Ear Surgery (Otoplasty)

updated September 6, 2017

Many individuals, starting from childhood, are unhappy with the size or shape of their ears. Or, for some, the ears protrude more than they should, are asymmetrical, or droop too low. Children may be teased at school; and adults might go to great lengths to hide their imperfect ears with their hair or by wearing hats. Fortunately, otoplasty, also referred to as ear plastic surgery, is readily available to cosmetically alter the ears. The procedure should only be performed by an experienced plastic surgeon, and can have a dramatic impact on a person's appearance, confidence, and overall quality of life. This corrective surgery is extremely popular among adults and children alike. If you are interested in ear pinning, or ear plastic surgery, it is important that you are well-informed of all pertinent details before moving forward. We invite you to continue reading to familiarize yourself with the treatment, so you can determine whether it is right for you.

Ear Surgery Procedure

Otoplasty, or cosmetic ear surgery, is used to reshape one or both ears. Patients who are dissatisfied with the size, shape or orientation of their ears can alter their appearance through this outpatient procedure. Otoplasty also includes ear/earlobe reduction and cauliflower ear surgery to remove and recontour excess skin and cartilage. Because the ears are very prominent, many cosmetic ear surgery patients experience a significant increase in confidence and self-esteem once their ears have been given a more desirable appearance.

• RELATED: Find an ear surgeon in your area

Ear Pinning and Reconstructive Otoplasty

Ear pinning and ear reshaping surgery is usually performed under a local anesthetic with a sedative for adults and general anesthesia for children.

To begin ear pinning surgery, the surgeon makes an incision behind the ear to expose the cartilage. The cartilage is then reshaped and excess skin is removed. Finally, if necessary, the ear is repositioned more closely to the head, and the incision is closed with non-removable stitches or sutures.

Cosmetic ear surgery generally lasts between one and two hours, depending on the extent of the surgery.

If a patient has protruding ears, ear pinning is used to position the ears more closely to the sides of the head. Ear pinning combines removing skin from the back of the ear, cartilage sparing, and scoring techniques. This fusion of techniques helps the surgeon to create the ideal shape and positioning of the patient’s ears.

There are many different techniques used to accomplish ear pinning during otoplasty surgery. The surgical technique the physician chooses depends upon the amount of correction the patient’s ears require. The various methods of ear pinning and reshaping can be classified into two primary groups: cartilage sparing and cartilage scoring (cutting).

Cartilage scoring techniques involve creating incisions in the cartilage to rearrange, add, or remove the tissue. There is a greater risk of scarring when these techniques are used, but those scars are difficult to see. Cartilage sparing techniques use stitches and sutures to change the ear’s position and shape. A cartilage sparing otoplasty surgery is non-invasive, often resulting in smooth, natural-looking curvatures.

Reconstructive ear surgery is a form of otoplasty used to correct deformities or injuries. It is commonly used to correct Microtia, a congenital defect of the ear that occurs in about three out of every 10,000 live births. Injuries that call for reconstructive ear surgery include burns, lacerations, and infected or torn piercings. Ronstructive ear surgery blends a variety of surgical techniques and other reconstructive procedures to recreate a natural-looking human ear. In some cases, cartilage can be removed from the patient’s ribs to augment the ear and help it attain a more natural appearance. If a skin graft is necessary, tissue is usually transferred from the patient’s upper buttock area.

What Is Bilateral Otoplasty?

While some patients require correction of only one ear, many patients have cosmetic concerns with both. Bilateral otoplasty is an ear pinning and reshaping surgery performed on both ears. Bilateral otoplasty is performed the same way as surgery involving a single ear, and has the same recovery time, potential complications, and benefits. Although post-procedural side effects such as itching and throbbing may be slightly more pronounced following a bilateral otoplasty, the discomfort should still be minimal.

Ear Reduction Surgery

Some patients are more concerned with the size and shape of their ears rather than their protrusion from the side of the head. A form of otoplasty known as ear reduction surgery is used for sculpting larger ears, giving patients a more natural look. Ear reduction surgery, which may include earlobe reduction, is an outpatient procedure and can be performed on children and adults. During the surgery, the doctor will remove unwanted cartilage and skin, and reshape the ear to create a smaller, more natural-looking size. Ear reduction surgery can provide balance and symmetry to the face and ears, and is often accompanied by ear pinning.

Preparing for Ear Surgery

Weeks of preparation for otoplasty are often required to achieve the best results. The process starts with finding the surgeon you are most comfortable with. Preparing for the procedure requires a lot of information, realistic expectations of the outcome, and some practical considerations, right down to what to wear on the day of surgery. Below are several steps and considerations for anyone who is about to undergo cosmetic ear surgery.

• RELATED: Find an ear surgeon in your area

The Otoplasty Consultation

After thoroughly researching the otoplasty procedure and finding a qualified surgeon, prospective patients will have an initial consultation that will be crucial to the procedure. The surgeon will thoroughly examine the patient’s ears and discuss various ways of correcting the problem. The initial consultation will first determine if otoplasty is the best procedure for the patient.

If otoplasty is indicated as a feasible treatment option, the surgeon will then discuss the ear surgery procedure in detail. This discussion will likely include details concerning the anesthesia, the patient’s a medical history, and the costs associated with the surgery. This initial consultaiton is a good time for prospective patients to inquire about the benefits of ear surgery as well as any potential risks and complications of otoplasty.

The Weeks Prior to Surgery

In the weeks prior to ear surgery, parents or guardians with children undergoing otoplasty should have discussions regarding the child's feelings. They should have genuine communication with their child regarding all of the details of the procedure and recovery, and reasonable expectations for the results.

