Ear Surgery

What is ear surgery?

Ear surgery or otoplasty is a reconstructive surgery to improve or change the size, shape, or proportion of the ears.  It is a cosmetic procedure to repair disfigured ears caused due to congenital birth defects or some injury in the past. It is mostly done in young children but adults can also benefit from the surgery.

The goal of ear surgery is to bring a balance between the face and the ear. It helps to make a profound difference in the appearance of the person and improves self-confidence. It also helps in the proper functioning of the ears. Apart from cosmetic reasons, ear surgery or otoplasty can be done for medical complications as well.

Otoplasty can be done in children after the age of four. If a child has prominent ears but needs some minor changes in the shape of the ear, splinting can be done.

Who is a good candidate for ear surgery?

Patients who are:

• Four to fourteen years is the recommended age for otoplasty. By this time, the auricle of the ear is fully grown or at least reaches 90% of the adult size.

• Though otoplasty is mainly done in children between the age of 4 to 14, it is also performed in adults.

• The patient must be in good health. Underlying health conditions or untreated ear infections can affect the healing process.

• They are good candidates for otoplasty. Smoking can slow down blood flow and hamper the natural healing process.

• Realistic expectations. Patients must have realistic expectations. They must talk to the doctors about the results they desire after having ear surgery.

Types of otoplasty ear surgery

Otoplasty, also known as cosmetic ear surgery is normally done on the auricle or the outer ear. If the auricle is not properly developed, or the patient wants to change the size and shape of the ears, otoplasty can be performed.

Otoplasty is of different types:

Ear augmentation

This procedure is generally done in children who have small or underdeveloped ears. The condition is known as microtia. This is a congenital deformity and can be unilateral (affecting one ear) or bilateral (affecting both ears). There are different grades of microtia. In most cases, otoplasty helps to increase the size of the outer ear.

Ear pinning

This is a cosmetic surgery done in patients with protruding ears or ears that “stick out”. Cartilages and skin from the outer ears are removed. The ears are pinned back using sutures and stitches. The surgery is mainly done for aesthetic reasons.

Ear reduction

Many patients want to reduce the size of their ears because they think they are too large. The medical term for the condition is known as macrotia. Otoplasty reduces the size of oversized ears and gives them a natural appearance.

During the procedure, the surgeon removes cartilages and unwanted skin from the ears to reduce the size or reshape the ears. Outsized earlobes are also sculpted to give the face a more balanced look. The ear reduction procedure is often done with ear pinning surgery. The cosmetic procedure helps to boost confidence and give a natural look to the patient.

Carbon dioxide laser-assisted cartilage reshaping (LACR)

In this technique, a carbon dioxide laser beam pointer is used to mark, penetrate and make corrections on the skin or cartilage of the ears. It is less invasive and recovery is faster.

Preparation for otoplasty ear surgery

After your consultation visit, the plastic surgeon will:

• Perform a physical examination of the ears. This includes the shape, size, placement of the ears, and possible deformities. The surgeon will take measurements and images of the ears. He/she will also examine whether there is an ear infection.

• Review the medical history. You have to give details about any past surgery, diseases, and medications you are taking.

• The surgeon will discuss the procedure and explain the associated risks, outcome, and cost of the surgery. You can talk about your expectations from the surgery and also ask questions about the risks of otoplasty.

• Preoperative laboratory tests will be done in advance. The doctor will order certain laboratory tests to assess your overall health.

• Before the surgery, the doctor will ask you to stop taking certain medications like aspirin, blood thinning agents, anti-inflammatory drugs, and other herbal supplements.

• You should not eat or drink anything at least 6 hours before the surgery. It may increase the risk of complications during anesthesia.

• Avoid smoking a few days before the surgery. Smoking may cause coughs and induce bleeding from the incision sites.

• Ask a friend or a family member to go with you on the day of the operation.

Procedure

Generally, otoplasty is done in an outpatient surgical unit either in the doctor’s clinic or a hospital. The procedure can be done with local anesthesia that uses sedation to numb the area of the incision site. General anesthesia is usually recommended for small children. The surgery usually takes 1 to 3 hours.

Before the surgery

• Patients must come to the surgical facility with sufficient time for preparation.

• They must bring all documents and medical history.

• Remove all jewelry or watches before entering the operation room.

• Wear loose-fitting clothes that can be easily removed before the surgery.

• Remove all makeup.

• Wash the face with soap and water and pat it dry.

• Do not apply any facial cream.

• Take medications that are only prescribed by the surgeon.

• The nurse will start the IV (intravenous) fluid before the patient enters the operating room.

During the surgery

The procedure technique depends on the type of otoplasty.

Typically, an otoplasty ear surgery involves the following steps:

• The anesthesiologist will administer the anesthesia and make you feel comfortable.

• Your blood pressure, oxygen saturation level, pulse, and heart rhythm will be closely monitored throughout the procedure.

• Incisions are made on the folds, on the ear, or the back of the ear depending on the type of surgery.

• The surgeon may remove skins and cartilages, graft the cartilages, fold or stitch the shape of the cartilages.

• After the operation, the wound sites are stitched.

• Following the procedure, the dressing will be applied to the wound sites.

After the surgery

After the operation, you will be shifted to the recovery room. Your vital signs will be monitored. You have to rest until you recover from the anesthetic effect. It generally takes a few hours. You can go home the same day. The doctor and nurse will give you instructions regarding post-operative care.

When should you go for an otoplasty ear surgery?

