Ears are a matter of concern only when they are abnormal in size, projection or deficient in shape as compared to the opposite ear. These defects are usually present since birth. Following types of ears require correction to avoid ridicule in young children by their peer group. Probably no other physical characteristic cries out for cosmetic surgery more than protruding ears. Children, long the victims of cruel nicknames like bat ears; elephant ears are the most likely candidates for otoplasty, but this surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Even if the ears are only mildly distorted, the condition can lead to self-consciousness and poor adaptation to school. When it comes to otoplasty, conventional wisdom is the earlier the better.
Adults may also benefit from this procedure, which improves self-esteem with relative ease. Not only is it possible to pin back ears, but ears can also be reshaped, reduced in size, or made more symmetrical.
Successful cosmetic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs.
General good health and realistic expectations are prerequisites. It is also important to understand the surgery. Otoplasty will not alter hearing ability. What is important for successful otoplasty is that the ears be in proportion to the size and shape of the face and head.
Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears does not provide the same moulding capacity as in children. A consultation with a cosmetic surgeon can help parents decide what is best for their child, not only aesthetically, but also psychologically and physically. Timing is always an important consideration. Having the procedure at a young age is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping and secondly, the child will experience psychological benefits from the cosmetic improvement.
During the consultation, the surgeon will examine the structure of the ears and discuss possibilities for correcting the problems. Even if only one ear needs pinning back, surgery will probably be recommended on both ears to achieve the most natural, symmetrical appearance.
After the surgeon and patient decide that otoplasty is indicated, your surgeon will discuss the procedure. Following a thorough medical history, your surgeon will explain the kind of anaesthesia required, surgical facility, and costs. Typically, your surgeon will suggest a general anaesthesia for young patients and a local anaesthetic combined with a mild sedative for older children and adults. Under normal conditions, otoplasty requires approximately two hours.
Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The surgeon will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage. In other instances, the surgeon will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, the surgeon will apply sutures to anchor the ear until healing occurs to hold the ear in the desired position.
Soft dressings applied to the ears will remain for a few days. Most patients experience some mild discomfort. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands are sometimes recommended to hold the ears in the desired position for two weeks after the surgery.
The risks are minimal. There will be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential. Anything unusual should be reported to the surgeon immediately.
Absence or rudimentary ears require multistage procedure and making of ear shape from the ribs and costal cartilages. These procedures require a high degree of surgical skill and often require more than one surgery.
Results and complications:
Prominent or bat and cup shaped ears can be restored to almost normal shape and size. The results for very small crumpled or absent ears vary from very good to not so good depending upon the defect and the surgeon’s skill.