External Ear Surgery – Otoplasty Otoplasty – An Overview Ear surgery, also known as otoplasty, is the surgical procedure utilized to improve the shape, proportion or position of the ear. Ear problems may be present at birth or caused by later injury but either can be corrected by otoplasty. In general, the conditions usually treated by surgery are: Noticeably large ears – a condition called macrotia Protruding ears on either one or both sides Dissatisfaction with previous ear surgery Improvement in contour of the ear folds or earlobes The most common ear deformity is an ear or ears which are too large. This condition occurs in approximately 5% of children. Unfortunately children with this condition are often teased about it, so otoplasty is most often performed on children to spare them the teasing and ridicule. However, these days many adults are also be interested in cosmetic ear surgery to improve their ear shape or position. Abnormal protrusion of the ear can be caused by several anatomical elements of the ear. This includes the lack of development or partial development of the antihelix, which provides a great deal of structure to the visible ear, or a deep or angled concha, which is the hollow next to the ear canal. Other variables include the angle of the ear cartilage fold and the angle of the concha in relation to the head. It is often a combination of these problems which need to be corrected by otoplasty. Before – After Who is a Good Candidate for Otoplasty? If you or your child are bothered by protruding or disfigured ears, you may want to consider external ear surgery. However, when it is your ears that are the problem, you should be sure that you want to have this procedure for yourself, not to fulfill someone else’s desires or to try to ﬁt any sort of ideal image. Although many otoplasty procedures are done for adults and adolescents, it can be advantageous to have ear surgery done when the patient is still a child, rather than waiting (which is usually not the case with most plastic surgery). If the ears are repaired at an early age, the ear cartilage is more pliable and easily shaped. Also, when corrected early, the child will have less chance of the condition affecting their self esteem as they begin socialization and school. The procedure should only be performed after the ear is fully developed at around age 5 and it’s usually done between the ages of 5 and 14 and the patient should be healthy to minimize any potential complications. If you are a parent who is considering Otoplasty for your child, you should be very attentive to your child’s feelings about their ears and be sure your child is ready for the surgery. Children who are unhappy their ears and want them fixed are typically happier with the results and more agreeable during the process than those who are solely motivated by their parents’ desire. Adults who are self conscious about their ears should not give up hope, even though their fully developed ears are not as conducive to reshaping as a child’s. Dr. Shvidler has had great success with Otoplasty on adult patients. Again, the patient should be in good general health and have realistic expectations, which Dr. Shvidler will discuss. Don’t let your ears define who you are, a talented surgeon such as Dr. Shvidler can create natural-looking results so you can feel more self-confident about the way you look. Before – After Preparing for Surgery he first step in the process is a consultation with Dr. Shvidler about your potential ear surgery and you should be prepared to discuss why you want the procedure, your expectations and desired outcome. He will review your medical history with you, including any medical conditions, drug allergies and medical treatments or previous surgeries. You should prepare a list of you current medications, vitamins, herbal supplements, and your usage of alcohol, tobacco and drugs. He will evaluate the status of your general health and any pre-existing risk factors, take photographs of your ears for your medical record and then discuss your options and recommend a course of treatment. He will also discuss likely outcomes of the Otoplasty procedure and any risks or potential complications. It’s important that you have all your questions and concerns addressed by Dr. Shvidler, so it can be helpful to write these out in advance to bring to the consultation. In preparing for your ear surgery, you may be asked to obtain lab testing or a further medical evaluation, take certain medications or adjust your current medications, and avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding. You should stop smoking well in advance of surgery as smoking can have very serious side effects on the healing process that may lead to scarring, deformities and poor outcome. Smoking cessation programs are encouraged and the patient will not be allowed to smoke 6 weeks prior to and immediately after the surgery. Dr. Shvidler will provide additional instructions about what to do on the day of surgery. He will also discuss the use of anesthesia during your procedure, which could be general anesthesia or IV sedation with local, and what to expect for post-operative care and follow-up. After Otoplasty Surgery After your ear surgery, bandages or dressings will be in place to be sure the affected area stays clean, to protect it from trauma and to support the ear in its the new position during the initial healing process. Before – After Most patients are up and about just a few hours after Otoplasty surgery. Even so, if your surgery is performed on an outpatient basis, you will need to arrange for someone to drive you home afterwards and someone should stay with you for at least the first night following surgery. After the surgery, you may experience some aching or throbbing of the ears during the first few days, and medication may be prescribed to relieve this. Swelling and bruising and swelling are typically minimal. You may experience an itchy feeling under your bandages. Even so, bandages must remain intact and should not be removed for any reason. Removing bandages too soon may result in loss of some of the correction and possibly require a secondary surgery. If you experience any complications beyond the normal discomfort, notify Dr. Shvidler immediately, who will determine if any additional treatment is needed. You will usually see results of the ear surgery right away once the bandages are removed by the doctor or medical practitioner. Now that the ear has been permanently positioned closer to the head, surgical scars are usually hidden well behind the ear in the creases of the ear. With more extensive ear surgery and reconstruction, the results may become apparent over time. Complications stemming from otoplasty are remarkably low. Occasionally, correction of the surgery may be needed, since the shape of the ear from the original procedure may not hold and recurrence of the original protruding ear can occur. Younger patients are less likely to have a recurrence because the cartilage is less developed and more amenable to change.