Otoplasty and Cosmetic Ear Surgery

Otoplasty is one of the few types of plastic surgery that is commonly performed on children. Most types of cosmetic surgery should not be done before the features have stopped growing, but the ears are usually at or close to their adult size when during early childhood. Ear pinning is often done on children aged 4 to 6, as are corrections of malformed ears. (The procedure does not involve any pins, by the way.) In some instances, health insurance will cover the costs of otoplasty to fix a deformed ear because the external ear plays a role in hearing.

Ear surgery is often done at an early age because it helps children avoid teasing by their peers. Children can be cruel and children and teens are often teased cruelly about prominent ears. Almost all forms of otoplasty are relatively simple and inexpensive. When the child is young, the procedure is carried out, and the child heals and forgets about it. However, an adult who is unhappy with the way his or her ears look can have the surgery done at any time. Ear surgery can make the world of a difference in self-esteem.

What Is Otoplasty?

Otoplasty is any cosmetic surgery of the ear. A common type, ear pinning, brings the ears closer to the head or lessen the appearance of large ears. Otoplasty can also correct ears that have congenital deformities as well as those caused by trauma or the habit of ear pulling. Many toddlers will pull on their ears when they are teething and the habit may result in a misshapen ear or elongated earlobe. Some people have ears that are too flat, curl strangely, or are bent. Trauma to the ear can result in scar tissue contracting the cartilage into a “cauliflower” ear.  Earlobes can be torn due to trauma or from wearing heavy earrings. Ear surgery can correct these problems.

Most ear surgery is performed on children and teens. However, many young adults seek otoplasty when they can pay for the surgery themselves.

Some types of ear pinning involve removing a sliver of cartilage from the back of the ear and suturing the cartilage back together. This reshapes the ear to be smaller or closer to the head.

Are You a Candidate for Otoplasty?

Otoplasty should be done on someone who is basically healthy. Any underlying conditions, such as asthma or diabetes should be controlled. Because ear surgery is often done on children, the parents should make sure that they completely understand what the risks are of the surgery and anesthesia. An older child should also understand these risks. The child should be the one who wants the surgery and feels the need for it, since this helps him or her deal with the surgery and its aftermath.

Because this is a surgery that can involve a child and his or her parents, communication is important. The child should be told what will happen in age-appropriate language. Both parents and the child should have realistic expectations of what the surgery will do. In cases of a seriously deformed ear, more than one surgical procedure may be needed.

What to Expect at Your Consultation

This is a surgery that can be performed by a plastic surgeon or an otolaryngologist, a surgeon who specializes in problems of the ear, nose, and throat. If possible, try to find a surgeon who specializes in ear surgery, or pediatric surgery if the surgery is being done on a child.

After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation. This is a chance to ask questions and hear what the surgeon has to say.

You should find out where the surgery will take place, since it can be done in a hospital, in a freestanding surgical center, or in the surgeon's office. You should also discuss anesthesia. An ear pinning on an adult can be done with local anesthesia or regional anesthesia, while a more extensive procedure might be done under light sleep sedation. However, for young children, the surgeon may choose to perform an ear pinning with general anesthesia or light sleep sedation to keep the child from fidgeting or moving during surgery. Please read more information about anesthesia and its risks here. Also, find out who will administer the anesthesia and what their experience is in administering anesthesia to children.

Whether you are the parent of the child having ear surgery or the patient, you will be told what to do to prepare for the surgery. You may be told to avoid taking anything with aspirin or ibuprofen in it. You will also be told when to stop eating (or stop feeding your child) the evening before the surgery.

You should be given an information packet that explains everything you should do and know before the surgery date. You (or your child) may have to have blood tests done, which may not be included in the fee for the surgery.

How Otoplasty Is Performed

An otoplasty procedure normally takes generally takes about 2 to 3 hours to perform.

The patient will usually have an intravenous (IV) line inserted to administer medications and fluids. This is usually inserted in the inside of the elbow. If you are having very minor ear surgery, you may just receive local or regional anesthesia, perhaps with an oral sedative.

If the ears are being pinned, an incision will be made at the back of the ear, in a natural fold where the scar will be hidden, and a vertical slice of the cartilage will be removed, perhaps along with some skin. The incision will be closed and the ear will be bandaged.

In cases where a malformed or absent ear must be rebuilt, the surgeon may take bone or cartilage from somewhere else in the body. This may mean an extra surgical site. Some work has been done with pieces of silicone used as implants to help rebuild an ear.

After the surgery, a pressure dressing is placed around your head to compress the ears slightly and hold everything in place. The patient is awakened and brought into the recovery room. An adult usually goes home in a few hours, but a child having extensive ear surgery and general anesthesia may be kept overnight.

The Road to Recovery

There will be some discomfort after ear surgery, but this should be relieved by pain medications. You (or your child) have to take it easy and sleep the head elevated for several days. The ears will be swollen and tender for the first few days, but this will dissipate.

Keep the bandages on until the surgeon says to remove them. This may be especially difficult in children as they tend to fidget. The bandages are usually removed after 5 to 10 days. Do not get them wet.

If you have excessive pain, redness, pus, a fever, or other symptoms that do not appear normal, contact your surgeon immediately!

Risks and Complications of Otoplasty

Otoplasty is a very low risk surgery, but all surgery has risks and complications. With otoplasty, these include allergic reaction to the anesthetic used and infection. There is the chance that the ears will not be symmetrical or that scar tissue can be visible. If there is bleeding in the ear, it can cause the ear to become misshapen as it turns into scar tissue. However, this is usually rare. Numbness is possible, it usually subsides within the first few weeks but it may become a permanent issue.

The Average Fees for Otoplasty

The approximate cost of otoplasty surgery varies from region to region. It ranges from $2,225 to $5,000. This fee does not usually include medications or postoperative supplies.