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Ear Surgery (Otoplasty)

Many individuals, starting from childhood, are unhappy with the size or shape of their ears. Or, for some, the ears protrude more than they should, are asymmetrical, or droop too low. Children may be teased at school; and adults might go to great lengths to hide their imperfect ears with their hair or by wearing hats. Fortunately, otoplasty, also referred to as ear plastic surgery, is readily available to cosmetically alter the ears. The procedure should only be performed by an experienced plastic surgeon, and can have a dramatic impact on a person's appearance, confidence, and overall quality of life. This corrective surgery is extremely popular among adults and children alike. If you are interested in ear pinning, or ear plastic surgery, it is important that you are well-informed of all pertinent details before moving forward. We invite you to continue reading to familiarize yourself with the treatment, so you can determine whether it is right for you.

Ear Surgery Procedure

Otoplasty, or cosmetic ear surgery, is used to reshape one or both ears. Patients who are dissatisfied with the size, shape or orientation of their ears can alter their appearance through this outpatient procedure. Otoplasty also includes ear/earlobe reduction and cauliflower ear surgery to remove and recontour excess skin and cartilage. Because the ears are very prominent, many cosmetic ear surgery patients experience a significant increase in confidence and self-esteem once their ears have been given a more desirable appearance.

Ear Pinning and Reconstructive Otoplasty

Ear pinning and ear reshaping surgery is usually performed under a local anesthetic with a sedative for adults and general anesthesia for children.

To begin ear pinning surgery, the surgeon makes an incision behind the ear to expose the cartilage. The cartilage is then reshaped and excess skin is removed. Finally, if necessary, the ear is repositioned more closely to the head, and the incision is closed with non-removable stitches or sutures.

Cosmetic ear surgery generally lasts between one and two hours, depending on the extent of the surgery.

If a patient has protruding ears, ear pinning is used to position the ears more closely to the sides of the head. Ear pinning combines removing skin from the back of the ear, cartilage sparing, and scoring techniques. This fusion of techniques helps the surgeon to create the ideal shape and positioning of the patient’s ears.

There are many different techniques used to accomplish ear pinning during otoplasty surgery. The surgical technique the physician chooses depends upon the amount of correction the patient’s ears require. The various methods of ear pinning and reshaping can be classified into two primary groups: cartilage sparing and cartilage scoring (cutting).

Cartilage scoring techniques  involve creating incisions in the cartilage to rearrange, add, or remove the tissue. There is a greater risk of scarring when these techniques are used, but those scars are difficult to see. Cartilage sparing techniques use stitches and sutures to change the ear’s position and shape. A cartilage sparing otoplasty surgery is non-invasive, often resulting in smooth, natural-looking curvatures.

Reconstructive ear surgery is a form of otoplasty used to correct deformities or injuries. It is commonly used to correct Microtia, a congenital defect of the ear that occurs in about three out of every 10,000 live births. Injuries that call for reconstructive ear surgery include burns, lacerations, and infected or torn piercings. Ronstructive ear surgery blends a variety of surgical techniques and other reconstructive procedures to recreate a natural-looking human ear. In some cases, cartilage can be removed from the patient’s ribs to augment the ear and help it attain a more natural appearance. If a skin graft is necessary, tissue is usually transferred from the patient’s upper buttock area.

What Is Bilateral Otoplasty?

While some patients require correction of only one ear, many patients have cosmetic concerns with both. Bilateral otoplasty is an ear pinning and reshaping surgery performed on both ears. Bilateral otoplasty is performed the same way as surgery involving a single ear, and has the same recovery time, potential complications, and benefits. Although post-procedural side effects such as itching and throbbing may be slightly more pronounced following a bilateral otoplasty, the discomfort should still be minimal.

Ear Reduction Surgery

Some patients are more concerned with the size and shape of their ears rather than their protrusion from the side of the head. A form of otoplasty known as ear reduction surgery is used for sculpting larger ears, giving patients a more natural look. Ear reduction surgery, which may include earlobe reduction, is an outpatient procedure and can be performed on children and adults. During the surgery, the doctor will remove unwanted cartilage and skin, and reshape the ear to create a smaller, more natural-looking size. Ear reduction surgery can provide balance and symmetry to the face and ears, and is often accompanied by ear pinning.

