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Greek Medical Clinic » For Your Face » Surgical » Ear Surgery (Otoplasty) »
Ear Surgery (Otoplasty)
Our genes largely dictate the shape and size of our ears. In these respects, ears can vary enormously between individuals as well as between the right and left side. In situations where the ears appear to be particularly prominent or when the shape looks decidedly out of the normal, psychological effects are often experienced. The child with protruding ears is often the subject of continuous taunts and teases that remind them again and again of their deformity. Feelings of self- consciousness, rejection and hostility can become underlying reactions to lack of peer acceptance. While adults generally do not express such attitudes openly, the grown individual frequently maintains the same sensitivities that were present during childhood. Although fortunately long hair can cover the ears, these can become obvious in windy conditions or when the hair is wet. If the ears are very prominent however, practically no hairstyle can hide them.
More recently, a fuller understanding of the anatomy and the development of the ear has allowed us to treat prominent or deformed ears non surgically in the first 8 weeks of life. This basically consists of a 6 week period of splintage. In 95% of early cases treated in this way, surgical intervention will not be required. Sadly if splintage is not performed at this critical early stage then the deformity will persist and thus will require surgical intervention if it is to be corrected. In these cases surgical correction can be performed quite effectively as early as the fourth year. Most surgeons would recommend having surgery just before a child starts school. In the preschool age group the deformity is often unnoticed by playmates and so the psychic trauma is minimised. Once school begins however, the situation frequently changes. In all cases parents should stay alert to their child's feelings about protruding ears along with any effects this may engender.
The procedure is performed in theatre and usually takes about 45 minutes. It is usually carried out with the use of local anaesthesia, mainly with sedation, or alternatively with a general anaesthetic.
In most types of procedures for prominent ear correction an incision (about 4-5 cm) is usually made in the skin in the groove behind the ears where any remaining surface scar will not be directly visible. Occasionally however incisions are placed on the front surface of the ear, although these are placed inconspicuously within the normal contours or creases.
After correction of the shape and position of the ear is accomplished, the incisions are sutured and the ears are carefully padded with cotton wool and a bandage is applied.
Mild infection around the stitches is common following ear surgery but this normally resolves itself quite quickly. Antibiotics would be prescribed as deemed necessary. Occasionally the wound behind the ear may loose adhesion and open up partially. This inevitably heals up again of its own accord although attention to dressings will be required.
The final appearance of any scar is impossible to predict. Thankfully in most cases of prominent ear correction the scar is hidden behind the ear. Nevertheless you should always expect these to appear red raised and lumpy in the first few months after surgery. After this time however these usually soften and fade. In rare cases the development of permanent, hard, thick scar tissue (keloid scars) can occur.
Bleeding, as in any operation can occur. Despite meticulous care taken during the operation to stop any bleeding from the small blood vessels divided during surgery, occasionally, a small blood vessel leaks postoperatively. The development of what is termed a haematoma (collection of blood under the skin) would then occur. If deemed significant then this would require drainage. One of the purposes of the head bandage and careful padding is to minimise the risk of this collection, which is why it should not be disturbed.
As a result of excessive swelling and bruising, occasionally the skin on the front of the ear forms a blister which subsequently breaks down and forms a scab over this. This normally heals up again of its own accord although it may take up to 4 weeks and may leave behind a small scar.
Finally the operation has no adverse effects upon the hearing mechanism, which involves the inner ear structures.
More recently, a fuller understanding of the anatomy and the development of the ear has allowed us to treat prominent or deformed ears non surgically in the first 8 weeks of life. This basically consists of a 6 week period of splintage. In 95% of early cases treated in this way, surgical intervention will not be required. Sadly if splintage is not performed at this critical early stage then the deformity will persist and thus will require surgical intervention if it is to be corrected. In these cases surgical correction can be performed quite effectively as early as the fourth year. Most surgeons would recommend having surgery just before a child starts school. In the preschool age group the deformity is often unnoticed by playmates and so the psychic trauma is minimised. Once school begins however, the situation frequently changes. In all cases parents should stay alert to their child's feelings about protruding ears along with any effects this may engender.
The surgery
The main surgical objective in the correction of prominent or misshapen ears is to reduce the protrusion and at the same time to provide a normal configuration when the ear is viewed from the side. This objective is achieved by modifying the flexibility of the cartilage beneath the skin thereby altering the shape and position to a more desired appearance.The procedure is performed in theatre and usually takes about 45 minutes. It is usually carried out with the use of local anaesthesia, mainly with sedation, or alternatively with a general anaesthetic.
In most types of procedures for prominent ear correction an incision (about 4-5 cm) is usually made in the skin in the groove behind the ears where any remaining surface scar will not be directly visible. Occasionally however incisions are placed on the front surface of the ear, although these are placed inconspicuously within the normal contours or creases.
After correction of the shape and position of the ear is accomplished, the incisions are sutured and the ears are carefully padded with cotton wool and a bandage is applied.
Risks
Probably the most common is residual irregularity in the cartilage when the ear is viewed from either frontal of side angles. It should be noted however, that both ears are never exactly alike, even in the normal state, and that perfect symmetry is therefore not a reasonable expectation. Significant degrees of differences may however require some secondary adjustment.Mild infection around the stitches is common following ear surgery but this normally resolves itself quite quickly. Antibiotics would be prescribed as deemed necessary. Occasionally the wound behind the ear may loose adhesion and open up partially. This inevitably heals up again of its own accord although attention to dressings will be required.
The final appearance of any scar is impossible to predict. Thankfully in most cases of prominent ear correction the scar is hidden behind the ear. Nevertheless you should always expect these to appear red raised and lumpy in the first few months after surgery. After this time however these usually soften and fade. In rare cases the development of permanent, hard, thick scar tissue (keloid scars) can occur.
Bleeding, as in any operation can occur. Despite meticulous care taken during the operation to stop any bleeding from the small blood vessels divided during surgery, occasionally, a small blood vessel leaks postoperatively. The development of what is termed a haematoma (collection of blood under the skin) would then occur. If deemed significant then this would require drainage. One of the purposes of the head bandage and careful padding is to minimise the risk of this collection, which is why it should not be disturbed.
As a result of excessive swelling and bruising, occasionally the skin on the front of the ear forms a blister which subsequently breaks down and forms a scab over this. This normally heals up again of its own accord although it may take up to 4 weeks and may leave behind a small scar.
Finally the operation has no adverse effects upon the hearing mechanism, which involves the inner ear structures.
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