Correcting Prominent Ears

Posted Thursday, September 13, 2007 to PROCEDURES > Face

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Jennifer Barnes spoke with Sherman Oaks plastic surgeon Peter Grossman, MD about the otoplasty procedure for cosmetic correction of prominent ears.

What are the psychological effects of having prominent ears?

Prior to school age, parents are quite often more concerned about a child's prominent ears than the child is. However, by the time a child reaches kindergarten or first grade, large prominent ears can be a point of ridicule from a child's peers. This may lead to misbehavior or social withdrawal. While the ears do not have the same prominence on the face that the nose does, they are a source of cultural adornment. As a child moves into adolescence and adulthood, they often become quite self conscious of the appearance of their ears, modifying their hairstyle and often avoiding social or athletic activities that might predispose them to expose their "funny looking ears". While to some this may seem like a simple case of vanity, to many individuals with prominent ears the psychosocial effects can be extremely traumatic.

At what age can the procedure be performed?

For all practical purposes, the normal ear is 90% developed by the age of 6, and while congenital deformities of the ear can be corrected before 5 years of age without ill effects on the ear's growth, there are practical considerations that speak against early intervention. Few children express concern about the size of their ears until school age, and correction before this time has a high incidence of complications; particularly post operatively when the child may pull at bandages and disrupt the repair. Most surgeons therefore do not perform otoplasty until the child is about 6 or 7 years old. It is quite common, however, to see patients in their teens, 20s, 30s or even older deciding to undergo otoplasty.

What is the surgical process?

Otoplasty usually takes between 1-2 hours to perform and is most commonly performed under general anesthesia. The technique employed by most surgeons to correct a prominent ear involves making an incision behind the ear in the skin over the concha. The skin is undermined so that the cartilaginous framework of the ear can then be exposed. Sutures are used to pull back the ear to be in closer proximity to the scalp, while at the same time creating a smooth, normal looking antihelical fold. The surgeon may decide that it is necessary to resect a portion of the cartilage in the concha if the back of the ear is too prominent.

What is the recovery time for the patient?

The patient or the patient's family needs to be aware that post operative care is going to be very important for the overall outcome of the correction. In general, dressings are left on for five to seven days, and it is usually recommended that the patient wear a headband (similar to a sports headband or skier's headband) at night for approximately three weeks. Contact sports are prohibited for four to six weeks following surgery The patient should also be aware that there may be a considerable amount of swelling in the ears after surgery,and it may take several months for all the swelling to go down before the optimal result is achieved.

Are there any possible complications?

In any surgery, there is the potential for complications. With otoplasty, complications include hematoma between the skin and the cartilage of the ear,asymmetry in the correction, and contour irregularities on the surface of the ear. In general, most patients are very happy with the results of their otoplasty.

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