Otoplasty: Reshaping Ears for Confidence and Aesthetics
Otoplasty is the surgical reshaping of the outer ear to correct any flaws and improve its overall appearance. The reasons someone would opt for an otoplasty can vary from person to person, but usually, it’s to reduce the prominence of larger than average ears.
Things like large ear lobes, prominent or droopy ears, and other abnormalities can cause people to become insecure about their appearance, causing low self-esteem, low confidence, depression, and anxiety in patients. The surgery can help reposition the ears to be closer to the head to create better overall proportions.
Otoplasties and their related surgical techniques were first developed in India around the 5th century BC by a physician named Sushruta. Numerous techniques and methods have evolved since then. Because there is no single-widely accepted procedure, every surgeon has their particular style of performing otoplasties. Since then, over two hundred distinct methods have been developed to correct prominent ear deformities.
Modern otoplasty techniques fall into two categories:
- Cartilage Cutting (Traditional)
A technique that cuts and removes excess cartilage from the outer ear, making it easier to remold and rearrange accordingly.
- Cartilage Sparing (Non-Surgical)
A technique that requires no incisions, just stitches. Without causing scarring, bruising, or swelling, the surgeon can reshape the ear.
What Causes Ears To Become Prominent?
Usually, the human ear sits at a 21 to 30-degree angle. Any angle above 30 will cause the ear to appear like it’s sticking out. Genetics and health conditions regulate the amount of cartilage grown in our ears, but accidents could also determine the ear’s shape as well.
Other ear problems that can be fixed via otoplasty are:
- Cupped Ear: Tiny ear.
- Lop-Ear: When the tip appears to fold down and forward.
- Shell Ear: When the outer rim curve, including the natural creases and folds, are missing.
- Increased Confidence
Adults and children will often experience a significant boost to their self-confidence after receiving an otoplasty, making the transition to school and social situations more easily.
- Correction of Ears
Through otoplasty, a patient can “flatten” protruding ears, place them closer to the head, and improve their face’s overall appearance.
- More Natural Facial Appearance
By reshaping the structure of the ears, a person can achieve a more natural-looking facial appearance.
The risks related to otoplasty are minimal to none. The procedure is safe for both children and adults.
- Permanent Outcome
The process itself is relatively quick at about 2 hours, but the results are permanent.
As with any surgical procedure, there will be potential risks associated with undergoing an otoplasty. Other factors like a patient’s medical history and lifestyle can also put them at risk.
Some of these possible complications of otoplasty include but are not limited to:
- Allergic reactions to sutures, dressings, and antiseptics.
- Blood clots forming under the incision site.
- Pain, bruising or swelling.
- Nausea and lack of balance from accumulated fluid collected in the inner ear.
- Asymmetrical ears – patients may need further surgery to correct any resulting irregularities in the cartilage.
- Temporary or permanent loss of feeling in the skin around the surgical site.
- Keloids & hypertrophic scars – Thick, raised scars that form over healed incisions.
The minimum age for otoplasty would be 5 to 6 years old when the ears are about 90% developed. Candidates should be physically healthy and have realistic expectations for what they hope to achieve by reducing their ears’ size and shape.
First, you will want to arrange for a consultation to determine whether you’d be the right candidate for otoplasty. Be prepared to talk about your reasons for pursuing surgery, your expectations, as well as your medical history.
Your surgeon will evaluate your overall health, give you a physical exam, and determine any potential risks that could occur. Remember, it’s okay to feel nervous.
Weeks Before Surgery
Your surgeon will instruct you to refrain from taking blood-thinning medications as well as specific vitamins, supplements, and nonsteroidal anti-inflammatory drugs. If you are a smoker, you will need to avoid the habit for at least two weeks before surgery. You should also arrange for a friend, partner, or family member to help drive you home and take care of you after surgery.
Day Before Surgery
If general anesthesia is to be used, your surgeon will instruct you to stop eating and drinking eight hours before surgery. Make sure to schedule time off from work or school beforehand.
On the day of your otoplasty, wash your hair thoroughly and come in wearing loose-fitting and comfortable clothes. Women should avoid wearing makeup and accessories and should either pin or braid their hair.
The specific type of method used varies depending on the type of correction that is needed. The technique determines the locations of the incisions. These incisions will either be made on the back of the ears or within the ears’ inner creases.
After creating the incisions, your surgeon may remove any excess cartilage or skin. He or she will proceed to fold the cartilage in place, then clinch it with internal stitches. Surgery generally takes up to two hours.
Try to avoid sleeping on your sides to keep pressure off your ears. Also, try wearing button-up shirts or shirts with loose-fitting collars while recovering.
For protection and support, your ears will be covered in bandages. Your doctor may prescribe you medications for pain and itching.
A few days later, your doctor will remove your bandages. Your ears will still be a little swollen and red. While you sleep, you’ll have to wear a loose-fitting headband over your ears for two to six weeks.
If your stitches are not the dissolving kind, talk to your doctor about when you can have them removed. Your doctor will let you know when you’ll be able to resume any actions like bathing or physical activity.
When your bandages are removed, you’ll notice an immediate change in your appearance. The results are permanent and will hopefully achieve in you a more symmetrical facial appearance.
No. Otoplasty is strictly a cosmetic procedure to the outer ear. It does not affect hearing.
Yes. Ear cartilage gets less malleable with age.
In most cases, this type of surgery is not covered by insurance since it’s considered to be an elective or cosmetic procedure. However, insurance may cover some of the costs if the surgery is for medical reasons.
Otoplasty takes place either at a hospital, outpatient surgical center or at a surgeon’s office-based facility.
Behind the ears.
Yes, but they will be well concealed as the incisions are made behind the ear.
Usually, for young children, general anesthesia is used. For older children and adults, local anesthesia plus sedation is used.
There may be some aching and throbbing for the next couple of days following the procedure. Your doctor may prescribe pain medication if it gets to be too much to handle.
The procedure usually lasts up to 1.5 to 2 hours to complete.
Some throbbing and aching may occur after the procedure, and your head will most likely be wrapped up in a bandage. Stitches will either be taken out or dissolve altogether within a week.
Most children generally need a week off from school, while adults can return to work, usually within a few days. You should avoid strenuous activities that can risk the ear for up to two months after surgery.
You should avoid contact sports and other related activities for at least two months.
An otoplasty is usually performed on both ears to achieve the best possible symmetry.
- Foustanos, A., Messinis, L., & Panagiotopoulos, K. (2012). Comparison of otoplasty results using different types of suturing techniques. Acta chirurgiae plasticae, 54(1), 3–7. https://pubmed.ncbi.nlm.nih.gov/23170940/
- Kelley, P., MD, Hollier, L., MD, & Stal, S., MD. (2003). Otoplasty: Evaluation, Technique, and Review. Journal of Craniofacial Surgery, 14(5), 643-653. Retrieved February 8, 2021, from https://journals.lww.com/jcraniofacialsurgery/Abstract/2003/09000/Otoplasty__Evaluation,_Technique,_and_Review.8.aspx
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