Ear Re-shaping/Otoplasty

WHAT DOES IT INVOLVE?

Most commonly the ante helical (inner) fold of the ear may not have formed completely making the outer rim and overall projection of the ear more pronounced. This is corrected by making an incision behind the ear under local anaesthetic (or general anaesthetic in children) and resculpting the fold in the cartilage using a permanent scoring technique. Suture (stitching) techniques in this area are best avoided as they are prone to high recurrence rates and, although they give a good initial result, the ears can spring back with time.
At the end of the operation the wounds are sutured with a dissolving stitch and a firm bandage is placed around the ears to support them in place. This is left on for one week. Occasionally other areas of the ear may be unaesthetic, such as the helical rim itself which may have irregularities. Most of the time these are entirely normal variants of a structure called Darwin’s Tubercule which is present in some ears but not in others. Trimming down the Darwin’s tubercules, or other helical rim irregularities, is very straightforward and performed through an incision made behind the ear.
It is also possible to reduce the vertical height of the ear in a predictable aesthetic way leaving only a small incision across the helical rim of the ear and one in the crease behind the ear.
Finally, stretched ear-piercing holes or cleft earlobes (which earings have been pulled out of) may require correction. Both are done under local anaesthesia; the former by freshening the edges of the stretched piercing hole with a biopsy punch and then simply suturing the edges together. The latter requires a small flap reconstruction and the ears may be repierced three months or so post-operation if desired.

HOW PAINFUL IS IT?

As with most other facial cosmetic procedures, local anaesthetic is injected into the area at the beginning of surgery and this helps to limit post-operative pain. The amount of discomfort after the local anaesthetic has worn off is usually quite easily tolerable and patients are offered a short course of pain killers on discharge from hospital.

WHAT HAPPENS AFTER THE SURGERY?

One week after the surgery the dressings are removed to reveal the new appearance of the ears. They are usually somewhat swollen at this stage but it does not take long for the swelling to subside. It is advisable to wear a ski-band or bandage over the ears at night for a further three weeks or so in order to prevent inadvertent trauma to this area. Three months after the operation a final review appointment is made and post-operative photography is obtained.

WHAT COULD GO WRONG?

Usually nothing. Prominent ear correction does have associated potential complications of haematoma (blood clot), wound infection, excessively prominent cartilage, excessive scarring and persistent asymmetry but these are extremely rare and only very occasionally require further corrective surgery.