Otoplasty: What Is It, | Risks, Results, Options and Cost

Introduction

According to data from the ISAPS (International Society for Aesthetic and Plastic Surgery), 122,968 otoplasties were performed in 2021 in USA, an 18% increase over the previous year. The says that within this denomination, can be considered more than 250 different surgical techniques s, which increased year by year, not only for the description and previous update, but by the publication of novel techniques as is common in surgery: they need to stand the test of time, and therefore experience.

What is an otoplasty?

Otoplasty is an operation whose purpose is to correct the position of the separated ears, bringing them closer to the head. It is also an intervention that can reduce the size of large ears.

The prominent ears are the result of an anatomical defect. These abnormalities can cause an ear without a central fold (lack of anthelix), detached from the skull, or with a detached lobe. There may be a combination of these causes, and in these cases, it is the entire ear that needs to be glued but also reshaped.

According to, otoplasty allows to glue of the ears and correct the separation, it also achieves a remodeling of the cartilage that in many cases has not developed or folded correctly. If necessary, some cartilage or lobes can also be reshaped to modify the shape of the ear.

The morphology of the ear is conditioned by the underlying cartilaginous skeletal framework on which it depends, therefore it is the target of the modifications to be undertaken. There are various components involved, ranging from the morphology of the helical rim, the definition of the antihelix applications, or, on the contrary, the absence of them, a hypertrophic or malformed shell in its two portions, and fibro adipose lobe. The combination of anomalies affecting the above, either individually or jointly, is what determines the appropriate modification to be made to avoid the typical sequelae called “operated ear appearance,” says

Other alterations include the contracted ear, “cup-shaped”, “elf”, the lobe deficiency, or, on the contrary, its excess due to hypertrophy, or its deformity in the event of previous surgeries, including the inadequate lifting of the middle third causing its stretching.

The opportunity for its correction is established, in the child, whenever it is this who spontaneously requests it, before the most advanced school integration. It is considered in some cases from five years of age, due to the stability of the highest development achieved. In the young adult who chooses short hair, he can quickly improve his body image, facilitating personal interrelationships.

An article published in the National Institutes of Health states that ” aesthetic otoplasty remains one of the most important surgical techniques and common procedures in plastic surgery. Using an integrated approach guided by known principles, as well as patient goals, allows an optimal result in surgery “.

How can I know if I am a candidate for otoplasty?

Otoplasty can be performed by women or men who have prominent ears and this causes a complex. Puff ears are often ridiculed and represent a bigger problem for men, who can hardly hide them with short hair. The SEC states that young people in their 20s are usually the ones who undergo this surgery the most.

The opportunity for its correction is established, in the child, whenever it is this who spontaneously requests it, before the most advanced school integration. According to, it s and considered in some cases from five years of age, the stability of the highest development achieved. In the young adult who chooses short hair, he can quickly improve his body image, facilitating personal interrelationships.

Most plastic surgeons recommend that parents observe their children’s behavior regarding their ears. The issue should not be stressed before the child wishes, and should not be discussed with him about this intervention if he has not commented on his ears. Children who are self-conscious and have been teased by their peers will be the ones who will take the first step and talk to their parents about it. They are also the ones who cooperate the most during the intervention and are most satisfied with the result.

How is the first consultation carried out?

During the initial interview, the consultant’s expectations and wishes for results are described, which the plastic surgeon will interpret in its proper measure through an understandable and simplified language, to convey the well-differentiated reality of what is imaginary.

Having ruled out any contraindication during the study of preoperative tests, including hemogram, hemostasis, biochemistry, and electrocardiogram, the date of the intervention can then be established, which must invariably take place in the hospital environment, completely refraining from performing it in any other setting.

How to choose a surgeon for ear surgery?

According to, the most important task of the consultant is to correctly choose the repairing plastic surgeon to whom all their concerns will be transmitted, and to perceive that they have been fairly understood, only in this way will it allow the definitive results to be approximated to The desired ones. For this reason, it recommends:

1. Check that the experience of the Specialist in Complex Reconstructive Surgery of the ears is abundant and diverse, not only the title, showing real images, not digitized or manipulated.
2. The specialist’s sense of harmony in terms of results.
3. The ability to repair second surgical times of sequelae derived from others, even secondary ones.
4. Years of experience, due to the significance of the results for both the consultant and the plastic surgeon himself.

As with any cosmetic surgery, it is important to choose a SECURE-certified plastic surgeon. To do this, you can enter their official website and verify their studies and training. We also recommend that you visit the clinic or hospital where the procedure will be performed and check the state of the facilities. In Spain, only surgeons specializing in plastic, reconstructive and aesthetic surgery, as well as maxillofacial surgeons, are authorized to perform an otoplasty.

How is ear surgery performed?

The indication of the type of anesthesia is conditioned especially by the previous state of health, in addition to the idiosyncrasy of the patient himself, considering that: if he were a collaborator, in most cases sedation-analgesia combined with blockages and nerve infiltrations is feasible sensitive of the ear. While in children ‘s age, and according to cases, p ou can be supplemented with general anesthesia to enable their successful conclusion.