For all prospective patients, aspirin use should be discontinued at least two weeks prior to surgery. Cessation of smoking and tobacco use is also strongly urged by physicians. Preparations for missing work or school, as well as a designated person to take care of the patient immediately following the surgery, should also begin to take shape during this time.

The Day before Surgery

Patients receiving general anesthesia for an otoplasty procedure will not be allowed to eat or drink after midnight the night before, or the morning of, the surgery. The last meal the night prior to surgery should be a very light one. Preparations should be finalized for an extended recovery period (e.g., making sure work or school has been notified) and arrangements made for someone to drive the patient home. The patient should be under another person’s care for at least the first night unless the physician requires an overnight hospital stay.

The Day of Surgery

Before coming into the surgical facility, otoplasty patients should plan to wear comfortable, loose-fitting clothing. Restrictive collars or shirts that patients have to pull over their heads should not be worn. It is important, especially for children, that nothing bends or pulls at the ears after the operation. Adult patients are also strongly urged to shower and shampoo their hair thoroughly the morning of surgery. Women should braid or pin their hair, and men should have a haircut or trim at some point before the procedure.

• Before the surgery begins, the surgeon will administer either general anesthesia (usually in cases of ear surgery for children) or local anesthetic with a sedative for adult patients. The otoplasty surgery itself should take two hours or less, depending on the extent of the procedure. Some physicians ask that children stay overnight in the hospital, and adults may also require an overnight hospital stay if their procedure is more complex than a traditional otoplasty. However, most adults should plan to have someone with them to drive them home and take care of them the night following the surgery.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Arizona Cosmetic Surgery

Ear Surgery Candidates

Ears are one of the few body features that people can't keep from being seen. Long hair can sometimes cover them up, but that's only temporary. They're so visible people regularly hang jewelry from them - so when someone feels uncomfortable with the shape of his or her ears, it can sometimes reach unbearable levels of embarrassment.

That's why otoplasty, or cosmetic ear surgery, can be such a popular procedure for so many people. Children who are constantly teased by their classmates, adults who are fed up with the self-confidence drag their ears give them, or someone who has suffered trauma to their ears, are just a few examples of people who can look to otoplasty for help.

Conversely, some children are born with severe ear defects, and may also be excellent candidates for reconstructive otoplasty. If you're wondering whether you or your child fall into the category of likely otoplasty candidates, the following information can help you decide.

Traditional vs. Reconstructive Otoplasty

Traditional otoplasty is also known as ear pinning, where large or extruding ears are "pinned" back towards the patient's head. This creates a more common look that patients usually feel is more normal and beautiful.

Reconstructive otoplasty helps deal with severe ear defects that can come from birth or some kind of outside trauma. Some of the defects that can be corrected with reconstructive otoplasty are listed below:

Congential Defects

• Cagot Ear - No earlobe is present
• Cat's Ear - The edges of the ear are folded forward, much like a cat's
• Lop Ear - Resembling a cup, the ear curves severely inward
• Scroll Ear - The ears are curled forward, like a rolled up scroll
• Wildermuth's Ear - The top curve of the ear is reversed, curving towards the scalp instead
• Stahl's Ear Deformity - Abnormal folding of the ear creates a pointed edge, resembling an elf's ear
• Cleft Earlobe - An indent occurring in the earlobe
• Question Mark Ear or Cosman Ear - Resembling a question mark, the ear has a separation in the skull between the earlobe and the outer curve of the ear
• Microtia - The ears are severely small and underdeveloped
• Macrotia - Abnormally large ears
• Constricted Ear - Partial absence of skin and cartilage on the outer back portion of the ear
• Cryptotia - The upper curved portion of the ear is embedded in the scalp

Other Trauma

• Cauliflower Ear - Due to repeated injury to the ear, cartilage gets separated from the perichondrium and fills with fluid, which becomes permanently cartilaginous and deformed
• Skin Cancer and Malignant Melanoma - Although not usually cosmetic, otoplasty can help remove skin cancer and then reconstruct the tissue left over

Although most of these conditions can appear as severe congenital defects, some people are just hate that their ears still too far out or are too big. These people are more likely to be traditional otoplasty candidates, but should talk to a surgeon to see if it's right for them.

Remember, otoplasty doesn't magically grant people new wonderful ears, so its important to take this procedure seriously and understand the realistic results and risks involved.

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Thomas L. Tzikas, MD, PA

Children and Otoplasty

Most of the conditions listed above are congenital defects, which are usually dealt with at a young age. Child patients tend to have otoplasty around the age of six, when their ears has developed to a size relatively close to an adults.

• RELATED: Find an ear surgeon in your area

Still, children between the ages of four and fourteen are common otoplasty candidates. Children younger than four are normally not candidates since their ears are still growing, but conditions caught early can be manipulated better with younger ear tissue.

Naturally there can be exceptions to these commonalities. If your child has a severe ear defect that you have not talked to your doctor about, it's worth a conversation to determine if he or she is a viable candidate for otoplasty. 

Benefits of Ear Surgery

Patients will experience a number of excellent benefits of otoplasty surgery, including:

• Procedure is safe - little to no risks involved
• Can correct a wide variety of ear imperfections
• Children can avoid teasing by peers
• Enhance confidence and self esteem
• Minimal downtime - approximately one week
• Improve emotional and psychological conditions
• Minimal scarring once healed
• Natural-looking results
• You choose how the ears will look

Visit the DocShop gallery to view otoplasty before and after photos.

Photo credit: Kovanda Plastic Surgery

Consult an Ear Surgery (Otoplasty) Plastic Surgeon

To learn more about cosmetic ear surgery, including the cost of otoplasty and the risks associated with ear plastic surgery, it is important to speak with a skilled plastic surgeon. We encourage you to use DocShop's extensive online directory locate a cosmetic surgeon in your area.