Otoplasty is a cosmetic procedure that sets prominent ears back closer to the head, or reduces the size of large ears. Dr. Markmann, a board-certified plastic surgeon in the Baltimore area, surgically reshapes and repositions the ears to fit in naturally with the face. For the most part, the operation is performed on children between the ages of 4 and 14. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient. Otoplasty gives patients the confidence to show their face from any angle without anxiety about their ears.
Ear surgery may also involve a torn earlobe. This can occur with heavy earrings or through other trauma. The surgical repair of a torn earlobe is generally straightforward. The skin cleft between the two sides of the tear is removed, and using either a skin graft or donated cartilage, a new lobe is reconstructed. Sutures are used that are placed in both the front and back of the ear and will remain intact for several weeks. Several post-operative visits may be required so that the sutures can be removed in several phases to ensure the lobe is strong and aesthetically appealing.
In the cases of protruding ears, the cartilages are reformed and sometimes supported by splints. Soft tissues may also be trimmed away. The incisions are made behind the ear to reveal the ear's confines. The ears will be repositioned by tightening the skin and then sutured. In cases of hidden ears, when cartilages are not fully developed, manipulations may include reshaping the cartilages by pulling or repositioning while splints are placed as supports. Sometimes, tissue grafting is also necessary to render volume.
Otoplasties are performed with general anesthesia in an accredited surgical facility. It takes 1 to 2 hours to complete, and the patient will be sent home for recovery. The ear will be bandaged to keep the new position and shape in place. This also helps so that children cannot touch or play with their ears, which may complicate healing. Activities must be limited, especially within the first week. Scars will remain hidden behind the ears or within the natural folds if the incisions are made in front of the ear.
The ears typically mature faster than any other part of the body, therefore, at an appropriate age and time when surgical adjustments are made, the results are generally long lasting. Even as the body changes due to age and gravity, the changes to the ear will be minimal and a secondary otoplasty is usually not needed.
On average, 5-6 year olds are ideal candidates for otoplasty as the ear will be already developed and the cartilage and tissues will still be soft, making it easy to reshape. This age is also recommended as it is a time before any schooling, which helps to avoid teasing.
Usually, the condition is symmetrical to both ears. The final shape that the surgery will aim for will depend on the initial structure of the ear and how cartilages are placed. If the procedure is only for one ear, the shape will be patterned after the normally formed ear.