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Ear surgery - Otoplasty

  • Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears.

    Most surgeons recommend that parents stay alert to their child’s feelings about protruding ears; don’t insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

    For the most part, the operation is done on children between the ages of 5 and 14, as ears are almost fully grown by age 5. At the Royal Children's Hospital we do not allow referrals under age 5. 

    If you’re considering ear surgery for your child, this information will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your child's individual circumstances. Please be sure to ask your surgeon if there is anything you don’t understand about the procedure.

    More natural-looking ears

    Most patients are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly-perfect symmetry is both unlikely and unnatural in ears. If you’ve discussed the procedure and your expectations with your surgeon before the operation, chances are, you’ll be pleased with the result.

    Things to consider

    All surgery carries some uncertainty and risk

    When ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure. A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle.

    Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area. Cartilage has memory and rarely recurrence of the deformity can occur.

    Planning for surgery

    In the initial meeting, your surgeon will evaluate your child’s condition, and recommend the most effective technique. Your surgeon will also give you specific instructions on how to prepare your child for surgery if required.

    Where will the surgery be performed?

    Ear surgery is usually performed as a day procedure. Occasionally, your surgeon may recommend that the procedure be done as an inpatient procedure, in which case you can plan on your child staying overnight in the hospital. One adult may stay with your child overnight.

    Type of anaesthesia

    Our surgeons recommend general anaesthesia, so your child will sleep through the operation.

    Other ear problems

    Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: “lop ear,” when the tip seems to fold down and forward; “cupped ear,” which is usually a very small ear; and “shell ear,” when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury.

    Sometimes, however, the correction can leave a scar that’s worse than the original problem. Ask your surgeon about the effectiveness of surgery for your child's specific case.

    Procedure details

    The surgery

    Ear surgery usually takes about 1 – 1 1/2 hours, although complicated procedures may take longer. The technique will depend on the problem.

    With one of the more common techniques, the surgeon makes an incision in the back of the ear to expose the ear cartilage. He or she will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.

    Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage. In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.

    Getting back to normal

    Children are usually up and around within a few hours of surgery. It is rare to stay in hospital overnight for this type of surgery.

    The patient’s head will be wrapped in a bulky bandage immediately following surgery to promote the best moulding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication.

    After a week, the bulky bandages will be removed. Occasionally, your surgeon will suggest wearing a headband, full time immediately following removal of the bandages, and then at night for a further period of time.

    Stitches will usually dissolve in about a week.

    Any activity in which the ear might be bent should be avoided for a month or so. Children can go back to school after seven days or so, if they’re careful about playground activity. You may want to ask your child’s teacher to keep an eye on your child for a few weeks.