Preparing for Ear Surgery

Weeks of preparation for otoplasty are often required to achieve the best results. The process starts with finding the surgeon you are most comfortable with. Preparing for the procedure requires a lot of information, realistic expectations of the outcome, and some practical considerations, right down to what to wear on the day of surgery. Below are several steps and considerations for anyone who is about to undergo cosmetic ear surgery.

The Otoplasty Consultation

After thoroughly researching the otoplasty procedure and finding a qualified surgeon, prospective patients will have an initial consultation that will be crucial to the procedure. The surgeon will thoroughly examine the patient’s ears and discuss various ways of correcting the problem. The initial consultation will first determine if otoplasty is the best procedure for the patient.

If otoplasty is indicated as a feasible treatment option, the surgeon will then discuss the ear surgery procedure in detail. This discussion will likely include details concerning the anesthesia, the patient’s a medical history, and the costs associated with the surgery. This initial consultaiton is a good time for prospective patients to inquire about the benefits of ear surgery as well as any potential risks and complications of otoplasty.

The Weeks Prior to Surgery

In the weeks prior to ear surgery, parents or guardians with children undergoing otoplasty should have discussions regarding the child's feelings. They should have genuine communication with their child regarding all of the details of the procedure and recovery, and reasonable expectations for the results.

For all prospective patients, aspirin use should be discontinued at least two weeks prior to surgery. Cessation of smoking and tobacco use is also strongly urged by physicians. Preparations for missing work or school, as well as a designated person to take care of the patient immediately following the surgery, should also begin to take shape during this time.

The Day before Surgery

Patients receiving general anesthesia for an otoplasty procedure will not be allowed to eat or drink after midnight the night before, or the morning of, the surgery. The last meal the night prior to surgery should be a very light one. Preparations should be finalized for an extended recovery period (e.g., making sure work or school has been notified) and arrangements made for someone to drive the patient home. The patient should be under another person’s care for at least the first night unless the physician requires an overnight hospital stay.

The Day of Surgery

Before coming into the surgical facility, otoplasty patients should plan to wear comfortable, loose-fitting clothing. Restrictive collars or shirts that patients have to pull over their heads should not be worn. It is important, especially for children, that nothing bends or pulls at the ears after the operation. Adult patients are also strongly urged to shower and shampoo their hair thoroughly the morning of surgery. Women should braid or pin their hair, and men should have a haircut or trim at some point before the procedure.

  • Before the surgery begins, the surgeon will administer either general anesthesia (usually in cases of ear surgery for children) or local anesthetic with a sedative for adult patients. The otoplasty surgery itself should take two hours or less, depending on the extent of the procedure. Some physicians ask that children stay overnight in the hospital, and adults may also require an overnight hospital stay if their procedure is more complex than a traditional otoplasty. However, most adults should plan to have someone with them to drive them home and take care of them the night following the surgery.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Arizona Cosmetic Surgery

Ear Surgery Recovery

After the otoplasty procedure, most patients are enthusiastic to see their results. However, it is important to know that there is a recovery period that patients must go through before bandages are removed and their beautiful, new ears are revealed. While patients generally experience some side effects, like swelling or discomfort, only immediately following the procedure, full recovery may take some time. Your surgeon will inform you of proper aftercare instructions, so you heal properly, and know what to expect during the recovery process. While recovery from ear surgery is relatively simple, it is important that you follow your doctor's instructions carefully for the best possible outcome. Ask any questions before the surgery so you have a full understanding of what is required of you. Additionally, make sure that you can invest the time and attention to recover properly. Continue reading for details on ear surgery recovery. Or, contact a qualified plastic surgeon in your area to learn more, or to schedule a consultation.

