Otoplasty is a surgical procedure designed to reshape the external part of the ear, known as the pinna. It is most commonly sought to correct ears that protrude significantly from the head, often referred to as “prominent ears.” The procedure also addresses other structural concerns, such as correcting asymmetry between the two ears or reshaping the ear following an injury or congenital anomaly. Otoplasty aims to create a more balanced and natural appearance.
Determining Candidacy
The physical development of the ear is a primary factor in determining suitability for this procedure. Surgeons typically wait until the ear has reached at least 90% of its adult size, which usually occurs around five or six years of age. Performing the surgery after this age ensures the ear cartilage is stable enough to hold the new shape without negatively affecting further growth.
Good general health is also a prerequisite for anyone considering otoplasty. Chronic conditions, such as diabetes, must be well-managed, and patients are advised to stop smoking several weeks before and after surgery to promote proper healing. For younger patients, psychological readiness is equally important; the child should express a genuine desire for the procedure rather than being pressured by parents. Patients must have realistic expectations, understanding that the goal is improvement and symmetry rather than absolute perfection.
Detailed Steps of the Otoplasty Operation
The otoplasty procedure usually begins with the administration of anesthesia, which may be general for children, or local anesthesia with sedation for adult patients. The choice of anesthesia ensures the patient remains comfortable and still throughout the surgery, which typically takes between one and three hours to complete. The surgeon then makes a discreet incision, almost always placed on the back surface of the ear, within the natural crease where the ear joins the head.
This incision allows the surgeon access to the underlying cartilage, the flexible structure giving the ear its shape. One common approach is cartilage scoring, where the surgeon carefully thins or weakens the cartilage in specific areas to allow it to bend more naturally backward toward the head.
The primary technique involves the placement of permanent, non-absorbable sutures, such as concho-mastoid sutures, to hold the cartilage in its newly created position. These strategically placed sutures act as an internal scaffolding, helping to create the antihelical fold, the curved ridge often absent in cases of prominent ears. Excess skin may be removed, and once the desired shape and position are achieved, the surgeon closes the incision with fine stitches.
Managing the Recovery Period
Immediately following the operation, a bulky, turban-like head dressing is applied to the ears to provide gentle compression and protection. This dressing supports the new ear position and minimizes the risk of hematoma, or blood collection, under the skin. Patients can expect mild pain, throbbing, and numbness for the first few days, which is managed with prescribed oral pain medication.
Significant swelling and bruising are common and usually peak within the first 48 to 72 hours before gradually subsiding. The initial dressing is typically removed by the surgeon after about one week, revealing the new ear shape. The patient then transitions to wearing a lighter, protective headband continuously for another one to two weeks.
After the full-time wear period, the headband is recommended only at night for several additional weeks to protect the healing ears from accidental bending during sleep. Patients should keep their head elevated while resting and avoid activities that put pressure on the ears, such as sleeping on their side or wearing pull-over shirts. Most individuals can return to school or work within about one week, but strenuous activity and contact sports must be avoided for four to six weeks.