Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. For the most part, the operation is done on children between the ages of 4 and 14. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient. If you’re considering ear surgery for yourself or your child, the following information will give you a basic understanding of the procedure – when it can help, how it is performed, and what results you can expect. You should know though that a lot depends on your individual circumstances. Therefore, make sure you consult your doctor if you have any questions that still need to be answered.
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 which may dissolve naturally or would have to be drawn out with a needle. Occasionally, patients might 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.
PLANNING FOR SURGERY
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. In the initial meeting, Dr. Makram will evaluate your child’s condition or yours, if you are considering surgery for yourself, and recommend the most effective technique. He will also give you specific instructions on how to prepare for surgery.
WHERE THE SURGERY WILL BE PERFORMED
Ear surgery is usually performed as an outpatient procedure in a hospital, or a freestanding surgery center. Occasionally, your doctor may recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight in the hospital.
TYPES OF ANESTHESIA
If your child is young, Dr. Makram may recommend general anesthesia, so the child would sleep through the operation. For older children or adults, Dr. Makram may prefer to use local anesthesia, combined with a sedative, so you or your child would be awake but relaxed.
Ear surgery usually takes about one hour, although complicated procedures may take longer. The technique depends on the problem. One of the more common techniques consists of making a small incision in the back of the ear to expose the ear cartilage. Your surgeon will then sculpt the cartilage and bend it back toward the head. Note that non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon removes 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 fades 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
Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the hospital with a child until all the effects of general anesthesia wear off. The patient’s head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication. The second day, the bulky bandages will be replaced by a lighter head dressing similar to a headband.
Be sure to follow Dr. Makram’s directions for wearing this dressing, especially at night. Stitches are usually removed, or will dissolve, in about two weeks. Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work about five days after surgery. 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 the child for a few weeks.
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 Dr. Makram about the effectiveness of surgery for your specific case.
MORE NATURAL – LOOKING EARS
Most patients, young and old alike, 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 the surgeon before the operation, chances are you will be quite pleased with the result.