Immediately After Ear Surgery

Once the otoplasty surgery is complete, the patient's head will be wrapped with special heavily-padded cotton bandages, referred to as "fluff bandages", for healing. After a few days, the patient can remove the fluff bandages, but will need to wear a lighter bandage for another few days. Approximately one week following the procedure, all bandages can be removed.

The patient will then be directed to wear a soft headband that covers the ears in order to hold them in their proper position. Depending on the needs of the patient, the doctor may indicate that the headband only be worn at night, which is when the ears are more likely to lose their new shape.

Important Tips for Ear Surgery Recovery

It is important for patients to know that the appearance of their ears will change from immediately after the surgery to the time they are completely healed. For example, the ears usually appear swollen or bruised right after the procedure, which will subside after some time. Don't be alarmed if the ears aren't instantly what you expected. Here are some important instructions to follow after ear surgery:

  • Avoid rigorous activity or any activities that could impact the ears until completely healed - this is particularly important to remember for young children as they should not play or overexert themselves.
  • Keep the head cool during the recovery period, especially while bandages are being worn - avoid extreme heat and refrain from using hot blow dryers.
  • Do not wash the hair with shampoo for up to one week after the surgery.
  • Keep head elevated to minimize swelling - use several comfortable pillows to keep you uplifted while sleeping or resting.
  • Try not to sleep on your side during recovery.
  • ake any prescribed pain medication as directed to alleviate any discomfort.
  • Apply any ointment directed by the doctor to the incision area, so scars heal properly and are not visible.
  • Have patience - allow yourself to rest and recover from the surgery.
  • Have realistic expectations - understand that the appearance of the ears will gradually improve over time.
  • Contact your doctor right away if you experience any complications.

Ear Surgery Recovery Timeline

  • Bandages can be removed after several days.
  • Resume normal activities approximately one week after surgery.
  • Adults can return to work after several days.
  • Children can return to school after one week.
  • A headband should be worn for several weeks.
  • Full otoplasty recovery takes approximately six weeks.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Arizona Cosmetic Surgery

Ear Surgery Candidates

Ears are one of the few body features that people can't keep from being seen. Long hair can sometimes cover them up, but that's only temporary. They're so visible people regularly hang jewelry from them - so when someone feels uncomfortable with the shape of his or her ears, it can sometimes reach unbearable levels of embarrassment.

That's why otoplasty, or cosmetic ear surgery, can be such a popular procedure for so many people. Children who are constantly teased by their classmates, adults who are fed up with the self-confidence drag their ears give them, or someone who has suffered trauma to their ears, are just a few examples of people who can look to otoplasty for help.

Conversely, some children are born with severe ear defects, and may also be excellent candidates for reconstructive otoplasty. If you're wondering whether you or your child fall into the category of likely otoplasty candidates, the following information can help you decide.

Traditional vs. Reconstructive Otoplasty

Traditional otoplasty is also known as ear pinning, where large or extruding ears are "pinned" back towards the patient's head. This creates a more common look that patients usually feel is more normal and beautiful.

Reconstructive otoplasty helps deal with severe ear defects that can come from birth or some kind of outside trauma. Some of the defects that can be corrected with reconstructive otoplasty are listed below:

Congential Defects

  • Cagot Ear - No earlobe is present
  • Cat's Ear - The edges of the ear are folded forward, much like a cat
  • Lop Ear - Resembling a cup, the ear curves severely inward
  • Scroll Ear - The ears are curled forward, like a rolled up scroll
  • Wildermuth's Ear - The top curve of the ear is reversed, curving towards the scalp instead
  • Stahl's Ear Deformity - Abnormal folding of the ear creates a pointed edge, resembling an elf's ear
  • Cleft Earlobe - An indent occurring in the earlobe
  • Question Mark Ear or Cosman Ear - Resembling a question mark, the ear has a separation in the skull between the earlobe and the outer curve of the ear
  • Microtia - The ears are severely small and underdeveloped
  • Macrotia - Abnormally large ears
  • Constricted Ear - Partial absence of skin and cartilage on the outer back portion of the ear
  • Cryptotia - The upper curved portion of the ear is embedded in the scalp

Other Trauma

  • Cauliflower Ear - Due to repeated injury to the ear, cartilage gets separated from the perichondrium and fills with fluid, which becomes permanently cartilaginous and deformed
  • Skin Cancer and Malignant Melanoma - Although not usually cosmetic, otoplasty can help remove skin cancer and then reconstruct the tissue left over

Although most of these conditions can appear as severe congenital defects, some people are just hate that their ears still too far out or are too big. These people are more likely to be traditional otoplasty candidates, but should talk to a surgeon to see if it's right for them.

