Otoplasty

Both adults and children are born with ' big ears' or sticky out ears called prominent ears. This can produce both functional problems or cosmetic concerns for the patient. Children can be taunted or teased. This can result in low self esteem. For people who need to wear helmets like in the military, prominent ears may get in the way.

The ears that stick out can be pinned back towards the head. This is called otoplasty. There are different types of otoplasty hence there is a need for a pre operative consultation. The most common type will be dealt with here. The patient ususally complains the ears stick out and place the ear back to show the ear shape they want.

When to have a otoplasty

The decision to have an otoplasty should be carefully made by you and in conjunction with the plastic surgeon, or for a child, with the child and the parents. It is important to have an examination with Dr Mahajani who will also like to know a detailed history of any ear problems. Sometimes otoplasty is not suitable and other procedures are suitable. For children, if the child is not bothered by the problem, then there is no need to do the operation. I would usually perform an otoplasty after the age of 6 when the ear has grown to 90 % of its adult size. Patients who are healty with realistic expectations of the surgical outcomes are good candidates for this surgery.

Before the operation

Discuss any queries regarding the operation and post operation requirements with Dr Mahajani and his staff. Any fee enquiries please discuss with the practice administration. Do not smoke 2 weeks before the operation to 3 months after the operation. Smoking significantly affects the wound healing. Stop any medications you have been advised to by the anaesthetist. Go to your anaesthetic appointment. We will give you the name of your anaesthetist so you can make contact with them. We will give you your operation date and time. Please bring the completed consent form with you.

What does the operation involve

The operation is performed under sedation or general anaesthetic as a day case or overnight stay. The incision is made behind the ear. The cartilage of the ear is then reshaped to create the curve that is absent in the prominent ear. In additon, the cartilage is then anchored closer to the head to fixthe sticking out component. The cartilage is not removed. Once the ears are reshaped, the incision behind the ear is stitched and bandages applied.

After the operation

In most instances you go home or are admitted for one night. There is pain relief but as this wears off, more pain relief is needed : 1. Resting over the next few days 2. Sleeping head up. 3 Take the antibiotic ointment and and any pain killers 4. There may some little bleeding. 5 The head bandage is worn all the time for the first week and at night for the second week.

Stitches are removed after 1 week in our office. There is a final appointment at 6 weeks to ensure all is fine and take post operative photos. You should rest the next day but resume normal activities 48 hours after surgery. Contact sports however should be avoided for 6 weeks. If you have fever, temperature, discharge or marked bleeding, please notify the practice.

Risks complications and expectations of otoplasty surgery

For most patients, the otoplasty is a safe and successful operation but we would like to discuss what to expect after the operation along with risks and complications.

The ears are initially swollen and will bruise. This bruising can extend down to the cheeks . Most swelling and bruising settles over 1-2 weeks but occasionally can take longer. 90% is gone by about 2 weeks but the rest of the swelling can take weeks to settle, the majority over 6 weeks.

The scars usually heal very nicely and are generally inconspicuous and hide behind the ears but occasionally can thicken. We cannot always predict outcomes of scars and occasionally scars stretch or thicken.

Asymmetry

There may be a little asymmetry after the otoplasty. Often this is a reflection of pre operative asymmetry and there is always asymmetry in between the ears . This is usually not noticeable and doesn need correction. The operation may be slightly different for ear to ear and depends on the degree of asymmetry however the aim is also to make the ears as symmetrical as possible. Despite this, some slight asymmetry does occur.

Pain

This is not usually a painful operation but there is some pain that takes 1-2 weeks in most to settle, sometimes a little longer. It is unusual to have more severe pain, this may mean some other problem and may need investigation including a referral to other practitioners.

Infections are very uncommon and usually settle with ointment or antibiotics. Severe infections like necrotic infections requiring surgery are extremely rare. It is uncommon for the cartilage to get infected but if it does occur, then it may need to be surgically addressed - see complications to cartilage.

Bleeding

There may be a little bleeding but this should be slight. If there is severe bleeding please notifiy Dr Mahajani

Complications to the cartilage

With this operation there may be damage to the cartilage which is uncommon but may cause some deformity of the ear. This is rare and may need surgical correction if it occurs. Occasionally, one part of the corrected ear is a little overcorrected and it may require a revision. This is also uncommon.

Loss of cartilage memory

In some cases, the reshaped cartilage may not hold it's shape. It may spring back. This is uncommon but it will require a revisional procedure.

Realistic expectations from a otoplasty

It is important for your expectations to be realistic. We will try as far as possible , within the constraints of your physical health and the state of the ears and your wishes to help you achieve your goals. The surgeon cannot guarantee all expectations and nor can guarantee the longlasting effect as the ageing process continues and there may be other variations. Sometimes other procedures are required, and infrequently sometimes severe complications are encountered. We will endeavour to the best of our ability to help you where possible. Rarely, it may be required to seek the help of other specialists. If you however have any concerns at any time please feel free to contact the practice. You are always entitled to second opinions at any stage and we are happy to help facilitate this for you if you so desired.