Ear Reshaping
(Otoplasty)

Introduction

If you have misshaped or protruding ears or you have a child who does, otoplasty may be for you. Otoplasty is the surgery to correct abnormalities in the structure of the ears. (It's also known as "pinback otoplasty").

In a perfect world, the surgery works best on children who are aged four to 14. But adults do undergo the surgery -- it's just that by this point in your life, you've probably heard all the teasing and you probably have suffered the psychological effects. Still, it's never too late to make a change.

This surgery isn't just for protruding ears, either. Otoplasty can correct:

• Abnormally large ear lobes
• Lop ear (ear tip folds down and trends forward)
• Shell ear (certain features of a normal ear are missing, such as the curve in the outer rim and other natural folds)

How It's Done

The good news is that medical advancements have made it much easier to undergo an otoplasty. Currently, there are several ways the ear can be reshaped. One involves cutting out the cartilage (the main structural component) of the ear. Another involves folding and stitching that cartilage instead of cutting it away. In the latter scenario, skin is cut away instead of cartilage.

In either case, your surgeon will begin by making a small incision at the back of your ear, allowing access the cartilage for the necessary procedure. After the surgery is complete, the incision site will be secured with stitches.

What To Expect and How To Prepare

In your consultation, you will be able to discuss all your expectations with your surgeon. Together, you can decide which option is best for you or your child. You should plan to stay home at least one week after the surgery; for children, they should stay home from school for at least one week.

The actual surgery will last about two to three hours, depending on the complexity of the procedure for your particular case. Again, if your situation requires a more complex procedure, it may take even longer than three hours. Your surgeon will detail all of this for you.

If you are an adult, your surgeon probably will use local anesthesia with a sedative. A child will likely receive general anesthesia (put to sleep) to ensure that he or she cannot move around during the operation.

If the patient is receiving general anesthesia, he or she cannot eat or drink after midnight the night before surgery or the morning of the surgery. The last meal the night before should be very light.

Most otoplasties are performed in the surgeon's office or in an outpatient facility.

You should be sure to wear loose fitting, comfortable clothing. Do not wear a shirt with a restrictive collar. Ideally, you should wear a button down shirt that you do not have to pull over your head. This is especially important for children, to avoid any unnecessary impact to the surgery site.

If you are an adult, the surgery will be completed within a few hours and you can go home the same day. It's a good idea to have someone with you who can drive you home and stay with you the first night. Sometimes, in the case of children, the doctor will prefer that they stay in the hospital one night. If you are undergoing a more complex procedure as an adult, you also may be required to stay in the hospital overnight.

Recovery

When you are sent home, your head will be bandaged. It's very important that you follow your doctor's instructions on how to handle the bandage to ensure a smooth recovery.

You will have to wear your bandage for at least three days, if not more. Your surgeon will instruct you on how long you will be required to wear it and how to best manage it while you sleep. When you have the first bandage removed by your surgeon, he or she will provide you with a headband-type dressing. Your surgeon may want you to keep this on for up to three weeks to promote proper healing.

If you have stitches that need to be taken out, your surgeon will do this about one week after the surgery.

You will have scars at the incision site. However, these probably will fade over time.

Complications and Side Effects

As with any surgery, there are risks. With otoplasty, more uncommon complications can include infection or blood clots. However, complications are rare and most people are extremely satisfied with the results. You should expect to experience pain and swelling, but your surgeon will prescribe a painkiller if necessary and a prescription antibiotic in some cases as a preventive measure against infection.

After Ear Reshaping Surgery Contact Your Doctor Immediately If:

• You develop a fever
• You experience excessive bleeding or swelling
• You have any trauma to your surgical site

Does Insurance Cover Otoplasty?

Your insurance carrier may provide coverage if an otoplasty is being used to correct a deformity or congenital abnormality. It's important that you begin talking to your insurance carrier early, so you can understand exactly what the company will cover. In most cases, your surgeon can write a letter to your carrier explaining your case. If you are merely having the surgery performed for cosmetic purposes, insurance coverage probably does not apply. In this case, it's important to receive your doctor's charges in writing and to discuss payment options.

Reviewed by the doctors at The Cleveland Clinic Department of Plastic Surgery
Edited by Charlotte E. Grayson, MD, Sept. 2003.

WebMD Medical Reference

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