear can be reshaped. The first one is cutting out cartilage of the ear, second one is folding and stitching that cartilage instead of cutting it away, and the last one is cutting out skin instead of cartilage. The surgeon usually makes the incisions hidden behind the ear. When incisions are necessary on the front of the ear, the surgeon makes them within the depths of the folds in the ear to hide them. He uses internal, non-dissolvable sutures to reshape and secure the cartilage in place and dissolvable sutures to close the incision on the back of the ear.

Otoplasty Recovery

Recovery will vary from patient to patient, but most children can go back to school after a week and most adults can return to work in the same time frame. After the procedure is complete, the patient’s head will be wrapped in a bandage. The surgeon will instruct the patient on how long he/she will be required to wear it and how to best manage it whilst sleeping. After removing the bandage, the patient should wear a loose headband at night for 3-6 weeks to protect the ears. The surgeon will prescribe pain medication to aid the healing process. If the patient has stitches that need to be removed, the surgeon will do this about one week after the surgery. The scars at the incision site will probably fade over time. During the recovery period, the patient should avoid activities that could cause trauma or injury to the ears. For example, physical contact sports, such as football, rugby, or judo should be avoided for at least 3 months and swimming should be avoided for up to 8 weeks after surgery.

Risks and Complications of Otoplasty

As with any surgery, there are risks and complications with otoplasty, which include:

• Infection
• hematoma or blood clot
• Suture complications
• Recurrence
• Unsatisfactory appearance
• Asymmetry in ear placement
• Changes in skin sensation
• Skin discoloration
• Partial Correction (ears are not positioned close enough to the head)
• Overcorrection (ears are positioned too close to the head)

Does Insurance Cover Otoplasty?

If an otoplasty is being used to correct a deformity or congenital abnormality, health insurance may cover part or all of the costs. If it is merely performed for cosmetic purposes, insurance coverage probably does not apply. As an example, otoplasty to correct too large or protruding and asymmetrical ears is considered a cosmetic procedure and cannot be covered by insurance.

Dr. Hamid Reza Vafaei