A variety of surgical procedures to reconstruct or correct inborn or acquired deformities of the external ear. Most commonly performed to set back the ears that stick out too far or appear to be too large for the head.
- correction of protruding ears (otapostasis) can have a great psychological benefit
- it can be done successfully at any age
- it is preferably done when the child is 5-6 years old
- the surgery usually takes about an hour and is performed on an outpatient basis
- in small children it is performed under general anesthetic
- reconstruction of missing ear (microtia) is a complex two stage procedure in which cartilage framework is created from the rib
- split earlobes are a common problem which can be fixed in local anesthesia
- stretched earlobes are often reduced for rejuvenation purposes
What is ear correction surgery?
Corrective ear surgery refers to an array of procedures that can normalize the appearance of the ears. We perform it to change the size of the ears, reshape the ears, reset protruding ears and fix the split earlobes. Most often it is used for correction of ears that project excessively from the head (otapostasis), which can negatively affect the lives of children and adults. There is a rise in the number of the stretched earlobes reshaping for rejuvenation purposes in adults.
There are other congenital malformations which can be improved with aesthetic surgery:
- Cup ear deformity – the outer ear is pulled together into a cup like shape;
- Stahl’s ear deformity – extra (third) fold and flat helix;
- Microtia – the outer ear is greatly underdeveloped or even missing at birth.
These are highly specialized and technically demanding procedures requiring a lot of skill and expertise. Correction of microtia is a two stage procedure, during which we create a complex framework of the ear from rib cartilage and cover it with thin skin.
When to correct the protruding ears?
Children are usually not self-conscious about their protruding ears until they begin to hear hurtful comments from other children. Correction of protruding ears can be done prior to starting the school in children who are aware of the problem or as an pre-emptive measure decided for by the concerned parents. At the age of 5-6, the ear has grown sufficiently for surgery to be done. It is important that the child is not submitted to the operation solely on the basis of the parent’s desire. Children are generally more cooperative and happy with the outcome, when they fully understand why the surgery is undertaken. Frequently we perform the correction of protruding ears in teenagers and adults.
How is the correction of protruding ears performed?
During the preoperative consultation we will evaluate the structure of the ear to determine which parts have to be corrected. Skin incision is made behind the ear. The back surface of the cartilage is incised and cartilage loosened from the skin. The cartilage is adjusted and reshaped to create the missing natural fold and to allow the ear to lie closer to the side of the head. Parts of cartilage can be reduced if indicated. Skin incision can be closed with normal or dissolving sutures. Young children are operated under general anesthesia and can leave the hospital on the day of the surgery. In teenagers and adults operation is carried out under local anesthesia as an outpatient procedure.
What is recovery after ear reshaping surgery?
After surgery we will wrap the head in soft dressing to protect the ears and promote healing in the new position. Bandages and sutures that do not dissolve on their own are removed within a week. Hair can be washed afterwards. Once the dressing has been discarded, a headband should be worn while sleeping for another two weeks preventing the ear from being bent forwards. The ears are often sore and tender for a couple of days and oral painkilling medication may be required. There may be some residual bruising and swelling which will subside in a week. Because the operation is carried out from behind the ears, a small scar is discretely hidden close to the groove between the ear and the side of the head. A week off work is recommended in adults to allow for initial healing. Children should avoid contact sports and playing for approximately three weeks.
What are the risks and complications?
Bleeding is avoided with careful bandaging, and if hematoma (collection of blood) forms it has to be removed. Infection is not common, but if occurs it requires treatment with antibiotics and regular dressing changes. Careful surgical technique can minimize the risk of ugly scarring after ear surgery. A few individuals with tendency for bad scarring can develop keloid scars that can evolve into solid red tissue behind the ears. Treatment with injection of steroids may hold down progression, but sometimes corrective surgery is also needed.
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