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Summary

Otoplasty involves reshaping a person's outer ear or pinna to correct any deformity and improve the appearance of their ear. Deformities of the ear can be by birth or develop due to trauma. Some of the deformities include small, constricted ears or a fold in the ear. Before the procedure, your doctor will examine your ear and carefully review your medical history. Make sure to inform your doctor about any medications you take, past illnesses, allergic reactions, and lifestyle habits like smoking or drinking. This will help in reducing the risk of complications during and after the surgery. You will be asked to abstain from eating and drinking anything from midnight before the procedure. Once you arrive at the hospital for surgery, the doctor will give you general anaesthesia or sedative medications. You may also receive local anaesthesia to numb the surgical area. The surgeon will make a cut in the ear to reshape it. You will need stitches to seal the incision after the surgery. A bandage will be wrapped over your head to help you heal better.

After the procedure, you will be asked to keep the surgical area clean and dry until it heals. You may also need medications to reduce pain. A follow-up will be scheduled two to four days after the surgery to remove the bandage. 

  1. What is otoplasty?
  2. Why is otoplasty recommended?
  3. Who can and cannot get otoplasty?
  4. What preparations are needed before otoplasty?
  5. How is otoplasty done?
  6. How to care for yourself after otoplasty?
  7. What are the possible complications/risks of otoplasty?
  8. When to follow up with your doctor after an otoplasty?

Otoplasty, also called ear reshaping or pinnaplasty, is a cosmetic procedure that is done to correct ear deformities and improve the appearance of a person's ear.

Ear deformities may be congenital (from birth) or due to an injury or trauma to the ear. These deformities may just be an aesthetic concern but they may also cause hearing problems. However, an otoplasty is usually done for cosmetic reasons.

The surgeon can modify the shape, proportion, and position of your ear through this procedure. They can even pin your ears to lay close to the head if your ears stick out too much.

Your healthcare practitioner may perform this surgery to correct the following conditions:

  • Macrotia (overly large ears)
  • Bat ear-shaped upper lobe 
  • Protruding ears 
  • Shell ear
  • Lop ear (folded ear)

This surgery can be carried out on children as well. However, they are eligible for the procedure if they:

  • Do not have any serious illness or ear infection
  • Are five years of age or until their ear cartilage is stable. In younger children, the ear cartilage is unable to hold stitches as it is very soft.
  • Can communicate and convey their feeling 

Adults and teenagers should preferably be non-smokers if they would like to undergo this surgery.

The relative contraindications (surgery can be conducted but with proper precautionary measures) associated with the surgery include: 

  • Acute (short-term) or chronic (long-term) ear, face, or scalp infection 
  • An ear piercing may affect the outcome of the procedure

Before undergoing this surgery, you will need the following preparations:

  • Medical examination:
    • Your doctor will examine your ear thoroughly and carefully review your medical history including any past surgeries, illnesses, allergic reactions, or vaccinations, your diet and exercise routine, and mental health.
    • He/she may also check your heart rate, temperature, oxygen saturation, blood pressure, and respiratory rate to assess your overall health before the surgery.
  • Fasting: You will be asked to fast from midnight before the surgery.
  • Medications: 
    • Inform your doctor if you are taking any medications vitamins, or supplements. He/she will ask you to stop taking blood-thinning medications to reduce the risk of excessive bleeding during the surgery. These medications include aspirin, warfarin, clopidogrel, or ibuprofen.
  • Smoking cessation: if you smoke, you will be asked to stop smoking for a few weeks before the surgery to help prevent complications after the surgery.
  • Your child will need to miss school for a week after the surgery. So, make sure to inform the school about this before the surgery. 
  • Arrange for a ride: You will require someone, a friend or a family member, to take you home after the surgery.
  • Consent: Once you are at the hospital, the medical staff will ask you to sign a consent form to grant your approval for the surgery.

The following steps will be performed for this surgery:

  • An intravenous (IV) line will be placed in a vein in your arm or hand to give you fluids, sedative medicines (to help you feel relaxed) or general anaesthesia (a medicine to keep you pain-free and asleep) during the surgery. You may also receive local anaesthesia to numb the surgical area.
  • After administering anaesthesia, the surgeon will make a small incision (cut) behind your ear and expose your ear cartilage. 
  • If required, the surgeon will remove small pieces of your ear cartilage. 
  • He/she will then reshape your ear into the desired shape and then close the surgical site with sutures. 
  • Finally, a soft dressing will be draped around your head to help you heal after the surgery.

The surgeon may take about two hours to complete this procedure. You do not require a hospital stay after the surgery. Once you wake up from anaesthesia, you will be allowed to go home.

Once you are home, you will need to take the following care:

Incision care:

  • Keep the surgical area clean and dry. 
  • Do not wash your hair until your bandage is removed. 
  • Wear a headband to protect your stitches while sleeping. 
  • Your doctor may prescribe medicines like paracetamol to ease your pain after the surgery.

Showering or bathing:

  • You may be allowed to bathe or shower 48 hours after the surgery. However, avoid soaking your surgical site while bathing.
  • Dry the wound immediately after taking a bath, and use either a moisturising lotion or antibiotic ointment until the area heals completely.

Diet and activities:

  • Your doctor will tell you when you can resume working after the procedure. If your child has the surgery, he/she may have to skip school for a weeks. 
  • You may resume swimming four to six weeks after the surgery.
  • You will be asked to consume a balanced diet and drink plenty of water to ensure good recovery. 

When to see the doctor?

Visit or call your healthcare practitioner urgently if you experience the following symptoms after the surgery:

  • Numbness
  • Nausea or vomiting 
  • Lightheadedness 
  • Mild pain or discomfort 
  • Bruising and swelling
  • Fever and chills 
  • Redness, excessive bleeding, or discharge from the ear 

This surgery has the following possible risks:

  • Scars like keloids
  • Breathing problems
  • Increased feeling of coldness at the site of surgery
  • Allergic reaction 
  • Recurrence of ear deformity 
  • Numbness
  • Haematoma (collection of blood) 
  • Infection

You will need a follow-up appointment two to four days after the procedure to get your stitches and bandage removed.

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Cleveland Clinic [Internet]. Ohio. US; Otoplasty (Ear reshaping)
  2. American Society of Plastic Surgeons [Internet]. Illinois. US; Ear Surgery
  3. National Health Service [Internet]. UK; Ear correction surgery, including ear pinning
  4. American Academy of Ophthalmology [Internet]. California. US; Otoplasty and Earlobe Surgery
  5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria. Australia; Otoplasty (external ear surgery)
  6. Thorne CH. Otoplasty and ear reduction. In: Rubin JP, Neligan PC, eds. Plastic Surgery: Volume 2: Aesthetic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.
  7. Adamson PA, Doud Galli SK, Kim AJ. Otoplasty. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 31.
  8. Theadom A, Cropley M. Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. Tob Control. 2006;15(5):352–358. PMID: 16998168.
  9. Beth Israel Lahey Health: Winchester Hospital [Internet]. Winchester. Maryland. US; Stapedectomy
  10. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Treatments and Procedures: Ear Pinning
  11. MUSC Health [Internet]. Medical University of South Carolina. US; After Ear Surgery Instructions
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