Plastic Surgery | Dr. Enrique Etxeberria, Plastic Surgery in Bilbao

Ears

Plastic Surgery - Ears - Otoplasty

Otoplasty

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The re-shaping of protruding ears is known as an OTOPLASTY. It is usually performed on patients from 16 years of age. However, it is an intervention which, quite frequently, tends to be performed on children where from a very early age, around six, the ears have already practically reached the size and shape they will have in adult life. On the other hand, children tend to be very cruel about corporal defects, and at this age protruding ears are often used to tease classmates. Often the reaction to this is aggression towards the environment or a tendency to isolation.
It is a procedure which takes approximately one hour and 30 minutes and can be done under local anaesthetic.
Although the most common problem affecting the ears is their prominence or protrusion, there are other types of deformity that can also be surgically corrected: the size of the ears can be reduced, the shape and size of the lobes can be changed, cup ear can be corrected. A new ear can even be created in the absence thereof or where it has disappeared as a result of accidents.

WHEN IS AN OTOPLASTY INDICATED?

Whenever the patient is unhappy with the shape, size or position of his or her ears, and there is a real anomaly, this operation would be indicated.
Due to the importance of these anomalies for children, it has been established that they can be operated on from four to six years of age (from four to six years of age the development of the ears is practically complete) in order to avoid possible trauma.  It is only on newborns that attempts can be made to correct the ears without surgery.

PRE-OPERATIVE RECOMMENDATIONS

As with any intervention, the initial medical examination is indispensable in order to detect any anomaly that may contraindicate the operation. In the case of children, it is advisable to perform the operation from the age of five onwards.

ANAESTHESIA

The intervention is performed under general anaesthetic in children. In the case of adults, it is performed under local anaesthetic and sedation. It is a surgical procedure that can be performed under local anaesthetic.

SURGICAL PROCEDURE

Numerous techniques have been described for the correction of protruding ears, but the most common method consists in making an incision behind the ear through to the area of cartilage which presents lack of curvature.  Here we will insert some stitches of non-reabsorbable material which fold the ear naturally, correcting the deformity.
In the case of patients who present a defect at concha level, we will also insert stitches which bend this part of the cartilage backwards.  We thereby reduce the angle formed by the ear in relation to the posterior part of the face.
The scar remains well hidden behind the earlobe.

HOSPITALIZATION

It tends to be a “day” procedure. Patients are admitted on the morning of the surgery itself, and tend to leave that same afternoon.

AFTER CARE

The patient will wear a padded bandage for the first 3-4 days.  When it is removed, the ears will present a slight inflammation which will gradually recede over the following days.  The stitches are removed after 8-9 days.  In the meantime, the patient can wash his or her hair, taking extreme care to not affect the wound.
Occasionally there may be a reduction in the sensitivity of the ears, which will return completely within a short period of time.
During the first few days following surgery, it is advisable to use a light form of compression at night (cotton wool and elastic band) to protect the ears from any impact or brusque movements.  In cases where daily activity represents a potential risk, it is advisable to also wear a “band” during the day.

RESULTS

In this type of intervention, the scar will remain behind the earlobe, and will therefore be imperceptible even when wearing your hair short or pulled back.
The results of an otoplasty to correct the defect of protruding ears are very satisfactory.  In addition to the resulting natural appearance, the psychological problem which is frequently associated with this malformation is also resolved.

RISKS AND UNCERTAINTIES

An otoplasty is a safe procedure with high success rates always provided it is performed by specialist surgeons who know and master these techniques.  However, like any surgical act, an otoplasty is not exempt from complications which, although rare, you need to know about.  An infection or a haematoma may require additional surgical treatment.
Although uncommon, the “memory” with which any cartilage naturally behaves, may mean that the ears once again separate a few millimetres, requiring slight retouching.  The appearance of anomalous scars on both the skin and around the cartilage is extremely rare.

AFTER THE INTERVENTION

After the operation the patient can leave the Hospital if he or she is in good condition. The patient will wear a bandage for a few days which will provide protection and facilitate the shaping of the ears.  If the correction was minimal, a bandage may possibly not be required.  For the first two or three days there may be some discomfort or pain, usually controllable with the medication prescribed.
After the first week, the extractable stitches are removed.  Occasionally a tennis-type headband may need to be worn for a variable period of time.
It is normal for the ears to be swollen and somewhat bruised.  Providing there will be no accidental blows, the child can return to school after the first week.  Any activity that may “bend” the ears must be avoided during a month or month and a half.  Due to the “asymmetrical” nature of our body, it is both impossible and unnatural to achieve perfect symmetry between both ears.  The result sought by this operation is to achieve a natural appearance as a whole, not “mathematical” symmetry. If you understand this concept you will value and enjoy the end result much more.  This leaflet will provide you with the basic principles of this operation, how it is performed and the results that can be obtained.  It will not however answer all your questions as a large part will depend on your particular circumstances.  Please do not hesitate to ask us if you have any questions or concerns.

FREQUENTLY ASKED QUESTIONS

What hospitalization time is required for this operation?
10-12 hours in the majority of cases.

From what age is an otoplasty recommended?
From the age of 5. Before this no elective surgery is recommended.

When can I return to normal life?
After a few days, apart from physical exercise, which can be re-started after three weeks.

Is it painful?
Not especially. It may be uncomfortable upon contact or pressure for the first month.

Basically, what does an otoplasty consist of?
It consists in re-positioning protruding ears and/or reducing the size of large ears.

How long does the intervention last?
Approximately 2 hours

How long do the results last?
They tend to be permanent