John Crock
Plastic and Reconstructive Surgeon

Member
Australian
Society of
Plastic Surgeons

Ear Surgery (Otoplasty)

Oversized or large ears can be quite an embarrassing physical problem. Even though large ears do not cause physical pain or harm, many endure social and emotional difficulties due to teasing about their ears, typically children. Individuals may feel self-conscious and reserved about this.

Otoplasty, commonly referred to as ear reshaping or ear pinning, involves reshaping the ear cartilage and removing excess skin. This procedure is typically undertaken to decrease the size of the ears or to make them sit closer to the head. Whether the goal is to prevent your child from experiencing embarrassment at school or to rectify an issue that has caused you lifelong self-consciousness, otoplasty can be an effective solution. The surgery is viable from the age of four or five, as the ears are nearly fully developed by this stage.

The initial phase in addressing your ear issue begins with a consultation. You will have a meeting with Dr. Crock to talk about your worries and what you hope to achieve with the surgery. He will examine the ears and inform you of the possible surgical outcomes. After you have considered the available options and chosen a plan, we will provide guidance on essential pre-surgical measures to ensure proper healing and minimise risks like bleeding.
 

What you can expect

Otoplasty is normally an outpatient procedure, so the patient will be able to go home the same day. There will be dressings around the ears for several days. Some gentle movement will help to maintain good blood flow, but it is advised to avoid strenuous exercise at this time. Try to keep your head elevated to reduce pressure, and avoid resting the head on your ears. If your child is undergoing the surgery, we strongly recommend to monitor them during this time, and ensure they avoid these positions in the first few weeks after surgery. Normal activities can typically be resumed in about a week, and the results will be visible in around two weeks once the swelling disappears.

Typically, the surgery includes:

  • Reshaping of the ear cartilage: Once the patient is anaesthetised, the otoplasty surgery begins with the incisions, which are typically done behind the ear but can occasionally be placed inside, depending on the needs of the patient. This is often done to adjust the shape or size of the ears, making them more proportional to the head and face.
  • Removal of excess skin: In some cases, excess skin around the ears may be removed to achieve a more aesthetically pleasing appearance. Some compromises may need to be made, but the aim is to make these subtle and inconsequential to make the ears sit nicely against the head. The procedure is a complex moulding procedure aimed to reshape the ear whilst maintaining a natural look.
  • Repositioning of the ears closer to the head: Commonly known as ear pinning, this procedure reduces the prominence of ears that stick out significantly.

 

Post-Procedure care

After ear surgery, or otoplasty, there are several important steps involved in the care process to ensure a smooth recovery and optimal results:

  • Rest and Recovery: Patients are advised to rest with their head elevated to reduce swelling. It’s important to avoid any strenuous activities or heavy lifting for a specified period, typically a few weeks.
  • Bandages and Dressings: Immediately after surgery, the ears are usually wrapped in bandages to provide support and protection. These are typically kept in place for a few days. Following the removal of these bandages, a lighter dressing or headband might be required, especially at night to prevent the ears from bending.
  • Pain Management: Some discomfort and pain are normal after the surgery. Your doctor will prescribe pain medication or recommend over-the-counter pain relievers to manage this.
  • Monitoring for Complications: Patients should watch for signs of infection or any unusual symptoms and report these to their doctor. Redness, excessive swelling, or discharge should be promptly addressed.
  • Follow-up Appointments: Attending follow-up appointments is crucial to monitor the healing process. During these visits, the doctor will check the ears and the progress of healing.
  • Avoidance of Certain Activities: Patients are generally advised to avoid activities that might bend the ear for a month or more. This includes certain sports and sleeping on the side.
  • Care for Scars: Once the wounds have healed, scar care becomes important. This might include the use of silicone sheets or gel, and massage to promote scar maturation.
  • Sun Protection: Protecting the ears from sun exposure is important, as the skin in this area can be more sensitive post-surgery.

 

Risks

Potential risks to be aware of for otoplasty surgery:

  • Infection and Scarring: There’s a risk of infection after the surgery, which can lead to scarring. Though scars are usually hidden behind the ear or within its natural creases.
  • Asymmetry in Ear Position: The ears may not be perfectly aligned or have a similar shape and size. However, this is mitigated so that it is not perceptible to the untrained eye.
  • Changes in Skin Sensation: The surgery can lead to altered sensation around the ear, including numbness or increased sensitivity. These changes are generally temporary, but can be permanent in rare cases.

To plan for ear surgery, you will need to:

  • Consult with the Surgeon: This involves discussing your concerns, objectives for the surgery, and an evaluation of the ears to determine what can be achieved surgically.
  • Medical Evaluation and Tests: A thorough medical assessment, including any necessary tests, to ensure you are fit for surgery and to identify any potential issues that might affect the procedure.
  • Pre-Surgical Instructions: You will receive detailed instructions about how to prepare for the surgery, such as fasting guidelines, medications to avoid, and what to expect on the day of the surgery.

 

Outcomes of successful Ear Surgery

Successful ear surgery typically results in a range of positive outcomes, which may include:

  • Improved Ear Appearance: The surgery can significantly enhance the shape, position, or proportion of the ears, leading to a more balanced and symmetrical look.
  • Boosted Self-Esteem and Confidence: By correcting issues such as overly large, protruding, or misshapen ears, individuals often experience a substantial increase in self-confidence and self-image.
  • Reduced Teasing or Bullying: Particularly in children, altering the ears to a more typical appearance can decrease instances of teasing or bullying, leading to better social interactions and emotional well-being.
  • Permanent Results: The changes made during ear surgery are usually permanent, providing a long-lasting solution to ear-related concerns.
  • Minimal Scarring: Ear surgery often results in minimal visible scarring, as incisions are typically made in discreet locations.
  • Quick Recovery: Recovery from ear surgery is generally quick, with many individuals able to return to normal activities within a few days to a week.
  • Enhanced Comfort: For some, the surgery can also alleviate any physical discomfort associated with large or heavy ears, especially when wearing certain headgear or accessories.

It’s important to have realistic expectations and to discuss potential outcomes and risks with a qualified surgeon prior to undergoing ear surgery.