Otoplasty
Otoplasty is a surgical procedure designed to alter the shape or position of the outer ear, commonly addressing concerns such as protruding ears or repairing damaged or absent ears. This surgery is typically performed on children around the age of five, as their ears are nearly fully grown by this time, although it can also be conducted later in life. The process involves reshaping the underlying cartilage and repositioning the ears closer to the head through incisions made on the back of the ear. For cases involving reconstruction of severely damaged ears, the procedure is more complex and may require multiple surgeries, including the use of rib cartilage and skin grafts.
Patients often wear dressings or a headband after surgery to aid healing, with stitches usually removed within a week. While otoplasty can enhance physical appearance, it may also come with risks, such as sensitivity in cold weather, potential skin graft failure, or infection. Additionally, some patients may experience discomfort following the procedure, which can typically be managed with over-the-counter pain relief. Overall, otoplasty is a valuable option for those seeking to improve their ear aesthetics or restore ear structure following injury.
Subject Terms
Otoplasty
Anatomy or system affected: Ears, skin
Definition: Cosmetic or reconstructive surgery performed on the outer ear
Indications and Procedures
Otoplasty is performed to improve the appearance of the outer ear, typically to flatten protruding ears or to repair or reconstruct a missing or badly damaged ear. Since the ears have reached 90 percent of their adult size by the time a child reaches age five, the surgery can be performed either at this early age or later.
The first step in flattening protruding ears is to remove a flap of skin from the back of each ear. The underlying cartilage is then remolded, and the two edges of the wound are stitched together, bringing the ear closer to the head. Dressings are applied to the ears and left for a few days when they are replaced by a headband that is worn for several weeks. The stitches are removed approximately one week after the surgery.
The reconstruction of a missing or badly damaged ear is a complex procedure that typically involves more than one operation, and long healing intervals are necessary between operations. The first step is to remove a piece of cartilage from a rib and sculpt it to resemble a normal ear. The cartilage is then transferred to a fold of skin where the ear will be located. A skin graft may be necessary. Dressings are applied to the ear for up to two weeks, and the stitches are then removed. In many cases, hearing in the reconstructed ear may not be normal. As long as hearing is normal in the other ear, however, no attempt is usually made to improve hearing in the reconstructed ear. Otoplasty is often performed on boxers and wrestlers who suffer debilitating trauma to their ears following years of participating in the sports.
Uses and Complications
Possible complications associated with otoplasty operations include sensitivity of the ear to cold weather, especially during the first year after surgery, and skin graft failure. On rare occasions, excessive bleeding or infection of the surgical wounds may arise. For minor pain, the patient can take acetaminophen or ibuprofen. As the ear heals, a hard ridge usually forms along the incision, but it will gradually recede. The scar will be hidden in the crease between the scalp and the ear.
Bibliography
Converse, J. M. Reconstructive Plastic Surgery. 2d ed. Philadelphia: W. B. Saunders, 1977.
Davis, Jack. Otoplasty: Aesthetic and Reconstructive Techniques. 2d ed. New York: Springer, 1997.
"Otoplasty." Mayo Clinic, August 23, 2012.
“Otoplasty (Cosmetic Ear Surgery): Procedure & Recovery.” Cleveland Clinic, 7 Feb. 2023, my.clevelandclinic.org/health/treatments/11021-otoplasty-ear-reshaping. Accessed 20 July 2023.
Stedman, Thomas Lathrop. Stedman’s Plastic Surgery/ENT/Dentistry Words. 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008.
Townsend, Courtney M., Jr., et al., eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia: Saunders/Elsevier, 2012.