Ear Reshaping (Otoplasty)By
Hedy Marks, MPH
What is ear reshaping (otoplasty)?
Ear reshaping, or otoplasty, is surgery to correct misshapen or deformed ears. Ear reshaping is a type of plastic surgery on the outer ear. Doctors may recommend otoplasty for medical reasons, such as the repair of ear abnormalities from birth defects or injuries. Some people seek otoplasty for cosmetic reasons to change the size or shape of their ears.
Ear reshaping is a common but major surgery with risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your cosmetic or treatment choices before having ear reshaping.
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Other procedures that may be performed
Your doctor may perform other procedures in addition to ear reshaping to enhance the appearance of your ears. For example, your doctor may recommend ear pinning surgery, another type of otoplasty, if you feel your ears stick out too far.
Why is ear reshaping (otoplasty) performed?
Your doctor may recommend ear reshaping to treat certain medical conditions that affect the external ear. Ear reshaping is also a common cosmetic surgical procedure to change the size, shape and position of the ears for aesthetic reasons. Good candidates for ear reshaping are healthy adults and children five years of age or older.
Your doctor may recommend ear reshaping for the following conditions:
Congenital (present at birth) ear abnormalities including microtia, also called "small ear," or atresia, the absence of the external ear
Genetic conditions including Goldenhar syndrome and Treacher Collins syndrome
Injury or ear trauma including trauma from a car accident or a torn earlobe
Misshaped ears including pointed ears, large ears, or lop ear, where your ear tip folds down
Who performs ear reshaping (otoplasty)?
The following surgeons perform ear reshaping:
Plastic surgeons specialize in cosmetic and reconstructive surgery.
Otolaryngologists and pediatric otolaryngologists are ear, nose and throat (ENT) specialists.
Facial plastic and reconstructive surgeons specialize in plastic and reconstructive surgery of the face. They initially train as plastic surgeons or ENTs.
Head and neck plastic surgeons specialize in plastic and reconstructive surgery of the head and neck. They also train as plastic surgeons or ENTs before further specialization.
How is ear reshaping (otoplasty) performed?
Your ear reshaping will be performed in a hospital or outpatient surgery setting. Minor ear reshaping surgery is usually an outpatient procedure. More involved surgeries may require a hospital stay.
Ear reshaping surgery techniques vary depending on your condition. Your surgeon will remove excess cartilage and skin or reshape existing cartilage to make the desired ear shape. Your surgeon may also use stitches to secure the new ear shape and position.
Congenital ear deformities, such as microtia or atresia, often require a series of surgeries to correct defects. Surgeons often take cartilage from the ribcage and graft it to build the structures of the outer ear. Later surgeries involve forming the earlobe and shaping the outer ear.
Types of anesthesia that may be used
Your doctor will perform ear reshaping using either general anesthesia or regional anesthesia, depending on the specific procedure.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your surgery
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of ear reshaping (otoplasty)?
As with all surgeries, ear reshaping involves risks and possible complications. Most ear reshaping surgeries are successful, but complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Blood clot, which can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of ear reshaping
Complications of ear shaping include:
Asymmetry or overcorrection of the ears
Changes in skin sensation near the ears
Hematoma, an accumulation of blood under the skin
Poor wound healing
Stitches that fall out prematurely
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery. After surgery, avoid sleeping on your side and try not to scratch or rub your incisions.
Informing your doctor if you are nursing or if there is any possibility of pregnancy
Not smoking. Smoking increases your risk of poor wound healing and may compromise the outcome of your procedure.
Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my ear reshaping (otoplasty)?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for ear reshaping by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include blood tests and other tests as needed.
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), blood thinners, and vitamin and herbal treatments. Your doctor will give you instructions for taking your specific medications and supplements.
Wearing a button down shirt the day of surgery so that you don't have to pull anything over your head following the procedure.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before ear reshaping and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Am I a good candidate for ear reshaping? Are there any other treatment options for my condition?
What type of ear reshaping procedure will I need? If I need a series of surgeries, how far apart will you space them?
How long will the procedure take? When can I go home?
What restrictions will I have after the procedure? When can I return to work and other activities?
When can I shower after surgery? How should I care for my incisions?
How will I look after the surgery?
What kind of assistance will I need at home?
How do I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my ear reshaping (otoplasty)?
Knowing what to expect can help make your road to recovery after ear reshaping surgery as smooth as possible.
How long will it take to recover?
Most people stay in the surgeon’s office, surgical center, or hospital for a few hours after ear reshaping. You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You will be drowsy and may be nauseous from sedation or anesthesia, so you will need a friend or family member to drive you home and stay with you the first 24 hours.
You will have bandages wrapped around your head to protect the incisions and support the ears while they heal. Bandages usually stay in place for a few days after surgery. After your provider removes your bandages, you may need to wear a headband, especially when you sleep, for two weeks or more. The headband supports your ears as they heal.
Recovery after surgery is a gradual process. Recovery time varies depends on the procedure, your general health, your age, and other factors. It may take a few weeks to return to normal activities and for your wounds to heal. Follow your doctor’s instructions about activities.
Will I feel pain?
Pain control is important for healing and a smooth recovery. You will have discomfort and possibly itching of the ears after your surgery. Your doctor and care team will treat your pain and itching so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after ear reshaping. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling of your incision
How might ear reshaping (otoplasty) affect my everyday life?
Ear reshaping may give you increased satisfaction with your appearance and increase your self-confidence. Many surgeons caution that it is important to be realistic about how much ear surgery may improve your self-image. It is important to be aware of what ear reshaping can and cannot do for your overall appearance and self-image.
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- Ear Surgery: Otoplasty. American Society of Plastic Surgeons. http://www.plasticsurgery.org/cosmetic-procedures/ear-surgery.html.
- Ear Surgery. The American Academy of Facial Plastic and Reconstructive Surgery. http://www.aafprs.org/patient/procedures/otoplasty.html.
- Ear Pinning (Otoplasty). Palo Alto Medical Foundation. http://www.pamf.org/plasticfacialsurgery/Services/earpin.html.
- Ear Plastic Surgery. American Academy of Otolaryngology -Head and Neck Surgery. http://www.entnet.org/HealthInformation/earPlasticSurgery.cfm.
- Ear Reshaping. NHS. http://www.nhs.uk/conditions/ear-reshaping/Pages/Introduction.aspx.
- Otoplasty (Ear Reshaping). The Cleveland Clinic. http://my.clevelandclinic.org/services/Cosmetic_Surgery/hic_Otoplasty_Ear_Reshaping.aspx.
- Ear Surgery (Otoplasty). The American Society for Aesthetic Plastic Surgery. http://www.surgery.org/consumers/procedures/head/ear-surgery.
- Congenital Ear Deformity. Shriners Hospitals for Children. http://www.shrinershospitalsforchildren.org/CareAndTreatment/Burns/CongenitalEarDeformity.aspx.
- Malformations of the External Ear. TheFetus.net. http://www.sonoworld.com/Fetus/page.aspx?id=205.