Remember, otoplasty doesn't magically grant people new wonderful ears, so its important to take this procedure seriously and understand the realistic results and risks involved.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Thomas L. Tzikas, MD, PA

Children and Otoplasty

Most of the conditions listed above are congenital defects, which are usually dealt with at a young age. Child patients tend to have otoplasty around the age of six, when their ears has developed to a size relatively close to an adults.

Still, children between the ages of four and fourteen are common otoplasty candidates. Children younger than four are normally not candidates since their ears are still growing, but conditions caught early can be manipulated better with younger ear tissue.

Naturally there can be exceptions to these commonalities. If your child has a severe ear defect that you have not talked to your doctor about, it's worth a conversation to determine if he or she is a viable candidate for otoplasty. 

Benefits of Ear Surgery

Patients will experience a number of excellent benefits of otoplasty surgery, including:

  • Procedure is safe - little to no risks involved
  • Can correct a wide variety of ear imperfections
  • Children can avoid teasing by peers
  • Enhance confidence and self esteem
  • Minimal downtime - approximately one week
  • Improve emotional and psychological conditions
  • Minimal scarring once healed
  • Natural-looking results
  • You choose how the ears will look

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Kovanda Plastic Surgery

Ear Surgery Risks

Anyone experiencing self-consciousness because of protruding, deformed or large ears can find an excellent solution in cosmetic ear surgery (otoplasty). By repositioning the ears closer to the head (pinning), or surgically altering the shape of the ears, patients can enjoy boosted confidence and increased self-esteem, knowing their ears have become far less prominent. Otoplasty also involves a relatively brief recovery time, making it a very rewarding plastic surgery procedure for many patients.

However, like every surgical procedure, cosmetic ear surgery involves risks. The chances of experiencing complications during this treatment, or as a result of it, are usually minimal. However, it is important to have an understanding of the problems that occur, and to discuss them with your surgeon before committing to otoplasty.

Ear Surgery Side Effects

Patients who undergo cosmetic ear surgery (otoplasty) are often eager to begin enjoying their “new” ears, along with the boosted confidence this procedure can provide. However, patients should understand that the results are not immediate, and that the six-week recovery period often involves some degree of mild discomfort.

As with any surgical procedure, the reconstruction and repositioning of the ears has potential side effects. Although they are extremely minimal, these side effects can cause patients post-surgical discomfort and pain. Anyone considering cosmetic ear surgery and hoping to benefit from the physical and psychological benefits it can provide should have a thorough understanding of the mild discomfort that can occur during the recovery process. Moderate pain, itching and numbness are common following a cosmetic ear surgery procedure. However, by carefully following your surgeon’s recommendations for caring for the surgical site during the recovery period, this temporary discomfort can be a small price to pay for the many years of rewards otoplasty can provide.

Pain after Otoplasty (Ear Surgery)

The general post-operative pain associated with otoplasty is almost always minimal. In most cases, this pain can be relieved with painkillers and anti-inflammatory medications. After surgery, special bandages are carefully wrapped around the patient’s head to prevent as much discomfort as possible. These bandages also allow the patient to rest more easily. The patient must wear these bandages for the first one to two days following surgery. They will be replaced by lighter dressings after that time. After about a week, the patient can cease wearing bandages altogether. Although slight pain is normal following cosmetic ear surgery, prolonged pain may indicate the development of complications from the surgery. If pain persists, the patient should contact a medical professional right away.

