Definition and Overview
Otoplasty, commonly known as ear repair, refers to all kinds of procedures performed to correct or reconstruct ear deformities using both non-surgical and surgical approaches. This procedure addressed numerous deformities including congenital defects like microtia or underdeveloped ears, oversized ears or macrotia, or lop ears, to name a few. Acquired ear deformities, such as cauliflower ears and split earlobes, which are usually caused by trauma to the ears, can likewise be managed with otoplasty. Although earlobe tears are more commonly seen in women, the incidence of earlobe tears has also been increasing in men in recent years.
Because the external ear is readily exposed, it is prone to injuries. Avulsion injuries, such as those that occur with torn earlobes, and incomplete amputations are quite common. Treatment of these conditions is surgical, and is best performed by a plastic surgeon.
Who should undergo and expected results
The procedure is recommended for people with split earlobe caused by:
- Trauma, such as accidental tears due to earrings being tugged or pulled inadvertently
- Traction deformities caused by repeated use of heavy earrings
- Widened ear piercings due to ear gauging, or the intentional enlargement of ear piercings using flesh or ear tunnels. This practice can lead to the lengthening of the ear piercing and splitting of the earlobe.
Choosing a qualified specialist to perform the otoplasty is crucial in determining the results of the procedure. Although it is a simple procedure, the repair of a torn or split earlobe should be done meticulously to make the earlobe appear as close to normal as possible and to avoid potential complications. Realistic expectations need to be discussed with the patient prior to the operation.
How the procedure works
Split earlobe repair is typically performed on an outpatient basis under local anesthesia. If the patient is a child, the procedure may have to be performed under general anesthesia. The surgery usually takes less than an hour to complete. After standard prepping, the earlobe is draped. A small area of normal tissue around the split earlobe is then excised, freshening up the edges of the wound. Both ends are then re-approximated and both the anterior and posterior sides of the earlobe are sutured back together. Bigger defects may require the creation of flaps. Wound dressing is then applied.
The patient is usually allowed to go home immediately after the procedure. It is important to avoid excessive pressure on the ear at this time. The patient will be instructed on proper wound care techniques, which may involve the application of an antibiotic ointment to prevent infection or the use of silicone sheets to prevent the formation of hypertrophic scar or keloid. The patient may also be given oral pain medications to address post-operative pain. Sutures are removed on the follow-up visit, typically after five to seven days. The use of earrings is avoided for approximately 2-3 months to allow the wound to heal properly. It is recommended that small earrings, usually studs, be used initially to prevent the recurrence of the problem.
Possible risks and complications
Although uncommon, there are several possible early complications associated with split earlobe repair. Bleeding and hematoma formation are risks for any general surgical procedure. If the patient develops a hematoma, or a blood clot in the surgical site, it must be evacuated as soon as possible to prevent the development of an infection. Tissue necrosis is another possible complication. Adequate vascular supply to the ear is essential to prevent this complication and ensure proper healing.
Infection of the wound is another uncommon complication, which is typically addressed with rounds of antibiotics. Deeper or more severe infections may require hospitalization. Complications related to sutures, such as granuloma formation, can also occur, but are uncommon with split earlobe repairs.
Formation of hypertrophic scar or keloid on the surgical site is a late complication. Treatment involves steroid injections 1-2 times a month or laser resurfacing procedures. Patients who are prone to developing this kind of scar should be counseled regarding this possibility prior to the procedure. If the patient experiences any of these symptoms or complications, it is important to inform the surgeon immediately..
- Adamson PA, Doud Galli SK, Chen T. Otoplasty. In: Cummings CS, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 33.