Otoplasty: Is Your Child a Candidate for Ear Surgery?
Reviewed by Yael Halaas, MD
If your ears protrude too much, are too large, uneven or misshapen, ear surgery (otoplasty) can help.
Otoplasty is often performed on children around the age of 5 or 6. Unlike other facial features, the ear has reached its adult size and is almost fully formed by then. Another incentive for early intervention is that the ear cartilage is soft and malleable during childhood, making the surgery easier to perform. If done at a young age, otoplasty can allow children with larger or misshapen ears to avoid traumatic teasing by their peers.
Adults, too, may benefit from otoplasty. In addition to its cosmetic applications, ear surgery can also help reconstruct ears that have been injured in an accident or via persistent ear pulling. Similarly, earlobe surgery can be performed to repair earlobes that are torn due to trauma or from wearing heavy earrings.
Ear surgery can be performed by a board-certified facial plastic surgeon, otolaryngologist or plastic surgeon. It is important to choose a pediatric surgeon if the otoplasty is being performed on a child. Your child should be told what to expect in an age-appropriate manner. Both parents and the child should have realistic expectations of what the ear surgery will and won't do.
Whether you are the parent of the child having ear surgery or the patient, you will be told what to do to prepare for otoplasty. You may be told to avoid taking aspirin or ibuprofen, as these medications can increase your risk of bleeding. You will also be told when to stop eating (or stop feeding your child) before the surgery.
You should be given an information packet that explains everything you should do and know before the surgery date. It is important that you follow these instructions closely as they will help minimize the risk of complications.
Understanding Your Ear Surgery Procedure
An otoplasty procedure normally takes about one to two hours to complete. This surgery may be performed in a hospital, outpatient facility or in a surgeon's office. Young children may spend a night in the hospital after otoplasty.
Adult ear surgery usually involves local or regional anesthesia. In young children, however, the surgeon may use general anesthesia or light sleep sedation to keep the child from fidgeting or moving during surgery. Parents tend to become anxious about general anesthesia in children. Choosing a pediatric surgeon who works with a pediatric anesthesiologist can help alleviate some of these fears. These doctors have specialized training in the anesthesia needs and requirements of young children.
There are several otoplasty techniques that your surgeon can use to improve the appearance of your ears. In general, otoplasty incisions are made behind the ear where they can be hidden in a natural crease. Your surgeon may trim the cartilage, reshape it and then hold it back with permanent sutures. Sometimes, no cartilage is removed. Instead, stitches suspend the ear into its desired position, hence the term "ear pinning."
Complicated reconstructive ear surgery may involve additional steps. For example, cartilage can be taken from your ribs to reconstruct your outer ear. Tissue-expanders may be needed to grow extra skin for use in reconstructing your ear.
After the surgery, a bandage will be placed around your head to hold your ears in place. You may be asked to wear a headband or stocking cap for a week or so after your otoplasty. The results of ear surgery can be immediate and long lasting.
You may experience some discomfort during your ear surgery recovery. Your surgeon will advise you on what pain medication is appropriate for you or your child. Expect some bruising and swelling, but most people can go back to school or work within a week. Schedule your child's ear surgery so that it coincides with summer vacation or winter break so he or she doesn't miss any school.
Complications are possible with any surgery, including otoplasty. Ear surgery risks can include:
- Blood clot
- Unfavorable scarring
- Cosmetic dissatisfaction
- Reaction to the anesthesia
These complications are minimized when you choose a skilled surgeon and follow his or her advice closely. This may include taking an antibiotic after your otoplasty to reduce your risk of infection.
Ear Surgery Cost
Ear surgery cost can range from $2,225 to $7,000, depending on the nature of the surgery and who is performing it. Make sure you get a quote from the surgeon before booking your otoplasty. There may be hidden costs not included in this estimate such as medications or postoperative supplies.
If the otoplasty is considered reconstructive, your insurance company may cover some or all of the costs. Check with them in advance to avoid any misunderstandings. Patient financing may also be an option.