Itching and Aching

After otoplasty, there is a very good possibility that the patient will experience some itching and aching at the surgery site. The itching is typically a side effect of the sutures, which can become dry and irritated. It is particularly important that parents of young otoplasty patients take extra precautions to prevent their children from scratching their ears after surgery. Doctors recommend that children stay home from school for about a week following otoplasty. Parents and surgeons should speak to young patients about the importance of resisting the impulse to scratch or otherwise touch the surgical site. These seemingly insignificant reactions can result in ruptured sutures, which can cause significant damage to the improvements achieved with cosmetic ear surgery. It can also lead to infection and other complications.

Aching or throbbing are other common side effect of otoplasty and can be alleviated with medication. Ideally, these effects should dissipate several days after surgery. Because the surgery is performed on the head, an area of the body with significant and constant blood flow, throbbing after otoplasty is normal while the ears react to their new positioning. If the aching continues for an extended period of time, patients are advised to get in touch with their doctor immediately.

Numbness

Many otoplasty patients experience some degree of numbness following the procedure. Because the nerves in and around the ears must be regenerated, it is not uncommon for some feeling to be diminished or temporarily lost immediately after surgery. Numbness and other abnormal nerve sensations can last for a few days or up to several months after otoplasty before returning to a normal state. Patients with numbness of the ears must be particularly careful to avoid exposing their ears to extreme heat or cold, such as a curling iron or ice pack, as the area can become damaged without the patient even realizing it.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Thomas L. Tzikas, MD, PA

Infection

Infection of the skin and cartilage is one of the most common otoplasty complications. It also poses the greatest threat to the success of the procedure. Should an infection develop after cosmetic ear surgery, it is generally relieved with an antibiotic medication. If the infection results in the formation of scar tissue, a very rare complication, then it may be necessary to address the area surgically.

Blood Clots

The formation of a blood clot in the ear is another possible risk of cosmetic ear surgery. A very infrequent complication, blood clots can be removed with a needle or may simply dissolve naturally. If the patient experiences prolonged swelling and bleeding, then the surgeon should be contacted immediately to ensure that the ear is healing properly.

Overcorrection

When cosmetic or reconstructive ear surgery is performed by an inexperienced or poorly-skilled surgeon, the potential risk of overcorrection of the ears is elevated. Otoplasty overcorrection can refer to:

  • Placing the ears too close to the head
  • Contour distortions
  • Inadequate correction
  • Asymmetric correction

The risk of overcorrection can be greatly reduced by choosing a physician with extensive training and proven results. Anyone considering cosmetic ear surgery is encouraged to learn as much as they can about their prospective surgeon's credentials and qualifications before committing to any plastic surgery procedure.

Loosening of Sutures

A risk commonly faced by children that have undergone otoplasty is the loosening of sutures. Often a result of boisterous activity or inattention to bandaging, loosened or popped sutures may cause the ear to return to its original shape or position. Carefully following the surgeon’s post-operational instructions can prevent this from occurring. For adults and children alike, this usually means avoiding strenuous or vigorous physical activity should be avoided for at least a week following surgery. Adults are usually advised to stay home from work for a day or two after surgery. Young children are generally told to stay home from school for about a week. A full recovery from cosmetic ear surgery usually takes about six weeks.

Hearing Loss

Many ear surgery patients wonder whether there is a risk of hearing loss associated with otoplasty. Complications of this kind are extremely rare, and are almost never seen. Distortion of the auditory canal, through major changes of the concha, can cause alterations in hearing. However, a highly skilled cosmetic ear surgeon is able to evaluate the possibility of such a risk and take the necessary steps to avoid any hearing damage.

Unwanted Gradual Reversal of Treatment

In most cases of cosmetic ear surgery, the results are satisfying and permanent. But because the ears consist mainly of cartilage, a tissue with great natural elasticity, patients who have had their ears surgically pinned closer to their head may observe a slight amount of “springing back” taking place in the years following the procedure. In many cases, facial plastic surgeons take measures to reduce this effect during the initial procedure through slight overcorrection, leaving a margin for the ears to shift slightly while maintaining a long-term natural shape. In some cases, patients may wish to undergo otoplasty revision surgery many years after their initial surgery in order to keep the look they desire. However, studies show that about 85 percent of cosmetic ear surgery patients remain satisfied with the long-term results of otoplasty.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Arizona Cosmetic Surgery

Cost of Ear Surgery

For children and adults alike, cosmetic ear surgery (otoplasty) is an excellent way to correct aesthetically atypical ears, yielding boosted self-confidence that rewards the patient for the rest of their lives.

