OTOPLASTY

General Information

DEFINITION--Cosmetic or reconstructive surgery on the outer ear.

BODY PARTS INVOLVED--Ears.

REASONS FOR SURGERY

• Improve appearance of the outer ear (usually to flatten protruding ears). The surgery can be done as early as age 5 as ears have reached 90% of adult size by then.
• To construct or repair a missing or badly damaged ear.

SURGICAL RISK INCREASES WITH-- Previous severe ear injury such as burn or extensive laceration.

What To Expect

WHO OPERATES--Plastic surgeon, reconstructive surgeon, or ear, nose and throat specialist.

WHERE PERFORMED--Hospital; outpatient facility, well-equipped doctor's office.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies.
• After surgery: Usually none necessary.

ANESTHESIA

• Local anesthesia by injection.
• For young children who have difficulty in lying still for the 2 hour procedure, a general anesthetic may be used.

DESCRIPTION OF OPERATION

To flatten protruding ears (several procedures are available, one is described here):

• A flap of skin is removed from the back of each ear.
• The underlying cartilage is remolded and the two edges of the wound stitched together. This brings the ear closer to the head.
• Bulky dressings are applied to the ear and left for a few days. They are replaced by a headband that is worn for several weeks. Stitches are removed about a week after surgery. For a missing or badly damaged ear:
• The procedure is extensive and complex and normally involves more than one operation with long intervals of healing in-between..
• A piece of rib cartilage is removed and sculptured to resemble a normal ear.
• The cartilage is transferred to a pocket of skin at the site where the ear will be located. Sometimes a skin graft is necessary.
• Dressings are applied to the ear and left for 10-14 days until healing is completed and the stitches are removed.
• Hearing in the reconstructed ear may not be normal. When the hearing is normal in the other ear, there is usually no attempt made to improve the hearing in the reconstructed ear.

POSSIBLE COMPLICATIONS

• Sensitivity to cold weather, especially in the first year following surgery.
• Excessive bleeding (rare).
• Skin graft failure.
• Surgical wound infection (rare).

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 2 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually. The scar will be hidden in the crease between the ear and the scalp.
• Bathe and shower as usual. Keep the dressings dry by wearing a shower cap.
• While resting or sleeping, keep the head elevated on 2 pillows to provide greater comfort.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Resume work and everyday activity as soon as possible (usually 5 days for adults, 1 week for children).
• Resume mild exercise 2 to 3 weeks after surgery.
• Avoid vigorous exercise, swimming or contact sports for 6 weeks after surgery.

DIET---No special diet. Eat soft foods if chewing causes discomfort.

Call Your Doctor If

Any of the following occurs:

• Nausea or vomiting.
• Increased pain, swelling, redness, drainage or bleeding in the surgical area.
• Signs of infection: headache, muscle aches, dizziness, general ill feeling or fever.