Overly protruding ears are often a center of attention and can result in unnecessary ridicule. Ears that are excessively large or otherwise malformed are difficult to hide owing to their prominent position. Children are often victims of being labeled with unkind names such as “Dumbo” or “Mickey Mouse”. Even the mildest distortion in size or shape can lead to self-consciousness and, particularly in children, to low self esteem and difficulties with social adaptation.
Otoplasty refers to any of a number of procedures aimed at correcting the size, curvature, angles, or prominence of the ears. If only one ear is involved, the surgery can match the affected ear to the unaffected ear; if both ears are involved; well established norms of size, angles and prominence are used to set the ears in a more aesthetically pleasing position.
Otoplasty surgery is best performed before socialization and after the ear has grown to nearly adult size. This generally corresponds to age 5 or 6. By this time, the ear has achieved 95% adult size and it is early enough to spare children the potential for mockery upon commencing school. Additionally, the ear cartilage is much more pliable in childhood, allowing for easier shaping. Occasionally, the procedure is delayed until the child is older, particularly if the ears can be covered with long hair styles.
Protruding ears not corrected in childhood can be addressed in adulthood although the more rigid adult cartilage often requires additional techniques to be adequately molded.
The procedure may require various combinations of cartilage “folding”, placement of sutures under the skin, molding of the cartilage, and techniques to set the ears closer to the side of the head. Surgery usually lasts 1-2 hours. For adults, the procedure can be performed under local anesthesia, while for children general anesthesia is required because of the child’s fear and inability to fully cooperate.
After surgery, a compressive elastic, band-like dressing is placed.
There is very little discomfort associated with the procedure. The compressive dressing is removed after 24 hours and a lighter dressing is applied with a protective plastic “shell” which protects the ear(s) during sleep. This can be removed for showering or cleaning the ears but should be worn at all other times for 3-7 days.
The results are generally quite dramatic. The incision created in the crease behind the ear heals to a fine white line and is nearly invisible. The properly performed Otoplasty results in a natural appearing ear with smooth curves and angles, and with excellent symmetry between sides. The ears no longer dominate the frontal view of the face and better facial harmony is achieved.