These days, our external appearance has become extremely important for each and every one of us. It is associated with a higher level of confidence and many people will go to great extent to achieve the best possible look they can.

Botox injections, lip fillers, facelifts and brow lifts are all different kinds of cosmetic procedures that help improve facial appearance.

Otoplasty is a form of surgery that works along similar lines of improving cosmetic appearance. It involves reshaping the ears in individuals who have protruding ears and are not comfortable with it.

Otoplasty is also called pinnaplasty. We shall take a look at the procedure involved, why it is performed and what the risks and benefits of the procedure are.

What is otoplasty?

Otoplasty is a cosmetic surgical procedure that involves remodeling of ears to a desirable shape. It is often offered for young children to adults and involves removing excessive cartilage and repositioning the ear at a point close to the head.

The normal ear protrudes about 20 – 30° outwards from the head. Anything beyond 35° is classed as a protruding ear.

Why is otoplasty performed?

The most common indication for otoplasty is cosmetic reasons. Large protruding ears can be extremely prominent in both children and adults and can sometimes be associated with certain social stigma and even a degree of bullying. This can knock down the confidence of the individual and push them to seek some form of treatment.

While the confidence issue may not be as important in children initially, parents seem to worry a lot more and decide on their child undergoing the procedure in order to prevent any problems when they are out in public.

There are reasons other than just cosmetic once well which patients seek otoplasty. One such reason is difficulty wearing headgear such as helmets. In such situations, otoplasty can help the patient.

The video below provides a brief overview on otoplasty.

When is otoplasty performed?

In most cases, otoplasty is offered to children over the age of five years as the cartilage in the ear is a rather soft and may not hold the stitches easily. Furthermore, for the first few years of a child’s life, the cartilage in the year continues to grow until the ears reach the adult size. As is expected, any surgery performed in a child requires consent from the parent and a valid reason to perform otoplasty.

How is otoplasty performed?

There are two different kinds of otoplasty. The first kind is called ear splinting and is offered to babies who have protruding ears. The procedure does not involve any incisions as such but only requires the placement of splints on the outer aspect of the ear that will keep the ear in a position close to the head. As the infant grows, the ears tend to grow in the required position. Once they have reached the adult size and are not growing any further, the splints are removed.

On the other hand, otoplasty involves surgery and is carried out in children and young adults. The procedure is fairly straightforward and is performed under local anesthetic. However, some patients may require a mild sedative or even general anesthesia.

Once the local anesthesia is administered, an incision is made behind the ear through the skin in order to expose the underlying cartilage.

The excess cartilage is removed and the two edges are brought close to each other and are sutured. This brings the ear close to the head; in other words it helps reshape the ear.

The video below briefly demonstrates how otoplasty is performed.

The procedure can take anywhere between 1 to 2 hours to perform. Once complete, the ear is dressed with a sterile bandage and the patient is observed for a short period of time prior to discharge.

More recently, a new procedure has evolved called incision-less otoplasty. Here, a needle is used to score the cartilage in the ear to make it soft and bending. Once this is done, stitches are used to reposition the ear. The procedure is still in its early stages and there is yet to be enough evidence to support its long-term benefit.

After the surgery

Following the surgery, the patient is observed for a short period of time to ensure that they do not experience any side-effects from the anaesthetic agent or any complications from the procedure. Once the anaesthetic effect has worn off, patients will be discharged home with a view to review in the outpatient department soon. The patient’s head is covered with a bandage to keep the cartilage and ear in place to allow for healing. This bandage is usually removed after a week or so.

Risks and complications

It is not uncommon for patients to feel a mild amount of pain and discomfort at the site of surgery. This can be easily treated by using over-the-counter painkillers. Numbness of the ear is also a common phenomenon and usually passes after a few weeks.

In the rare cases, patients may develop a small blood clot at the site of surgery. Often, this disappeared by itself or may require removal. Similarly, infections may also occur at the site of surgery and can be treated with a course of antibiotics. If the infection is severe, an incision may need to be performed again at the site in order to train the infection.

Finally, there will be a small amount of scarring at the site of surgery but given that the incision is behind the ear, it will be hidden from plain sight.

The video below lists the common complications

Benefits of the procedure

Given how simple and straightforward otoplasty is, patients have found great degree of satisfaction in the appearance that they have achieved following the surgery. The most important beneficial effect is the boost in confidence that the patient’s state they experience.

Otoplasty is a commonly performed procedure that helps reshaping of the ear. It is offered to infants all the way to adults and is safe and effective.

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