Otoplasty

Otoplasty, also called cosmetic ear surgery, is a procedure that is performed to alter the size, shape, or placement of the external ears. Please continue reading to learn more about this outpatient procedure that plastic surgeons can perform for ear reshaping or ear repositioning.

What is otoplasty cosmetic ear surgery?

Otoplasty or cosmetic ear surgery is a procedure that is done to improve the shape, size, symmetry, proportion, or position of the external ear (outer ear or auricle). The auricle is made up of folds of cartilage covered with skin. The cartilage can be surgically manipulated to change the external ear structure.

Otoplasty ear correction surgery can also be done to address ear deformities present since birth or misshapen ears due to injuries - in this case it is called a reconstructive surgery.

There are different types of otoplasty ear surgery. An ear augmentation is performed to increase the size of the external ear in people who have small ears or under-developed ears. Ear pinning plastic surgery is performed to move the ears closer to the head. This type of otoplasty is performed in people with prominent ears that stick out from the side of the head. Macrotia (overly large ears) can be corrected with a type of otoplasty called ear reduction. Otoplasty can be combined with other cosmetic procedures such as neck surgery.

The goal of otoplasty surgical procedures is to create a more balanced and natural shape that matches the rest of the person's face. It has been found that correction of even minor deformities in the external ear by plastic surgeons can have a profound positive effect on a person's appearance and self-confidence.

Why is it done?

There are various reasons for children and adults to have ear reshaping surgery. It is usually done on both ears to obtain maximum symmetry. The main objective is to obtain a more natural shape, size, and position and for bringing balance to the face overall.

You might choose to have otoplasty if you have prominent ears that protrude from the sides of your head. Or if you are bothered by a disfigured external ear due to an injury or birth defect. Some people have otoplasty for overly large ears or for ears that are too small in proportion to their head. Lastly, the procedure is also done as a revision plastic surgery in patients who are dissatisfied with a previous otoplasty surgery, for example due to over-correction or an unnatural "pinned back" appearance.

It is worth noting that ear surgery (otoplasty) does not change the location of the ears on the head or improve hearing.

Who is a good candidate for otoplasty?

Healthy individuals, both children and adults, who do not have any chronic or life-threatening illness are considered good candidates for ear surgery. Like with any facial plastic surgery, it is important to have a positive outlook and realistic expectations from the procedure. Keep in mind that ear reshaping surgery is a highly individualized procedure. If you choose to undergo otoplasty, it should be for yourself and your self-esteem rather than someone's else's wishes or to achieve any kind of idealistic image.

What is a good age to have otoplasty ear surgery?

The external ear usually reaches full size by age 5. This is also the age when the child's ear cartilage is stable enough to be surgically manipulated for correction. Children of this age and older children can usually follow instructions after the correction, cooperate with their doctors, communicate their wishes, answer questions, and voice objections. Therefore, otoplasty can be done at any time after age 5, through the teenage years and into adulthood.

How do you prepare for ear reshaping or protruding ears surgery?

You will be seen in initial consultation by a facial plastic surgeon. At this appointment, the surgeon will examine your ears, including their size, shape, symmetry, and placement. They may take pictures to place in your medical record and for before/after otoplasty photos comparison.

At the time of the initial visit, the doctor will also carefully review your medical history, including past medical conditions and current medical conditions. They will especially ask about any untreated chronic ear infections. Your doctor will ask about your over-the-counter and prescription medications and medication allergies as well as any surgeries you have had in the past.

An important part of your otoplasty ear consultation will be a discussion about your expectations. The doctor will make sure you understand what otoplasty can and cannot achieve and that you understand the risks of the procedure.

Patients who are deemed to be good candidates for otoplasty will be booked for surgery. The doctor will give instructions on what to do in preparation for the procedure.

What is the otoplasty procedure like?

Preparation

You may need to undergo some lab testing or medical evaluation before your surgery. Your plastic surgeon will instruct you to avoid certain medications for a few days around your surgical otoplasty. These include aspirin, non-steroidal anti-inflammatory drugs, and certain herbal supplements which can increase the risk of bruising and bleeding.

If you smoke, you will be advised to stop smoking before and after your facial plastic surgery. Smoking causes a decrease in blood flow to the skin and can delay the healing process of the ears.

Otoplasty is usually an outpatient procedure. It means you can go home the same day. However, you will need to arrange for someone to drive you home and stay with you overnight for at least one day.

Procedure

An otoplasty is typically done in an outpatient surgical facility or hospital setting. It can be performed under local anesthesia with sedation (this numbs only the part of the body being operated upon, in this case the ears) or under general anesthesia (you are unconscious during the surgery). The procedure usually takes 1 to 3 hours to complete.

