EAR
SURGERY

If protruding or disfigured ears bother you or your child, you may consider plastic surgery. Ear surgery – also known as otoplasty – can improve the shape, position or proportion of the ear. It can correct a defect in the ear structure that is present at birth as well as misshapen ears caused by injury.

Ear surgery creates a natural shape by bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self-esteem.

Ear surgery can treat:

• Overly large ears – a rare condition called macrotia
• Protruding ears occurringin varying degrees on one or both sides

Children who are good candidates for ear surgery are:

• Healthy individuals who do not have a life-threatening illness or untreated chronic ear infections
• Generally 5 years old or have ear cartilage that is stable enough for correction
• Cooperative and follow instructions well
• Able to communicate their feelings and do not voice objections when surgery is discussed

Teenagers and adults who are good candidates for ear surgery are:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals for ear surgery

During your consultation, be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Previous surgeries

Your surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your ear surgery options
• Recommend a course of treatment
• Discuss likely outcomes of your ear surgery and any risks or potential complications

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Your plastic surgeon will also discuss where your procedure will be performed. Depending on the type of surgery, your procedure may be performed in your plastic surgeon’s accredited office-based surgical facility, a licensed ambulatory surgical center or hospital.

Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include local anesthesia combined with intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision
Correction of protruding ears uses surgical techniques to create or improve the antihelical fold (just inside the rim of the ear) and to reduce enlarged conchal cartilage (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within its folds to hide them. Internal, non-removable sutures are used to create and secure the newly shaped cartilage in place.

Step 3 – Closing the incisions
External stitches close the incision. Techniques are individualized and care is taken to avoid distorting other structures and to avoid an unnatural “pinned back” appearance.

Step 4 – See the results
Once the dressings are removed, ear surgery offers near immediate results in cases of protruding ears. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

The decision to have ear surgery is extremely personal. You will have to decide if the benefits will help you achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and its risks.

The risks include:

• Anesthesia risks
• Bleeding
• Infection
• Poor wound healing
• Change in skin sensation
• Asymmetry
• Persistent pain
• Unfavorable scarring
• Possibility of revisional surgery
• Allergies to tape, suture materials, glues, blood products, topical preparations or injected agents

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

Dressings will be used to support the new shape of the ear during initialhealing phases. Once these are removed, the results of your ear surgery are immediately visible. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

Discomfort immediately following ear surgery is normal and can be controlled with pain medication. There may be an itchy feeling under bandages. It is essential that bandages remain intact and are not removed for any reason. Failure to do so may result in loss of some of the correction and may require a secondary surgery.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

The results of your ear surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery. The final results of your surgery will appear over the next few months.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Prices for ear surgery can vary. A surgeon’s cost may be based on his or her experience, the type of procedure used and the geographic location of the office. Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

• Anesthesia fees
• Hospital or surgical facility costs
• Medical tests
• Prescriptions for medication
• Surgeon’s fee

Some health insurance plans cover otoplasty in children. In adults, it may be considered cosmetic surgery and not covered.

Your satisfaction involves more than a fee:
When choosing a plastic surgeon for ear surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Plastic surgery involves many choices. The first and most important is selecting an American Society of Plastic Surgeons (ASPS) member you can trust. ASPS member surgeons meet rigorous standards:

• Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada®

• Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
• Pass comprehensive oral and written exams
• Graduate from an accredited medical school
• Complete continuing medical education, including patient safety each year
• Perform surgery in accredited, state-licensed or Medicare-certified surgical facilities

Do not be confused by other official sounding boards and certifications.
The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS-recognized certifying board with “cosmetic surgery” in its name. By choosing a member of The American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.