If You're Considering Ear Surgery...
Ear surgery, or otoplasty, is usually done to set prominent ears
back closer to the head or to reduce the size of large ears.
For the most part, the operation is done on children between the
ages of four and 14. Ears are almost fully grown by age four,
and the earlier the surgery, the less teasing and ridicule the
child will have to endure. Ear surgery on adults is also
possible, and there are generally no additional risks associated
with ear surgery on an older patient.
If you're considering ear surgery for yourself or your child,
this information will give you a basic understanding of the
procedure-when it can help, how it's performed, and what results
you can expect. It can't answer all of your questions, since a
lot depends on your individual circumstances. Please be sure to
ask your doctor if there is anything you don't understand about
the procedure.
All Surgery Carries Some Uncertainty and Risk
When ear surgery is performed by a qualified, experienced
surgeon, complications are infrequent and usually minor.
Nevertheless, as with any operation, there are risks associated
with surgery and specific complications associated with this
procedure.
A small percentage of patients may develop a blood clot on the
ear. It may dissolve naturally or can be drawn out with a
needle.
Occasionally, patients develop an infection in the cartilage,
which can cause scar tissue to form. Such infections are usually
treated with antibiotics; rarely, surgery may be required to
drain the infected area.
Planning For Surgery
Most surgeons recommend that parents stay alert to their child's
feelings about protruding ears; don't insist on the surgery
until your child wants the change. Children who feel
uncomfortable about their ears and want the surgery are
generally more cooperative during the process and happier with
the outcome.
In the initial meeting, your surgeon will evaluate your child's
condition, or yours if you are considering surgery for yourself,
and recommend the most effective technique. He or she will also
give you specific instructions on how to prepare for surgery.
Where The Surgery Will Be Performed
Ear surgery is usually performed as an outpatient procedure in a
hospital, a doctor's office-based surgical facility, or a
freestanding surgery center. Occasionally, your doctor may
recommend that the procedure be done as an inpatient procedure,
in which case you can plan on staying overnight in the hospital.
Types of Anesthesia
If your child is young, your surgeon may recommend general
anesthesia, so the child will sleep through the operation. For
older children or adults, the surgeon may prefer to use local
anesthesia, combined with a sedative, so you or your child will
be awake but relaxed.
The Surgery
Ear surgery usually takes about two to three hours, although
complicated procedures may take longer. The technique will
depend on the problem.
With one of the more common techniques, the surgeon makes a
small incision in the back of the ear to expose the ear
cartilage. He or she will then sculpt the cartilage and bend it
back toward the head. Non-removable stitches may be used to help
maintain the new shape. Occasionally, the surgeon will remove a
larger piece of cartilage to provide a more natural-looking fold
when the surgery is complete.
Another technique involves a similar incision in the back of the
ear. Skin is removed and stitches are used to fold the cartilage
back on itself to reshape the ear without removing cartilage.
In most cases, ear surgery will leave a faint scar in the back
of the ear that will fade with time. Even when only one ear
appears to protrude, surgery is usually performed on both ears
for a better balance.
Getting Back to Normal
Adults and children are usually up and around within a few hours
of surgery, although you may prefer to stay overnight in the
hospital with a child until all the effects of general
anesthesia wear off.
The patient's head will be wrapped in a bulky bandage
immediately following surgery to promote the best molding and
healing. The ears may throb or ache a little for a few days, but
this can be relieved by medication.
Within a few days, the bulky bandages will be replaced by a
lighter head dressing similar to a headband. Be sure to follow
your surgeon's directions for wearing this dressing, especially
at night.
Stitches are usually removed, or will dissolve, in about a week.
Any activity in which the ear might be bent should be avoided
for a month or so. Most adults can go back to work about five
days after surgery. Children can go back to school after seven
days or so, if they're careful about playground activity. You
may want to ask your child's teacher to keep an eye on the child
for a few weeks.
Other Ear Problems
Besides protruding ears, there are a variety of other ear
problems that can be helped with surgery. These include: "lop
ear," when the tip seems to fold down and forward; "cupped ear,"
which is usually a very small ear; and "shell ear," when the
curve in the outer rim, as well as the natural folds and
creases, are missing. Surgery can also improve large or
stretched earlobes, or lobes with large creases and wrinkles.
Surgeons can even build new ears for those who were born without
them or who lost them through injury.
Sometimes, however, the correction can leave a scar that's worse
than the original problem. Ask your surgeon about the
effectiveness of surgery for your specific case.
More Natural-Looking Ears
Most patients, young and old alike, are thrilled with the
results of ear surgery. But keep in mind, the goal is
improvement, not perfection. Don't expect both ears to match
perfectly-perfect symmetry is both unlikely and unnatural in
ears. If you've discussed the procedure and your expectations
with the surgeon before the operation, chances are, you'll be
quite pleased with the result.
