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Otoplasty, or ear surgery, is performed either to set prominent ears closer to the head or to reduce the size of one or both ears that are too large in proportion to the shape of the face. By age five, ears are considered to be fully developed so this operation is often performed on children between the ages of five and fourteen. The surgery is occasionally performed early so the child can avoid teasing from other children. While otoplasty is also performed on adults, the more mature cartilage cannot be reshaped as easily as the cartilage of children, which is more pliable and thus the surgery is easier and more effective. In addition to protruding ears, other ear problems can be corrected through surgery. For example, for those who were born without fully developed ears or for those who have lost part of the ear from injury or trauma, the ears can reconstructed. Large or stretched earlobes can be corrected as well as earlobes that have large creases resulting from age or years of wearing heavy earrings. Earlobe repair or reduction is often combined with facelift surgery.
Typically, ear surgery is an outpatient procedure that can be performed with general or local anesthesia with sedation. Depending on the specific problem being corrected, the surgical techniques will vary. Often times, a small incision in the back of the ear will be made to expose the cartilage. Then the cartilage is sculpted to give a more natural-looking fold in the final result. To anchor the ears until they are healed, sutures are often used; in some cases, non-removable stitches will be necessary to keep the ear’s new shape in place. Other options include a similar incision in the back of the ear, where skin is removed and stitches are used to maintain the new shape. In some patients a large portion of cartilage will need to be removed to produce a better fold. In other cases, although only one ear protrudes, surgery is usually performed on both ears for a good balance. Perfect symmetry can never be guaranteed.
Although both adults and children are usually moving with in a few hours of surgery, the head will be wrapped in a bulky bandage for the best molding and most effective healing. Soft dressing will stay in the ears for a few days. A lighter head dressing will replace the bulky bandages with in a few days. After a few more days, a headband will be worn for two weeks to hold ears in their new position. If sutures are not self-dissolvable and need to be removed, they will be taken out about a week after surgery. Mild to moderate discomfort after surgery is common as well as throbbing or aching ears for several days.
In time, the scar in the back of the ear will fade; ideally, once completely healed, the scar will be a thin white line. The incision can be made in a natural crease behind the ear to make it less conspicuous. Most people are able to wear their hair short or pulled back without incident. Though not common, a blood clot on the ear is possible; if it does not dissolve on its own, it can be removed with a needle. Scar tissue can form if the patient develops an infection in the cartilage. Infections are typically treated with antibiotics; in rare cases, though, surgery may be needed to drain the infected area. Additional surgery may be needed to correct asymmetry between the ears; for example one is higher than the other. Relapse is also a possible in the first weeks after surgery, The is typically easily correctable with a few additional sutures.
Procedures are performed by Dr. Barry Cohen, Board Certified Plastic and Reconstructive Surgeon with great interest in cosmetic surgery. Procedures conducted in Rockville MD, and McLean, VA.