Cosmetic Ear Surgery (Otoplasty)

Otoplasty is a procedure designed to “pin-back” prominent ears. The condition of protruding ears has been given many different terms (“bat ears”, “lop ears”, “cup ears” etc.) in order to differentiate between different anatomic situations. For the otoplasty surgeon, these terms have only limited usefulness in planning the ear procedure. The goal of otoplasty surgery is to reshape the ear cartilage of the particular patient to achieve a normal looking ear without unnatural shapes and sharp edges.

Plastic Ear Surgery to Achieve Normal Looking Ears

Otoplasty Ear Cosmetic Surgery
Patients or parents who have been bothered by protruding ears sometimes just do not want to see the prominent auricle any longer. This desire for overcompensation is common and understandable. Dr. Fechner always explains his patients that a person’s ears are usually not noticed when one looks at a face unless they are abnormal. It is the unusual that we want to remove and create normal ears without placing them to close to the head. It is this “plastered down” look that is strange looking and also difficult to correct.

Anatomy of Protruding Ears

The auricle’s shape is determined by the shape of the ear cartilage. This cartilage is very soft in newborns and becomes stiffer and stronger as the child grows. The ear has a complex shape made of folds and bends in the cartilage. Although no one ear matches exactly the next, two main reasons are commonly responsible for the excess in ear “projection”: first, absence or flattening of a main ear fold called antihelix and second, a “bowl” that is too large. Dr. Fechner’s experience shows that approximately 60 percent of patients have variable combination of both abnormalities and 40 percent have a flat anti-helix only. A large ear bowls (a.k.a. concha or cavum conchae) as an isolated problem without abnormalities of the antihelix are exceedingly rare.

Contemporary Otoplasty Principals

Conservative preservation of the ear cartilages characterizes the modern technique of otoplasty favored by Dr. Fechner. Rather than removing the cartilage during otoplasty, Dr. Fechner reshapes it with the help of internal sutures in order to achieve the desired normal anatomy. During the consultation, Dr. Fechner will examine the ears thoroughly and he will take important measurements. Following the examination, he discusses the exact plan for the ear operation with the patient and the family. The incisions are concealed in the natural fold behind the ear so that no visible scars are left behind.

Correction of Prominent Ears in Teenagers and Adults

Otoplasty is a relatively common plastic procedure in the young child before school age and in teenagers and young adults. In mature patients, this procedure can effectively and safely be performed in the office under local anesthesia with a sedative. Numbing of the ears is usually achievable with a single injection of lidocaine. From there on the ears appear “non-existent” to the patient for approximately 2 hours, sufficient time for an otoplasty procedure. The face and ears are sterilized with special surgical scrub solution. Dr. Fechner performs otoplasty surgery through relatively small incisions hidden within the crease behind the ears. The back of the ear cartilage is identified and isolated for accurate sculpting of the ear. The normal location of the antihelical fold is determined and sutures are used to fold the cartilage. Careful observation and adjustments during this process predicts a good outcome. If a large concha contributes to the ear protrusion, an appropriate amount of excess conchal cartilage can be removed without creating sharp edges. Lastly, the ear lobe needs to be adjusted. Dr. Fechner uses key sutures to convince the earlobe to stay harmony with the new ear position. After the ear has been moved closer to the head, little excess skin is present and is trimmed. The incision is sutured with a melt-away stitch and a dressing is placed.

Recovery after Cosmetic Ear Surgery

Otoplasty can be safely performed in an outpatient setting and recovery time ranges from 7 to 10 days. The first dressing will stay in place for 24 to 36 hours. Children will require observation and encouragement from mom and dad to ensure that this important bandage will stay in place for this first night. Ear soreness will be present for a few days but should be eased with pain medication. Dr. Fechner will examine the patient after the first dressing is removed ensuring that the healing progress is appropriate. At this time, the ears show their new position and shape. The ear skin will appear puffy and sometimes bruised. The patient will be able to take a shower now. A sports sweat band is placed to protect the ears in their new position. The sports band should be worn for the next 5 to 7 days. After this time, it is recommended to wear the headband at nighttime only.

Otoplasty in Children

When a child is between four and six years of age, his or her ears have grown sufficiently and otoplasty surgery is safe and predictable. Furthermore, the cartilage, which determines the ear’s shape, is pliable enough to undergo corrective surgery. Parents commonly consider correction of protruding ears before the child enters school. Because prominent ears may run as a trait within families, relatives may remember the psychological trauma due to teasing and ridicule by their peers. In children younger than 12, the procedure is commonly performed as an outpatient procedure under twilight sleep. In smaller children (4 to 8 years), a general anesthetic is commonly preferred.

For more information about some of the most common facial cosmetic procedures please follow the links below:

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Facial Cosmetic Surgery

* Results may vary by individual.