Otoplasty procedure facts

  • Otoplasty is performed to improve the appearance and function of the ear.
  • Otoplasty is safe and effective.
  • Otoplasty can improve one's self image.

Cosmetic and reconstructive surgery of the external ear is often performed to repair cosmetic or defects resulting from injury. The most common procedure is otoplasty which is done to correct prominent ears in children. The goal of this type of surgery is to improve both the functional and cosmetic appearance of the ears. Frequently, psychological trauma is associated with such features.

You should discuss freely with your doctor your cosmetic concerns and expectations. In turn, your surgeon will discuss his/her recommendations and any particular limitations set forth by the preoperative structure of your ears, face, and skin. Preoperative and postoperative photographs will usually be taken to help with preoperative planning and to document postoperative results.

The following instructions are designed to help you, or your child, recover from cosmetic/reconstructive surgery of the ears (otoplasty) as easily as possible. Taking care of yourself, or your child, can prevent complications. It is very important that you read these instructions and follow them carefully.

What are risks and complications of cosmetic ear surgery?

Your surgery will be performed safely and with care in order to obtain the best possible results. The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. It is here for your information only, not to frighten you, but to make you aware and more knowledgeable concerning this surgical procedure.

  1. Infection of the skin or of the cartilage (chondritis) of the ear.
  2. Bleeding or hematoma formation.
  3. A cosmetic or functional result that does not meet your expectations. An unfavorable result may occur at any time following surgery, and includes inadequate correction, recurrence, contour distortions, or asymmetric correction, all of which may require secondary surgery.
  4. Permanent or temporary numbness of the skin of the ear or face.
  5. Scar or keloid formation, which is an overgrowth of scar tissue.
  6. Prolonged pain, impaired healing, and the need for hospitalization.
  7. Narrowing of the external ear canal.
  8. Suture extrusion. When permanent sutures are used to maintain shape, they may become evident through the skin and may eventually require removal.
  9. If the surgery is being done because of a tumor, there can be recurrence of the tumor and the need for additional surgery or other therapeutic modalities including radiation therapy or chemotherapy.

What happens before surgery?

In most situations, the surgery is performed as an outpatient at either the hospital or the surgicenter. In both facilities, quality care is provided without the expense and inconvenience of an overnight stay. An anesthesiologist will monitor you throughout the procedure. Usually, the anesthesiologist will call the night before surgery to review the medical history. If he or she is unable to reach you the night before surgery, they will talk with you that morning. If your doctor has ordered preoperative laboratory studies, you should arrange to have these done several days in advance.

You should not take aspirin, or any product containing aspirin, within 10 days of the date of your surgery. Non-steroidal antiinflammatory medications (such as Advil, Naprosyn, Nuprin) should not be taken within 4-7 days of the date of surgery depending on the preparation. Many over-the- counter products contain aspirin or antinflammatory drugs. So it is important to check all medications carefully. If there is any question, please call your doctor's office or consult your pharmacist. Acetaminophen (Tylenol) is an acceptable pain reliever. Usually your doctor will give you your prescriptions at the preoperative visit. It is best to have these filled prior to the date of your surgery.

You must not eat or drink anything 6 hour prior to the time of surgery. This includes even water, candy, or chewing gum. Anything in the stomach increases the chances of an anesthetic complication. Smokers should make every effort to stop smoking, or at least reduce the number of cigarettes. This will help to reduce postoperative coughing and bleeding. If you are sick or have a fever the day before surgery, call the office. If you wake up sick the day of surgery, still proceed to the surgical facility as planned. Your doctor will decide if it is safe to proceed with surgery.

What happens on the day of surgery?

It is important that you know precisely what time you are to check in with the surgical facility, and that you allow sufficient preparation time. Bring all papers and forms with you including any preoperative orders and history sheets. You should wear comfortable loose fitting clothes which do not have to be pulled over the head. Leave all jewelry and valuables at home. Remove all make-up with a cleansing cream. Thoroughly wash your face with soap and water. Do not apply make-up or cream to your face.

Do not take any medication unless instructed by your doctor or the anesthesiologist. Usually in the pre- operative holding room, a nurse will start an intravenous infusion line (IV) and you may be given a medication to help you relax.

What happens during surgery?