Cosmetic ear surgery can cost several thousand dollars, and this price normally does not include pre- and post-operative care and medication. Though this may sound like a hefty price tag to prospective patients, most surgeons offer payment plans and other financing options to help cover the cost of otoplasty. Patients should also check their insurance coverage to see if their provider covers the cost of the procedure. Regardless, if you or your child are suffering undue anguish because of self-conscious feelings caused by protruding or deformed ears, the benefits of cosmetic ear surgery can far outweigh the cost of surgery and related treatment. Furthermore, by taking the time to educate yourself about cosmetic ear surgery and research prospective surgeons’ credentials and track records, you can feel more confident about spending the amount of money needed to ensure your otoplasty procedure will give you a lifetime of benefits.

Average Cost of Otoplasty

Cosmetic ear surgery is a highly individualized procedure that calls for different treatment methods from patient to patient. As such, it is difficult to say exactly how much the procedure will cost a prospective patient before they consult a plastic surgeon. The American Society of Plastic Surgeons reports that the average surgeon fee for otoplasty in 2004 was $2,339. When anesthesiology and facility fees are accounted for, the procedure can cost more than $5,000.

Exactly how much your otoplasty surgery will cost depends on several factors, including:

  • The surgeon’s experience: A surgeon with elite credentials, a superior reputation and long-standing practice may command a higher price for his or her services than other surgeons with less experience or renown in the cosmetic surgical community.
  • Location of the procedure: The cost of plastic surgery procedures varies throughout the United States. There are surgeons offering competitive pricing in other countries as well, though patients must also factor the cost of travel and lodging into their budgets.
  • Extent of the surgery: The difference in cost between a simple ear pinning to correct protruding ears, and the cost of correcting a deformed or severely injured ear can be significant because of the amount of treatment involved.
  • Pre- and post-operative care: Anesthesia, follow-up appointments and other measures taken to ensure your cosmetic ear surgery is a success all factor into the total cost of the procedure.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Kovanda Plastic Surgery

Reconstructive Ear Surgery

The most extensive and invasive form of otoplasty is reconstructive ear surgery. As such, it usually costs more than other otoplasty procedures.

Reconstructive ear surgery is a complex procedure addressing deformation or traumatic injury to the ear. It often involves taking skin and cartilage from other parts of the body to augment a patient’s existing ear structure for the purpose of creating a natural-looking ear. This results in a longer procedure, longer recovery time and a more involved post-operative care. In general, otoplasty insurance coverage will not cover procedures done to correct traumatic injuries to the ear.

Otoplasty and Insurance Coverage

The cost of otoplasty can sometimes be offset by insurance, depending on the reason for the procedure. If ear surgery is performed to correct a congenital deformity or defect in the ears, some providers may offer coverage. When otoplasty insurance coverage is sought, insurance carriers should be contacted as early as possible to find out what they will cover. Patients or their family members should also ask the ear surgeon to write a letter to the insurance company to explain the patient's case. When otoplasty is performed solely for cosmetic reasons, the cost is usually not covered by insurance companies.

The cost of ear pinning or reconstructive ear surgery may seem unaffordable at first; however, there are solutions available. While not everyone may be eligible for otoplasty insurance coverage, many people can be helped by the various ear surgery financing options available.

Consult an Ear Surgery (Otoplasty) Plastic Surgeon

To learn more about cosmetic ear surgery, including the cost of otoplasty and the risks associated with ear plastic surgery, it is important to speak with a skilled plastic surgeon. We encourage you to use DocShop's extensive online directory locate a cosmetic surgeon in your area.

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