Prominent ear correction, also known as otoplasty or pinnaplasty, is a common operation in the U.K. It is usually done to set prominent ears back closer to the head or to reduce the size of large ears. Most surgeons try to perform the surgery when the child is at an early age to reduce bullying and teasing at school. Pinnaplasty on adults is also performed and there are no additional risks in an older patient.
The risks of the procedure are low. A small percentage of patients may develop a blood clot behind the ear. This may dissolve naturally or can be drawn out with a needle or may require reoperation.
Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.
It is sometimes very difficult to achieve symmetry between the two sides. Any difference is usually very minor. In some instances if it is noticeable it may require a reoperation.
The scar on the back of the ear can very occasionally heal with a red and raised scar. This usually settles down over a prolonged period but may need treatment. Discuss this with your surgeon.
Most surgeons recommend that parents stay alert to their child’s feelings about protruding ears; don’t insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.
In the initial meeting, your surgeon will evaluate your child’s condition, or your’s if you are considering surgery for yourself, and recommend the most effective technique. He or she will also give you specific instructions on how to prepare for surgery.
If your child is young, your surgeon may recommend general anaesthesia, so the child will sleep through the operation. For older children or adults, the surgeon may prefer to use local anaesthesia, combined with a sedative, so you or your child will be awake but relaxed. Discuss this with your surgeon.
The technique used will depend on the problem.
With one of the more common techniques, the surgeon makes a small incision in the back of the ear to expose the ear cartilage. He or she will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape.
Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.
Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.
In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.
Adults and children are usually up and around within a few hours of surgery and can go home on the day of surgery. Occasionally patients may prefer to stay overnight in the hospital until all the effects of general anesthesia wear off.
The patient’s head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication. If the pain increases, it is important that you let your surgeon know.
Within a few days, a lighter head dressing similar to a headband will replace the bulky bandages. Be sure to follow your surgeon’s directions for wearing this dressing, especially at night.
Stitches are usually removed, or will dissolve, in about a week. Any activity in which the ear might be bent should be avoided for six weeks. Most adults can go back to work about five days after surgery. Children can go back to school after seven days or so, if they are careful about playground activity. You may want to ask your child’s teacher to keep an eye on the child for a few weeks.
Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind; the goal is improvement, not perfection. Don’t expect both ears to match perfectly. Perfect symmetry is both unlikely and unnatural in ears.