Dr. De Fazio Plastic Surgeon :: Procedures :: Face :: Otoplasty or Ear Plastic Surgery

Otoplasty (Ear Surgery)

defazio_otoplastica.jpgThere are different kinds of ear deformities and each of them has to be treated in a different way. Otoplasty (Ear Surgery) is a surgical procedure performed to correct protruding ears, in order to get them in a more normal position and, as a consequence, make them less apparent. It is important to keep in mind that ears are never equal to each other even when normal; therefore, it is not reasonable to expect a perfect symmetry.

local + sedation
1 hour
outpatient / day surgery
1 week

The procedure

This surgical procedure can be performed under local anesthesia, often with sedation. The choice of anesthesia can also depend on the patient's wishes and the surgeon's assessment. Local anesthesia is intravenous sedation performed by the anesthetist before the procedure and, if necessary, repeated during the procedure. The area to be treated will also then be injected with small quantities of local anesthetic.

The stay in hospital/clinic is normally 1-2 hours (day surgery),, but both the anesthetist and the surgeon will check the patient one hour after surgery and decide when to dismiss him/her.
The procedure consists of an incision on the back surface of the ear, cutting out a small diamond-shaped piece of skin. This makes the cartilage exposed so that it can be reshaped in order to get a better profile and the ear can be placed in a normal position at the end of the procedure. A turban-shaped head bandage is applied in order to protect both ears and to control swelling and discomfort. It will be removed the day after surgery. The following days, it is recommended to use a headband (hair band or tennis headband).

Preoperative Preparation

The patient will be asked not to take aspirin, or other drugs containing it, 2 weeks before and 2 weeks after surgery. Aspirin can cause bleeding and, as a consequence, increase the risk of complications. No make-up product should be used on the day of surgery.

It is recommended to female patients taking oral contraceptives to stop taking them one month before surgery.
The patient is hospitalized on the day of surgery, in the morning, in preoperative fasting (abstaining from eating or drinking) since midnight the day before. After filling in the clinical record and consulting both the anesthetist and the surgeon, the procedure will start.

Post-operative care

One hour after surgery, the surgeon and the anesthetist will check the patient and decide when to dismiss him/her. At dismissal, the patient will get a letter including a presciption for follow-up therapy back home.

The surgical team at dismissal decides the first check-up after surgery. Usually, it is scheduled about one week after surgery.
Further follow-up care is decided by the surgeon according to how the patient is recovering. Usually, the patient is asked to return for follow-up care three, six and twelve months after surgery.

After the procedure

After the procedure, the patient will feel some discomfort, rather than real pain, which is anyhow minimal and not lasting for so long. It can anyway be reduced with analgesics (painkillers). 

The bandage applied after surgery has to be left in place overnight; then, it can be removed by the patient himself/herself who will replace it with a headband. As soon as the bandage is removed, the ears might look swollen and bluish: this condition is normal and will improve within 4 weeks after surgery.
The surgical wound is hidden behind the ear and, therefore, the scar will not visible; the stitches do not need to be removed, but one week after surgery the surgeon checks the surgical wounds.
Hypertrophic scars or keloids might form in patients with a tendency to scar formation: when occurring, a secondary surgery to remove them or treatments with cortisone injections might be necessary.

Possible complications

Bleeding. It might occur during the first day after surgery. If so, it might be necessary to change the bandage. Serous fluid and blood collections might accumulate between the cartilage and the skin and, as a consequence, it can be necessary to re-open the wound in order to remove them.

Infections. They are normally rare and, when occurring, responding quickly to antibiotic therapy.
Hypertrophic scars or keloids. They might form in patients with a tendency to scar formation: when occurring, a secondary surgery to remove them or treatments with cortisone injections might be necessary.
It might happen that the ears, after some time, return to their original position; if this condition occurs, surgery can be repeated, but it is extremely rare.

The surgical procedure does not affect hearing.

Recovery time (back to social life)

Work and social life should be reduced for at least 7-10 days after surgery; during this period, the patient can perform those activities which do not require big efforts if he/she feels able to do it.
Physical activity like jogging, dancing and yoga should be reduced for about two weeks after surgery in order to avoid swelling and discomfort; on the contrary, more intense sports like skiing, tennis, football, basketball, surfing, swimming and diving should be avoided for 5-6 weeks.
Driving can be resumed one day after surgery.
Sun exposure or UVA tanning can be resumed only two weeks after surgery: it is however recommended to use total sunblock on the surgical wounds for at least 3 months.