Considering Cosmetic Ear Surgery? The Facts about Otoplasty

Otoplasty is the medical term used to describe surgical procedures that alter, restore or enhance the appearance of the external ear(s). This can include reshaping, resizing or repositioning the ears to achieve an improved appearance; reconstructive procedures to correct congenital deformities and defects of the outer ear; or procedures to repair damage caused by trauma or injury. Otoplasty does not refer to ear surgeries or procedures that are intended to address any type of hearing deficit or defect.

The most common types of otoplasty include:

• Ear Pinning. A procedure used to correct prominauris – large or protruding ears. This operation moves protruding ears closer to the head, to achieve a more balanced appearance that is proportional to the individual’s head size and other facial features. Approximately 5 percent of people are born with prominauris.
• Lobuloplasty. A procedure to reshape/resize the earlobe and address abnormalities such as elongated or enlarged earlobes that have developed due to age, the wearing of heavy earrings or earlobe gauges, or defects from prior trauma or injury.
• Ear Molding. A non-surgical procedure to reshape the ear using a custom ear mold applied to the external ear for short periods of time. If successful, this can prevent the need for surgical otoplasty at an older age. Depending on the type of ear shape and deformity, ear molding can be considered early in infancy – ideally in the first or second month of life when the ear is still quite soft and malleable. There are certain ear shapes where molding can be performed later in life as well. Early consultation is critical to assess for eligibility to undergo molding.
• Revision Otoplasty. A surgical procedure to correct or refine the results of a prior ear procedure. Revisions are usually minor and can be done under local anesthesia with minimal recovery time.

“Regardless of the primary reason for the procedure, the goal of otoplasty is always to achieve a result that is as balanced and natural-looking as possible,” says UH facial plastic surgeon and board-certified otolaryngologist, Cyrus Rabbani, MD.

Who is Eligible for Surgical Otoplasty?

Otoplasty can be performed on both children and adults. For optimal results, the surgeon may require that children be at least five years old to ensure that their ears are close to fully developed. This allows the surgeon to really assess what needs to be done to achieve facial balance and symmetry. Children are ideal candidates because their cartilage is softer and easier to reshape. Adults and teenagers, however, will also typically have excellent aesthetic results from otoplasty.

Otoplasty among children is growing in popularity as parents recognize the impact that large or protruding ears can have on a child’s developing self-confidence. This is why 5 years is an ideal age for the procedure – it is the age when most children enter school. By pre-emptively correcting the appearance of the ears, otoplasty may prevent the schoolyard teasing and negative attention that can be harmful to the child’s self-esteem.

Preparing for Otoplasty

Regardless of their age, all potential otoplasty patients will first meet with the surgeon. At this initial consultation, the doctor will review the patient’s medical history and may order lab tests. This is done to ensure the patient is healthy enough to undergo surgery and identify any health risks that may exist.

The doctor will then carefully evaluate all of the patient’s facial features, not just the ears. He or she will then develop a personalized treatment plan designed to achieve the desired appearance of the ears while maintaining or enhancing facial balance as a whole.

Patients will be given a list of pre-operative instructions to follow to help prevent complications and support a smooth recovery. Most instructions apply only to adults and may include:

• Which medications, vitamins and dietary supplements to avoid and for how long before and after surgery. Some medications such as aspirin and ibuprofen can cause an increased risk of bleeding.
• Avoid smoking, vaping and any nicotine replacement products for at least two weeks before and after surgery. Nicotine can reduce flood flow and slow the healing process.
• Patients undergoing general anesthesia for the procedure, will be advised when to stop eating and drinking prior to surgery. These patients will also be required to arrange for a friend or family member to accompany them to and from the surgery.

How is Otoplasty Done?

Generally a safe, straightforward procedure, otoplasty is performed in a surgery center or hospital. It is almost always done on an outpatient basis – meaning the patient is discharged to home after the procedure. Children have the surgery under general anesthesia, whereas adults may have the procedure under local or general anesthesia.

Using a variety of techniques to minimize visible scars, the surgeon will make an incision behind the ear or inside the folds of the ear. He or she will then carry out the surgical plan which may include removing cartilage or skin, reshaping cartilage with permanent stitches or grafting cartilage to the ear. Incisions made during otoplasty typically heal very well.

What can I expect after otoplasty?

Most patients will experience some swelling, bruising, itchiness and/or soreness in the first few days after surgery. Your doctor may prescribe pain medications but most people don’t need it after the first day or two.

You will go home with a surgical bandage covering the ears to protect them and minimize the risk of infection. These are typically removed after a few days and patients may be advised to wear a soft, loose headband while sleeping to protect the ears. Side-sleepers should try to sleep on their back for the next several days. Additional recommendations include:

• No strenuous activities or contact sports for 3-6 weeks, or until the ears are fully healed
• Keep the head elevated to reduce swelling
• Keep the incisions dry for the first week – no showers or shampooing
• Avoid over-the-head clothing like turtlenecks

Most patients can return to their normal activities, including work or school, 7-10 days after otoplasty. Full recovery may take up to six weeks.

When Will My Ears Look Normal?

When the surgical bandages come off in the first week, the ears will likely be red and swollen. These symptoms will gradually subside over the next several weeks and the final surgical result will be evident.

How long does otoplasty last?

Otoplasty is a permanent procedure and the results are intended to last a lifetime although slight changes may occur over time due to normal aging.

Does Insurance Cover Otoplasty?

Most cosmetic ear procedures are not covered by insurance. The financial counselors at UH are available to help patients develop a payment plan to fit their budget.

The facial plastic surgeons at University Hospitals have the advanced training and expertise to offer patients a wide variety of facial plastic procedures including otoplasty with optimal cosmetic and functional results.