In the operating room, the anesthesiologist will usually use a mixture of a gas and an intravenous medication to put you to sleep and to maintain your anesthetic at a safe and comfortable level. During the procedure, you will be continuously monitored including blood pressure, pulse, oxygen saturation (pulse oximeter), and heart rhythm (EKG). The surgical team is prepared for any emergency. In addition to the surgeon and the anesthesiologist, there will be a nurse and a surgical technician in the room.

Depending on what is required and whether or not you are also undergoing additional procedures, the surgery may take several hours. Your doctor will typically come to the waiting room to talk with any family or friends once you are safely to the recovery room.

What happens after surgery?

After surgery, you will be taken to the recovery room where a nurse will monitor you. You will be able to go home the same day as the surgery once you have fully recovered from the anesthetic. This usually takes several hours. You will need a friend or family member to pick you up from the surgical facility and to take you home. He or she should spend the first night after surgery with you. When you arrive home from the surgical facility, you should go to bed and rest with your head elevated on 2-3 pillows. By keeping your head elevated above your heart, you can minimize edema and swelling. You may get out of bed with assistance to use the bathroom. It is best to eat a light, soft, and cool diet as tolerated once you have recovered fully from the anesthetic. Avoid hot liquids for several days. Even though you may be hungry immediately after surgery, it is best to go slowly to prevent postoperative nausea and vomiting. Occasionally, you may vomit one or two times immediately after surgery; if it persists, your doctor may prescribe medication to settle the stomach. It is important to remember that a good overall diet with ample rest promotes healing.

You will be prescribed antibiotics after surgery, and should finish all the pills that have been ordered. Some form of a narcotic will also be prescribed (typically hydrocodone/Vicodin), and is to be taken as needed. If you require narcotics you are cautioned not to drive. In some situations your doctor may give you steroids to be taken either preoperatively and/or post-operatively. It is very important that you take this medication as prescribed, and not discontinue it prematurely. If you have nausea or vomiting post-operatively, you may be prescribed medications for nausea (anti-emesis), such as phenergan. If you have any questions or you feel that you are developing a reaction to any of these medications, you should consult your doctor. You should not take any other medication, either prescribed or over-the-counter, unless you have discussed it with your doctor.

What are the general instructions and follow-up care?

In most situations, a bandage will have been placed to cover the wound. If you are undergoing an otoplasty, a compressive dressing will be placed. You should not remove the dressing because these are holding the external ears in the appropriate position. Your doctor will probably check the ear the next day in the office. If you experience severe pain on only one side, please call the office to report this to the doctor. It may be the first indication of a hematoma. Unless instructed otherwise, the bandages should remain in place for one week. At this time, you are asked to return to the office to have the sutures removed. We usually recommend that you wear an elastic band (ear band-it) at night for the next 6 weeks. It is best to wear the band even during the day when it is "socially acceptable". We discourage facial tanning for 6 months after surgery. If you must be in the sun you should use a number 15 or greater sun block. You may use your usual make-up anytime after surgery. Do not wear earrings or glasses (if possible) for 3 weeks.

After the bandages have been removed, clean the wound with a Q-tip soaked in hydrogen peroxide to remove all crusts. By gently removing all crusts, the wound edges will heal better with a less obvious scar. Apply polysporin ointment, or a similar antibiotic ointment of your choice, to the cleaned wound. If you develop a rash, discontinue the ointment and notify your surgeon. You may wash you face and hair after the bandages have been removed. Avoid excessive scrubbing of the wound.

Use a gentle soap and shampoo. We ask that you stay out of the pool for several weeks, and after that to wear the ear band-it for the next 6 weeks. Numbness, slight swelling, itching, and discoloration are normal complaints, and should go away with time. You should plan to stay in town for 3 weeks to allow for after-surgery (postoperative) care.

NOTIFY YOUR DOCTOR IF YOU HAVE:

  1. A fever greater than 101.5 degrees F which persists despite increasing the amount of fluid you drink and acetaminophen (Tylenol). A person with a fever should try to drink approximately one cup of fluid each waking hour.
  2. Persistent sharp pain or severe one- sided pain which is not relieved by the pain medication you were prescribed.
  3. Increased swelling or redness of the ears.
  4. Drainage from the wound.

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

Isaacson, Glenn C., M.D. "Congenital anomalies of the ear." UptoDate. Updated Feb. 4, 2016.

Last Editorial Review: 9/14/2016

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Reviewed on 9/14/2016
References
Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

Isaacson, Glenn C., M.D. "Congenital anomalies of the ear." UptoDate. Updated Feb. 4, 2016.

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