Protruding ears can often cause more self-consciousness than is generally understood by family or friends. In young children, classroom teasing and nicknames may sometimes have a long-term, damaging psychological effect. Otoplasty is the procedure designed to reposition or set back protruding ears. The abnormal position of the ears and lack of normal ear folds may be improved with this surgery.
Following surgical correction, the visual and psychological improvement may be dramatic and is usually rewarding to the patient, family, and surgeon.
What Causes Protruding Ears?
During embryologic development (before birth), the ears project straight out, away from the head. By the ninth month of development, the ears usually assume a position closer to the head and develop natural folds. When the pre-birth developmental process stops short of completion, the ears are prominent and may lack the usual folds.
Since the anterior one-half of the head develops from two opposite sides, even ears considered “normal,” are rarely identical; the ears may also attach to the skull at slightly different levels or angles. Perfect symmetry of “corrected” ears is an unrealistic expectation. Therefore, small differences in corrected ears should not detract from the excellence in improvement.
At What Age is Ear Surgery Usually Done?
Since children may experience teasing by their classmates, it may be important to perform the surgery around age six to nine, thus sparing the child the emotional trauma that can occur during the early school years. However, the procedure can be done later; many teenagers and adults undergo otoplasty.
The otoplasty procedure is designed to finish the developmental process by positioning the ears closer to the head and attempting to create the normal ear folds. Otoplasty is performed through skin incisions made along the back of the ears. Cartilage is repositioned and held in place with permanent sutures. An appropriate amount of skin behind the ears may be removed to compensate for the new position of the ears.
With adults, this procedure can be performed under “twilight” and local anesthesia at the clinic surgical center. Patients usually relate that the surgery is painless and that they have amnesia of the procedure. Children may sometimes require hospital-based anesthesia, depending upon age and emotional maturity.
Otoplasty Surgery Aftercare
There is usually little discomfort after otoplasty surgery. Swelling is usually minimal and subsides in five to seven days. A turban-like dressing is left in place until the day following surgery when it is removed at the clinic. After that, a stocking cap or elastic headband is worn for about two weeks to protect the ears.
The decrease in the space behind the ear is a normal occurrence after repositioning. Incisional scarring is usually minimal and not noticeable to the casual observer because the incisions are made behind the ears. Rarely, thickening of the scar may require treatment.
In some situations, when the ear cartilage is thick and strong, it tends to resist the correction, and an “ear tuck” may be indicated in six to twelve months after the initial surgery.
Although most patients may return to light work or school after a week, you should protect the ears for at least two months. As with any surgery, it may take a year, occasionally longer, for the healing process to complete.