Reshaping of the Ears (Otoplasty)

Understanding Otoplasty: Surgery of the Ears

Otoplasty (left ear) - Before and After
Otoplasty (left ear) - Before and After

When it comes to otoplasty, conventional wisdom is "the earlier the better". Children are the most likely candidates for otoplasty as they are often scarred psychologically as the victims of cruel nicknames like "Dumbo" or "Mickey Mouse." This surgery can be performed at any age after the ears have reached full size, typically five to six years of age. Even if the ears are only mildly distorted, the condition can lead to self-consciousness and poor adaptation to school. Adults may also benefit from this procedure, which improves self-esteem with relative ease. Often adults choose this surgery in conjunction with other facial plastic surgical procedures. Not only is it possible to "pin back" ears, but ears can also be reshaped, reduced in size, or made more symmetrical.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Morgan can answer specific questions about your individual needs.

Is Otoplasty for You?

General good health and realistic expectations are prerequisites. It is also important to understand the surgery. Otoplasty will not alter hearing ability. What is important for successful otoplasty is that the ears be in proportion to the size and shape of the face and head.

When considering otoplasty, parents must be confident they have their child's best interests at heart. A positive attitude toward the surgery is an important factor in all facial plastic surgery, but it is especially critical when the patient is a child or adolescent.

Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears does not provide the same molding capacity as in children. A consultation with Dr. Morgan can help parents decide what is best for their child, not only aesthetically, but also psychologically and physically. Timing is always an important consideration. Having the procedure at a young age is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping, and the child will experience psychological benefits from the cosmetic improvement.

Making the Decision for Otoplasty

During the consultation, Dr. Morgan will examine the structure of the ears and discuss possibilities for correcting the problems. Even if only one ear needs "pinning back," surgery is often recommended on both ears to achieve the most natural, symmetrical appearance. Following a thorough medical history, Dr. Morgan will explain the kind of anesthesia required, surgical facility, and costs. Typically, Dr. Morgan will suggest a general anesthesia for young patients and a local anesthetic combined with a mild sedative for older children and adults. Under normal conditions, otoplasty requires approximately two hours.

Understanding the Surgery

Otoplasty begins with an incision on the back of the ear. This incision is nicely hidden when the surgery is complete. Dr. Morgan will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, Dr. Morgan will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage. In other instances, he will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, Dr. Morgan will apply sutures to anchor the ear to hold it in the desired position until healing occurs.

What to Expect After Surgery

Soft bulky dressings applied to the ears will remain for up to a week. Most patients experience some mild discomfort that is controlled with oral pain medicine. Sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas, and should sleep on your back. Headbands are often recommended for sleeping, to hold the ears in the desired position for up to four weeks after the surgery. The risks are minimal. There will be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential.