OTOPLASTY

If prominent, misshapen or asymmetrical ears make you feel self conscious about your appearance, book a consultation to find out how our corrective procedures can help.

let's put those ears in their place

What is an ‘otoplasty’?

Ear pinning surgery, also known as otoplasty, improves the shape, position or proportions of the ear. Otoplasty can correct a defect in the ear structure that is present at birth, prominence that becomes apparent with development - or misshapen ears caused by an injury. Otoplasty creates a natural shape, while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self esteem. This procedure is most commonly performed in children, but can also be performed on teenagers and adults. If protruding or disfigured ears bother you or your child, book a consultation with a qualified specialist plastic surgeon to discuss otoplasty surgery. The images on the right show an adult female before and 3 months after otoplasty surgery performed by Dr Sharp.

Otoplasty surgery can treat:

  • Overly large ears (a rare condition called macrotia)
  • Protruding ears occurring on one or both sides in varying degrees (not associated with hearing loss), sometimes described as ‘bat wing’ ears
  • Adult dissatisfaction with previous ear surgery
  • Trauma or injury to the ear that has altered its shape

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Candidates for otoplasty surgery can include:

  • Children aged 5 years or older (due to stability of cartilage)
  • Patients who are able to communicate their feelings and do not voice objections when surgery is discussed
  • Patients who are able to communicate their feelings and do not voice objections when surgery is discussed
  • Healthy adults or children who don’t have a life threatening illness or untreated chronic ear infections
  • Non smokers
  • Patients who are able to follow post operative instructions, specifically the necessity to keep dressings intact around the head for the first week post operatively, and wear a compression band around their ears in the weeks following surgery. Adherence to post operative instructions is integral to a good result
  • Individuals who have a positive outlook and specific goals in mind for ear surgery; this procedure improves the appearance of the ears, but it will not perfect the ears, so it’s important to have realistic goals and be patient as healing and scar maturation takes time.

Most importantly, otoplasty is something you should only do for yourself - not to fulfill anyone else’s expectations about your appearance.

Below: before and 3 months after otoplasty surgery with Dr Sharp

Is otoplasty surgery covered by Medicare or private fund rebates?

In some cases, yes. If you are aged 18 years or younger and have an ear deformity that causes your ears to be visibly prominent, a Medicare Benefits Schedule item number may apply. If you meet the criteria for this item number and have private health insurance, you may be eligible for rebates on your a portion of your surgeon’s fees, anaesthetist’s fees and hospital costs. If you don’t have private health insurance and you meet this criteria, Medicare may rebate a small portion of your surgeon’s fee and anaesthetic fees.

What happens during ear surgery?

Step 1 – Anesthesia
Most otoplasties are performed under general anaesthesia, meaning you are asleep for the entire procedure.

Step 2 – The incision
Correction of protruding ears uses surgical techniques to create or increase the antihelical fold (just inside the rim of the ear) and to reduce enlarged conchal cartilage (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within its folds to make them as inconspicuous as possible. Internal, non-removable sutures are used to create and secure the newly shaped cartilage in place.

Step 3 – Closing the incisions
External stitches close the incision. Techniques are unique to each case, taking care not to distort other structures and to avoid an unnatural appearance. You will wake up with a large bandage-like looking headband around your head, which will remain in place until it is removed at 1 week post surgery.

Step 4 – Results
Ear surgery offers near immediate results in cases of protruding ears, visible once the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

Ear surgery recovery

Discomfort immediately following ear surgery is normal and can be controlled with pain medication. There may be an itchy feeling under bandages, which is normal. It is essential that bandages remain intact and are not removed, for any reason. Failure to do so may result in loss of some of the correction and may require a secondary surgery. It is important to avoid any activity that may bump or dislodge the dressings, and prop yourself up on pillow or in a comfortable armchair to sleep, so that you do not roll onto your side or disrupt the dressings.

Some questions to ask your surgeon at your pre operative consultations include:

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • What will my dressings/bandages look like after surgery? When will they be removed, and how long do I wear my support garment?
  • Are stitches removed? When?
  • When can I resume normal activity/work/exercise?
  • When do I return for my post operative appointments?

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Important facts about the safety and risks of ear surgery

The decision to have ear surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

Otoplasty risks include:

  • Bleeding (hematoma)
  • Blood clots
  • Asymmetry
  • Infection
  • Poor wound healing
  • Change in skin sensation
  • Skin contour irregularities
  • Skin discoloration/swelling
  • Anesthesia risks
  • Unfavorable scarring
  • Allergies to tape, suture materials, glues, blood products, topical preparations or injected agents
  • Pain, which may persist
  • Possibility of revisional surgery

Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Where will my surgery be performed?

Ear surgery should be performed in a hospital. It is usually performed as a day procedure, meaning you go home on the same day as your surgery. Dr Sharp operates from Southbank Day Hospital in Brisbane, Greenslopes Private Hospital in Brisbane and St Andrews Private Hospital in Ipswich.

What to expect during your otoplasty consultation

The success and safety of your procedure depends very much on your adherence to post operative instructions, and having open communication with your surgeon both pre and post operatively. You’ll be asked a number of questions about your health, desired result and lifestyle - it’s important to be honest, so your surgeon can assess if you are ready for this procedure.

Be prepared to discuss:

  • Your mindset around the surgery; why you want the procedure, your expectations and desired outcome
  • Medical conditions, drug allergies and medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, cigarettes and drugs
  • Previous surgeries

Your surgeon may also:

  • Step you through your Informed Financial Consent documentation, including diagrams of the surgical process and the risks and complications you may experience
  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Take clinical photographs for your medical record
  • Discuss your options and recommend an alternative
  • Discuss likely outcomes of ear surgery and any risks or potential complications specific to you

Otoplasty: words to know

Antihelical fold: A fold that is just inside the rim of the ear.
Conchal cartilage: The largest and deepest concavity of the external ear.
Constricted ear: Also called a lop or cup ear, has varying degrees of protrusion, reduced ear circumference, folding or flattening of the upper helical rim, and lowered ear position.
Cryptotia: Also called hidden ear, occurs when the upper rim of the ear is buried beneath a fold of scalp secondary to abnormal folding of the upper ear cartilage toward the head. The folding is the reverse of that commonly seen in the protruding ear.
Ear axis: The main line of ear growth.
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Macrotia: Overly large ears; a rare condition.
Microtia: The most complex congenital ear deformity when the outer ear appears as either a sausage-shaped structure resembling little more than the earlobe, or has more recognizable parts of the concha and tragus or other normal ear features. It may or may not be missing the external auditory or hearing canal. Hearing is impaired to varying degrees.
Otoplasty: A surgical procedure also known as ear surgery to improve the shape, position or proportion of the ear.
Stahl’s ear: An ear that is distorted in shape due to an abnormal fold of cartilage.

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