Otoplasty

Otoplasty in children is performed under general anesthesia. In adults, it may be performed under general anesthesia or local anesthesia, with or without sedation. Most otoplasties take about two hours to complete. Many plastic surgeons prefer to use absorbable sutures during otoplasty to minimize the risk of altering the ear’s shape by removing stitches later. The specific technique depends on the changes you aim to make. Dr. Moradzadeh will customize your otoplasty to meet your specific needs.

There is no single, universally accepted technique for performing a setback otoplasty. Variations in the procedure are due partly to the different causes of ear protrusion. The patient’s ear may have a large concha (the shell-like hollow of the external ear); the angle of the fold in the ear cartilage may cause the ear to protrude; or the ear lobe may be unusually large.

After the patient is anesthetized, the surgeon makes an incision behind the ear, in the fold of skin where the ear meets the head. In one technique, the surgeon exposes the ear cartilage beneath the skin and reshapes it to recreate the natural fold in the ear cartilage (Mustarde sutures). If the conchal bowl is large and pushing the ear out too far, the cartilage is bent back toward the head and secured in place with non-removable sutures (Furnas sutures). Removal of cartilage is sometimes referred to as a conchal setback.

Another procedure for protruding ears involves removing excess skin and suturing the cartilage back onto itself. This technique reshapes the ear without removing cartilage; it is sometimes referred to as a cartilage-sparing otoplasty.

After the surgeon finishes reshaping the ear and carefully dries the area, the incision is closed. The ear is then covered with a soft dressing moistened with Vaseline ointment.

General good health and realistic expectations are prerequisites. It is also important to understand what’s involved with the surgery and what it can and cannot accomplish. For example, otoplasty does not improve hearing.

While a positive attitude toward surgery is an important factor in all facial plastic surgery, it’s particularly critical in otoplasty—especially when the patient is a child or adolescent. A consultation with Dr. Moradzadeh can help parents decide what is best for their child, not only aesthetically, but also psychologically and physically. Timing is always an important factor to consider. Dr. Moradzadeh does not perform surgery on children under four years of age, but having the procedure at a young age (starting at around 5 or 6) is highly desirable for two reasons: The cartilage is extremely pliable, allowing greater ease of shaping, and the child will experience psychological benefits from the cosmetic improvement.

Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears is less pliable than in younger patients.

During the initial consultation, Dr. Moradzadeh will examine the structure of the ears and discuss a range of options for correcting the problem. Even if only one ear needs “pinning back”, surgery will probably be recommended on both ears to achieve the most natural, symmetrical appearance.

Otoplasty can improve the appearance of protruding, asymmetrical, or otherwise unusual ears. One major benefit is improved facial balance, as ears that sit closer to the head or have a more natural contour tend to blend seamlessly with the rest of the face.

For children, otoplasty can help reduce teasing and self-consciousness at an early age. For adults, it often provides long-standing confidence and eliminates the need to hide ears with hairstyles or accessories.