Otoplasty is mostly done for cosmetic reasons. Reasons for otoplasty include:

Prominent ears

The outer ears generally appear at an angle of 21 to 30 degrees. Beyond that angle, the ears may appear large and stick out. This can be due to:

• Family history
• Cartilage growth
• Past injury

The most common factor for prominent ears is genetics or family history. Babies born with normal ears may later develop prominent ears when the ears are fully grown. Ear pinning can help reduce the projection of the ears.

Ear prominence does not cause any problem in hearing. Sometimes treatments are not needed at all and the prominence may resolve without any medical intervention.

Disproportionate ears

The ears may appear disproportionate compared to the other facial structures. One or both of the ears appear oversized and appear asymmetrical to each other.

The ears may be re-positioned or reduced in size to restore symmetry or balance in the facial structures.

Ear deformities

Patients who have suffered trauma or injury in the past can undergo otoplasty ear surgery. Ear piercings, surgeries, and diseases like cancer can cause deformity in the ears.

Types of ear deformities:

Constricted ears

Also called lop ears where the helical rim of the ear is folded.

Stahl’s ear

Extra cartilage formation on the scapha of the ear.

Cryptotia

When the cartilage is partially buried under the skin beside the head.

Ear tags

Benign growths consisting of cartilage and skin in front of the ears.

Cauliflower ear

Deformity caused due to abnormal cartilage growth. It results in swelling of the external ear in the shape of a cauliflower.

Traumatic deformities

Bite injuries, lacerations, or ear piercings can cause deformity to the ears.

Ear keloids

Excessive formation of scar tissue on the ears after a trauma or ear piercing.

Hemangioma

Benign tumors that occur on the ears especially after birth.

Earlobe deformities

Wearing heavy earing can cause split earlobes. Other reasons for earlobe deformities are duplicate earlobes, skin tags, etc.

Genetic disorders

Congenital birth defects like CHARGE syndrome or Goldenhar syndrome can cause ear abnormalities.

The distorted appearance of ears

Many patients want ear surgery to correct the appearance of the ears. There may be creases or wrinkles in the ears or the ears may look pointed.

Surgery options

An otoplasty surgery does not need hospitalization and is done in an outpatient surgical facility. Once you have decided to have the operation, you can choose to have it in the doctor’s clinic or a specialized hospital.

Small clinics

Pros

• The overall cost of surgery is low

• Personalized care due to limited number of patients

• Small clinics often offer discounts to patients

Cons

• Lack of proper infrastructure and facilities to handle complications

• Limited medical staff

• Surgeons must be highly trained to handle critical patients

Hospitals

Pros

• Specialized doctors

• Big infrastructure with latest technologies

• Good number of nursing and medical staff

Cons

• High surgical fees due to additional staff in the operating room

• Patients may not get undivided attention and care due to a large number of patients

• Delay in offering services

Cost of surgery

Otoplasty is one of the most common cosmetic surgeries done in children. However, teenagers and adults are also good candidates for this procedure. The cost of surgery depends on various aspects:

• Type of surgery.

• The hospital or clinic where the surgery is done.

• The city or place of surgery. The cost of surgery in metropolitan cities is much more than in small towns.

• Hospital fees and cost for diagnostic tests.

• Physician fees.

• Charges for operating room staff, surgical technologist, and post-surgery care.

• Instruments used during the surgery.

• Additional costs for any complications post-surgery.

Post-op care and things to keep in mind

Take ample rest after surgery to avoid any complications. There will be slight discomfort and itching on the incision site. Some patients may vomit once or twice after the surgery. This will eventually wear off. The doctor may prescribe some medications for nausea, vomiting, and ear pain.

Arriving home, follow certain precautions:

• While going to bed, keep your head elevated. Use two to three pillows to minimize swelling and edema. Do not turn your head on the side while sleeping.

• Do not touch or scratch the wound site.

• Wear loose clothing or buttoned-up shirts or tops so that you can remove them easily.

• Do not wet the dressing. Keep it dry and clean.

• Eat light food.

• Take medications as prescribed.

• Do not drive without taking permission from the doctor.

The compressive dressing will be removed after the doctor checks the wound site on the follow-up visit. After the bandages have been removed, you have to wear a headband to protect the ears. At this point, you can start washing your face with mild soap and shampooing the hair. Apply antibiotic ointments as prescribed by the doctor on the wound site.

Complications from otoplasty ear surgery

Otoplasty like any other surgery is prone to certain risks. Some common side effects post-surgery include:

• Tenderness or soreness in the incision site.

• Itchiness.

• Swelling and redness.

• Bruising.

• Tingling sensation.

• Numbness.

• Nausea and vomiting.

These post-operative side effects usually go away after a few days.

Call your doctor/surgeon if you are experiencing the following symptoms:

• High fever may indicate a possible infection.

• Severe or sharp pain on the incision site that is not relieved through the prescribed pain medications.

• Inflammation in the ears.

• Bleeding.

• Drainage from the incision site.

• Scarring in or around the wound site.

• The sutures or stitches start coming out.

• Reaction to anesthesia.

• Improved skin sensitivity.

• Ears are asymmetrical or look unnatural.

Best option

Otoplasty ear surgery is a minimally-invasive operation and does not require a hospital stay. Many patients prefer laser-assisted otoplasty surgery because the complications are less and recovery is faster. If you are considering an otoplasty ear surgery in Bangalore, consult goficure for complete treatment and post-op care. Goficure provides all kinds of medical services in elective surgeries and treatments.

Reasons to choose goficure:

• Personalized medical assistance.

• Hassle-free treatment.

• Full confidentiality of patients.

• High-quality services at cheaper rates.

• Specialist doctors from top hospitals and medical facilities.

• Transportation facilities.

• Post-op care for recovery.

• Medical insurance.

References