When the ears protrude from the sides of the head, it may be an embarrassing condition that causes people to change their hair styles in order to hide their ears or makes them more introverted. Until children reach the age of five or six when they come in contact with other kids their age it is not a problem. Peer pressure though can be devastating to self esteem and self image of developing children. For this reason otoplasties are usually performed at an age when children are mature enough to understand that their ears are different and want the surgery, yet young enough that they haven’t been subjected to a lifetime of peer pressure. Otoplasty can be done at any age, however. For very small changes in the ear, particularly just the shape of the top of the ear, when the top of the ear protrudes and the mid portion of the ear protrudes, the ears need to be reshaped and set back both. To do this an incision is made behind the ear, where it is hidden. The shape is carefully designed to match the opposing side and to have a natural appearance.
In adults or in children who are mature enough the procedure can be done under local anesthesia. Numbing cream can be placed behind the ears an hour before surgery and then using local anesthetic the ears are numbed. The work can then be done while the patient is awake but comfortable and listening to music of their choice. The most common area to be fixed is recreating the fold in the mid to top portion of the ear. This is created by multiple sutures, which are placed underneath the skin, thus hold the ear in the correct position. A minimal amount of skin and/or cartilage is removed in order to help preserve the shape of the ear and keep it natural appearing for the child’s lifetime. The incision is closed with a few stitches behind the ear and a dressing is placed.
Following surgery, the dressing is left on overnight and the patient comes in the following morning to have the dressing changed. Pain medication is given if needed. The patient receives an antibiotic to take to help prevent any infection. Most patients complain that it feels tight in the first few days to weeks after surgery. The surgical site is wrapped at day and at night, which the patient or the family can change for the first week. After the sutures are removed the patient is instructed to wear a sweatband when they are comfortable just to help take all the tension off the sutures. This also helps remind the patients not to pull at their ears when they are sleeping. There is some spring back that occurs with time when the cartilage is spared. This is natural and so the Dr. usually overcorrects slightly at the time of the initial surgery.