A plastic surgeon can use various surgical otoplasty techniques depending on the type of correction needed. The specific technique your plastic surgeon selects will determine where the incisions and scars are located. Typical otoplasty incisions are placed on the back of the external ear or in the inner creases of the ear cartilage, so that the scars are well hidden in the natural folds of the ears.

To correct protruding ears, the surgeon will increase the antihelical fold in the rim of the external ear. To reduce macrotia (overly large ears), they may work on the conchal cartilage (the biggest and deepest concavity in the external ear). They will remove excess cartilage and skin to correct unnatural contours and fold the ear cartilage into a more natural shape. They might fold the adult's or child's ear cartilage into proper position. The newly positioned and shaped ears will be secured with permanent stitches. The surgeon will use additional sutures (stitches) to close the incisions on the outer ears.

Recovery after otoplasty

After otoplasty, there will be bandages on your ears and head for support and protection. It is not unusual to experience some discomfort, itching, soreness, tenderness, swelling, bruising, and loss of skin sensation (numbness) after otoplasty. Pain medication can help relieve some of these symptoms. You should contact your doctor immediately if your pain after otoplasty increases over time instead of getting better.

The dressing on your head will stay in place for about one week. Do not remove the bandages during the healing process without taking to your doctor first. After the dressing comes off, you will need to wear an elastic head band for support for 4-6 weeks.

Follow your doctor's instructions to get the best results from your otoplasty. Ask your surgeon about when the stitches will come out - some stitches dissolve on their own while others need to be removed by the surgeon in the office after about a week. Your doctor will tell you when you can return to normal activities such as bathing and physical exercise. You will initially need to avoid sleeping on your side. It is also a good idea to wear buttoned shirts or shirts with loose collars so you don't tug on the ears when you pull shirts on and off your head. You may need to wear a loose headband for several weeks.

Does otoplasty hurt?

The ear pinning or ear reshaping surgery itself is not painful because it is performed with general anesthesia or local anesthesia with sedation. However, it is common to have some discomfort after the procedure. This can usually be managed with pain medicine.

When will I see the results of my ear surgery?

You will see an immediate improvement in your ears as soon as the bandages are removed. The results of an otoplasty are permanent. If, for some reason, you're dissatisfied with your otoplasty results, talk to your surgeon about possible revision surgery.

What are the risks?

As with any major surgery, otoplasty has risks and potential complications, including infection, bleeding, unexpected reactions to anesthesia, scarring, asymmetry, changes in skin sensation, allergic reactions to materials used during the procedure, persistent pain, skin discoloration, poor wound healing, contour irregularities, migration of the permanent stitches that might work their way to the skin surface and cause pain and inflammation, overcorrection, and other undesirable aesthetic results.

Your surgeon will discuss the risks and complications of otoplasty with you in detail at the time of obtaining surgical consent. Only you can make the decision whether the risks are worth the benefits.

Can otoplasty be done without surgery?

If a child is born with certain ear shape problems, it may be possible to correct the deformities with splinting that is started shortly after birth.

There are also some incisionless techniques that can correct minor deformities in the external ear, for example, techniques using threading sutures. These procedures are associated with a quicker and easier recovery because there are no incisions or cuts made in the ears.

Is otoplasty covered by insurance? How much does it cost?

According to the American Society of Plastic Surgeons, the average cost of otoplasty ear surgery is around $3,500. The cost of surgical correction of prominent ears with also depend on the type of anesthesia - procedures done under general anesthesia are usually more expensive than those done with local anesthesia with sedation. The total price of your procedure may add up, depending on anesthesia costs, operating room costs, and other related expenses. If you are having additional procedures, such as neck surgery, the cost will obviously be higher.

Your plastic surgeon's office will provide you with a quote for the final fee for your cosmetic ear surgery. It will also depend on your surgeon's experience and your geographical location. Some plastic surgeons offer financing plans to make otoplasty affordable for patients.

Most health insurance plans do not cover elective surgery such as otoplasty. However, if you are having reconstructive surgery for injuries or birth defects, it may be covered. Pre-certification is usually required for reimbursement. Contact your insurance company before the surgery to find out if your otoplasty will be covered.

Finding plastic surgeons for otoplasty ear procedures

Want to find out more about ear reshaping or ear pinning surgery? The MeTime app makes it easy to find experienced facial plastic surgeons in your area. You can chat with experts, send photos across, do a video consultation, and book your initial consultation when you're ready. Download the MeTime app and get in touch with an otoplasty surgeon today.