Otoplasty (Ear Reshaping)
People who feel they have excessively large or protruding ears can have serious issues with self-confidence. They can often feel teased, especially during their formative school years.
A small percentage of the population considers their ears to be too large or prominent. In many cases the shape and lie of the ears is inherited. The most prominent ears often lack a normal fold and sometimes one ear is more prominent than the other.
The first thing to do is to talk to your GP who can refer you to Mr Meagher. By talking to your GP and Mr Meagher you are more likely to get the results you want from the surgery.
Otoplasty can reduce large or protruding ears by setting the ears back closer to the head as well as moulding, shaping and/or removing cartilage. The operation can be conducted on patients once the ears have reached, or nearly reached, their full size which is usually around 5-6 years of age.
Ear surgery can dramatically change a person’s appearance simply by making protruding ears look more ‘normal’. Often the problem is caused by an undeveloped middle fold of the ear. There may be other deformities as well, making it necessary to perform several procedures on the ear at the same time. Otoplasty can reshape the ears, reduce their size, make them more symmetrical, and position them closer to the head.
An ideal candidate for otoplasty surgery is one who:
- Has ears that have reached their full size
- Is in general good health
- Has no history of scarring problems, such as keloids
- Wants to improve the appearance of their ears
- Has realistic expectations
- Understands they must limit their activities to help good healing
- Will carefully follow Mr Meagher’s advice
Alternatives to otoplasty surgery
If you would prefer not to have the surgery the options to:
- Accept the protruding shape of the ears – they are a part of what makes you unique
- Wear a headband, headscarf or bandana
- Camouflage your ears with long hair
Before the operation
The most important thing to do is to talk with Mr Meagher so that there is a clear understanding of your desires and expectations, in light of any biological prerequisites. We want you to be well informed and have realistic expectations of the results.
Mr Meagher will examine the structure of both ears, taking measurements and photographs for your medical record. Even if only one ear needs correction, surgery may still be recommended on both ears to achieve the most natural, symmetrical appearance.
Mr Meagher will describe the type of otoplasty technique he will use, the type of anaesthesia, the hospital, any additional surgery, the pros and cons, benefits, potential complications, possible risks and the costs of the procedure.
You will be asked to discuss your medical history, including information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. Mr Meagher will also examine the structure of your ears, soft tissue structure and underlying bone framework. You will have to stop taking medication which alters blood viscosity, e.g. aspirin. As for all surgery, patients are requested to stop smoking at least 6 weeks prior to the operation.
Specific individual risks will also be explored especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, medications and any deficiency in blood clotting. As well as assessing your general health and the appearance of your ears, Mr Meagher will assess your mental and emotional attitudes toward the surgery.
If you decide to proceed with the operation you will be required to confirm your understanding of all aspects of the surgery and agreement to proceed by signing a consent form.
During the operation
Your surgery will be performed in a major hospital under a local or general anaesthetic. It can take between 1 and 2 hours for the operation and, for your safety, the attending anaesthetist will use various monitors to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
Pinnaplasty or otoplasty is an operation which adjusts the shape of the cartilage within the ear to create the missing folds and to allow the ear to lie closer to the side of the head. Because the operation is carried out from behind the ears, a small scar is left close to the groove between the ear and the side of the head. Where the lobe of the ear is especially large, we can also perform a small procedure to reduce its size.
This procedure generally involves reforming the cartilages that shape the ears, to pull them in, and reduce the protrusion. Sutures (stitches) are placed in the cartilage on the back of the ear to maintain the new position. Incisions and the resulting scars are well concealed so that there is no visible scarring.
The first surgical action is to prepare an incision just behind the ear, in the natural fold where the ear is joined to the head and Mr Meagher will examine the structure of both ears, taking measurements and photographs for your medical record. Even if only one ear needs correction, surgery may still be recommended on both ears to achieve the most natural, symmetrical appearance. will then remove the necessary amounts of cartilage and skin. In some cases, Mr Meagher will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage. In other cases, Mr Meagher will not remove any cartilage at all, using stitches to hold the cartilage in place.
After the operation
After the operation you will occasionally need to stay in hospital overnight. We recommend that you wear a headband for a few weeks to protect the surgical site and if you can wear this headband at work, then you can probably return to work quickly.
You can wash your hair after the dressing and the stitches have been removed and it is important to keep the grooves behind the ears clean.
Most normal activities can be resumed within a few weeks, but you will need to be very careful to protect your ears for at least 6 weeks or possibly even longer. In order to make sure that there is no infection or bleeding in the ear after the surgery, you must be very careful to protect the ears and keep them clean. Remember that bending the ears forward in the first few months after the surgery can destroy even the finest surgical result, so be very careful to follow all Mr Meagher’s instructions.
The results are usually permanent, although there is always some small amount of ‘springing back’ of the ears due to the elastic recoil nature of the ear cartilage.
Your hearing will not be affected by this operation – only the outer ear is operated on, not the middle or inner ear, where hearing takes place.
The scars are hidden behind the ear and hence are not easily visible. However, if you are prone to scarring problems such as keloids, you should discuss this with Mr Meagher before the procedure.
Naturally, there are risks associated with any type of operation and this surgery is no exception. Mr Meagher will explain the possible risks, which are rare, but may include:
1. Infection: Infection does not happen very often and you will be given an antibiotic at the time of your surgery to prevent this. If you do develop an infection, see Mr Meagher as soon as possible. Most infections can be treated with an antibiotic but they can cause serious problems and increased scarring.
2. Infection: Infection does not happen very often and you will be given an antibiotic at the time of your surgery to prevent this. If you do develop an infection, see Mr Meagher as soon as possible. Most infections can be treated with an antibiotic but they can cause serious problems and increased scarring.
3. Haematomas: Haematomas are a solid swelling of clotted blood within the tissue and they can happen after any surgery. The risk of infection is higher if a large haematoma or seroma (a collection of watery fluid within the tissue) collects immediately after surgery. Mr Meagher may use a surgical drain to help prevent small haematomas but, in some cases, Mr Meagher may need to re-operate to remove a large haematoma.
4. Poor wound healing: Healing can take longer in cases of:
- Fluid accumulation
- Overly tight stitches
- Improper support during healing
- Pressure against the scar tissue
Wound healing may also take longer in patients who have diabetes, or other medical conditions, or who smoke.
Other potential issues
The risks associated specifically with a otoplasty procedure include:
- Rough skin
- Asymmetry – uneven results on each side. Some slight asymmetry is common, uncommon cases of profound asymmetry may need corrective surgery
- Scarring on the front of the ear
- Cartilage deformity
- The earlobes may be asymmetrical.
- A notch or indentation on the margin of the lobe may be present due to scarring post operatively but is not usually noticeable.
After the operation you will occasionally need to stay in hospital overnight.
Because of the very nature of cosmetic surgery, sometimes patients can be dissatisfied with the results.
Special care should be taken because infection or collection of blood under the skin can deform the ear cartilage. A second procedure is rarely necessary although can sometimes be required. Occasionally one of the non-dissolving stitches left in the ear will work its way to the surface and will have to be removed but serious complications are quite rare. The ears are often a little numb and red in colour after the procedure, and this usually takes several weeks to settle.