Definition and Overview

Also known as ear reshaping or pinnaplasty, otoplasty is a cosmetic ear surgery that enhances the shape and size of the outer ear. It focuses on solving problems of the pinna, the part that protrudes on each side of the head. In certain cases, the pinna appears larger than normal (sometimes referred to as Mickey or Dumbo ears) or is misshapen due to congenital defects or traumatic injury.

Who Should Undergo and Expected Results

Otoplasty is a cosmetic procedure, which means it doesn’t have any profound impact on the function of the ears. It may result in changes with how sound is perceived, but they are almost always subtle that they don’t affect the hearing process.

The surgery is often performed on children five years and above. By this time, the ears have already fully developed and patients are also more likely to be prepared to undergo the procedure.

How Does the Procedure Work?

Otoplasty begins with a consultation with a cosmetic surgeon, preferably one with a background in paediatric if the patient is a child. An ENT specialist (otolaryngologist) can also be consulted to make sure the surgery will not affect the ear’s function.

Because surgery can have psychological effects, a child may also be requested to consult with a psychologist or surgical counselor. The goal is to see to it that the child or his parents/guardians fully understand the risks and complications, as well as the possible results, of the cosmetic ear surgery.

During the surgical consultation, the surgeon examines the condition, shape and size of the ears. Photographs are typically taken and uploaded to a computer. A special type of software is then used so the doctor can devise the best surgical technique to achieve the surgery’s goal. If the patient is a minor, the surgeon also discusses surgery details like costs, procedure, results, and post-operative care or follow-up with the parents or guardians.

The procedure is performed under local anaesthesia with sedative or general anaesthesia if the patient is struggling to keep still or become highly anxious.

The surgeon will proceed by making a small incision along the lines that mark the ear’s connection to the head so he can remove, trim, or cut a part of the cartilage or skin until the desired shape and size are achieved. In some cases, especially when the ears appear to be more forward, the surgeon pulls, rather than trims, the cartilage back, suturing it to the back of the ears and to the head to keep the ears in place.

The surgery may take at least two hours and the patient is allowed to go home once the effects of anaesthesia have worn off. However, the doctor may advise against getting involved in strenuous physical activities for the next two months.

Possible Risks and Complications

The risks and complications, such as throbbing pain and redness on the surgical site, are normally obvious a few hours to a day after surgery. Scarring is also a complication, but this often fades as years go by, particularly if the patient is a child.

Although rare, the cosmetic ear surgery may cause allergic reactions from anesthesia. The reaction may be so severe that it can lead to anaphylactic shock, a life-threatening emergency situation. There could also be a problem with blood clotting, especially if the child has a bleeding disorder. The patient may also develop an infection, which may be indicated by swelling, fever and persistent pain despite medications.

Although the procedure has a very high success rate, it may not prevent the recurrence of outer ear protrusion.

Reference:

  • Adamson PA, Doud Galli SK, Chen T. Otoplasty. In: Cummings CS, Flint PW, Haughey BH, et al, eds. Otolaryngology: He
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