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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 clots

  • Infection 

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

  • Scarring

  • 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 s