Otoplasty.

What otoplasty corrects

Otoplasty reshapes, repositions, or reduces the ears. I see it for ears that stand out noticeably from the head, for ears that do not match each other, for ears that are simply large, for congenital shapes such as a lop ear or a cupped ear, and for earlobes that have torn or stretched from heavy earrings or gauges. For some adults it answers something they have been self-conscious about for years; for parents it is often about a child who is about to start school.

Children and adults

Ear surgery is one of the few cosmetic operations routinely done in children, because the ear reaches most of its adult size early, around five or six years of age. Operating before school begins can spare a child some difficult attention. With children I take particular care over the experience itself, for them and for their parents. Adults can have otoplasty at any age, and the principles are the same.

How I approach the cartilage

The shape of an ear is the shape of its cartilage, and that is where the work happens. I make the incision behind the ear, in the crease where it meets the head, so the scar sits out of sight even with the hair worn up or short. For an ear that stands out, the main correction is to reshape the antihelical fold, the inner curve of the cartilage: I score and shape it, then hold the new fold with permanent internal sutures. When the bowl of the ear, the concha, is too deep and pushes the whole ear outward, I reduce it, often alongside reshaping.

The aim is proportion rather than flatness. An ear set too tightly against the head is as noticeable as one that stands out. I almost always operate on both ears in the same procedure, because comparing one side with the other as I go is the best way to reach symmetry. For both ears the operation usually takes one to two hours, under local or general anesthesia. There is more on ear surgery in Newport Beach at Allure MD, including earlobe repair.

Earlobe repair is the smallest version of this work. A torn, split, or stretched lobe can be repaired in the office, along the natural contour of the lobe, and the ear can usually be pierced again after six to eight weeks.

Recovery

Recovery is one of the gentler ones in plastic surgery. For the first day or two the ears are protected with a bandage, and discomfort is generally mild to moderate and well controlled with medication. Sleep on your back, with the head raised. After a few days the bulky dressing gives way to a lighter headband. At about a week, children can go back to school and adults to desk work, with the headband still worn at night for the next few weeks to protect the ears during sleep. Contact sports wait until the swelling has settled, typically after a month or two, when the ears are in their final position.

The correction is permanent. The ears continue to age as ears do, but their new shape and position hold. Very rarely the cartilage’s memory causes a small relapse, and that can be addressed with a minor touch-up.

At consultation I will examine the ears, show you what I would change and what I would leave, and, for a child, talk through timing with the family.

Cartilage reshaping  ·  Conchal reduction  ·  Earlobe repair  ·  Children & adults