It is usually an outpatient intervention, which in most cases does not require hospitalization, simplifying all its stages: from access to hospital facilities to convalescence.

Each surgeon has his technique and will adapt it according to his case and what he believes is the best option. The procedure takes 30 minutes to 1 hour for each ear and is done on an outpatient basis. Here are the general lines of the surgery:

• During the operation, an incision is made in the back of the ear, in the natural fold, and a scar is left that will be well hidden, even invisible.
• The surgeon dissects to remove the skin and access the cartilage.
• Next, reshape the cartilage. The objective is to recreate or enhance the natural reliefs (creation of the anthelix fold). Sometimes the surgeon must remove excess cartilage before repositioning the ear and placing the skull pocket. In the case of a reduction in the size of the ears, the surgeon can also make this correction at that time.
• Then check that the ears are symmetrical and place the stitches with absorbable threads.
• Finally, put the bandages on.

How is the postoperative?

The bandage applied immediately after finishing the intervention, is reviewed in less than twenty-four hours, and is exchanged for a containment band, which considerably improves comfort, allowing its use for two to three immediate weeks depending on each case treated, to protect the morphology desired.

Sometimes there are more or less marked changes in skin coloration that are explored in the first treatment. As in most surgeries, protective measures against the external environment include avoiding excessive heating by solar or environmental radiation, exposure to crowds, and trauma, in addition to humidity, during the first month of convalescence. The restoration of protective sensitivity is gradual, being observed over weeks or months. Wound care is simple, providing written instructions for its execution, and allowing shortly, labor reintegration, always appropriate to the type of activity and risk.

We carry out a close follow-up at regular intervals, adjusted to the evolutionary course of each patient, to certify the results, both in immediate and delayed convalescence: several months and a year, to especially prevent, or correct if necessary any subsequent event. Although the complete de-inflammation lasts for around a year, the new shape obtained is revealed when the bandage is removed, and it is refined around the first months of convalescence, says Dr. Carlos Cuesta Romero.

For the first few days, the ears are bruised and may show signs of edema, these signs disappear after about a week. The patient should avoid sleeping on their side for the first two weeks and will wear a lighter elastic band to prevent the ear from bending and the internal stitches from loosening. “The patient must wear an elastic band during the first week of the intervention to avoid possible unexpected blows and facilitate the new position of their ears. Afterward, you will only have to put it on to sleep for 2 more weeks, ”

It is normal for the scar area to be read during the first weeks and it can even feel hard to the touch, so the massages indicated by the surgeon should be performed for proper healing.

In most cases, there will be hidden behind the Orech minimal scarring. However, the final scar can be evaluated after 6 to 12 months and depends on the surgeon’s incision, the achievement of stitches, and respect for postoperative care.

Recovery is very fast and the postoperative period is easily tolerated because it is a painless procedure. Most patients can resume normal activity after a week. It is recommended to avoid constantly looking in the mirror, bruises and swelling need several days before disappearing.

Risks and possible side effects of otoplasty

There are general risks, common to most surgeries, such as:

• Non-externalized bleeding that can be complicated by hematoma and residual deformity if not treated promptly. They should not be confused with transient bruising or ecchymosis.
• Local pain due to the perception of an anchoring suture, which sometimes appears late, when sensitivity has been recovered.
• Externalization and infection of some internal anchoring suture, which when it happens, is usually delayed, after months of the intervention. It is usually resolved through its extraction by the Specialist, to prevent cartilaginous damage (chondritis), without other inconveniences.
• Alterations in the scar, which is systematically hidden in the posterior groove, thus significantly reducing the risk of exposure to other people’s vision.
• Dehiscence or separation of wound edges, therefore it is an important condition to prevent any type of humidity.

Specific Otoplasty Risks:

• Depending on the deformity treated, the more complex the more likely, depending on the management of the tissues overlying the cartilage, considerable edema may appear, with different skin tones.
• The irregularities of the contour can occur with a delay, as the discontinuity of modeling cartilage but are rare in conventional otoplasty.
• Differences in morphology such as asymmetries, and even closeness to the skull, which is usually temporary, resolve spontaneously.
• Partial recurrence of the original deformity, due to the suture used, accidental traction, or sometimes inadvertent trauma. This event should always be diagnosed without hiding it so that its repair is effective and simplified.

What are the results?

The new shape of the ears, previously separated, can be seen as soon as the bandage is removed. The final result is obtained between 6 and 12 months when the inflammation is eliminated. The psychological benefits are usually immediate, improving the self-esteem and social relationships of the person.

The patient needs to work with their physician to set real goals regarding the appearance of their ears. You must bear in mind that it is normal to find small asymmetries after the operation because it is practically impossible to make two ears completely the same.

What are the other techniques to perform an otoplasty?

Earfold

These implants have revolutionized otoplasty by allowing this procedure to be performed without surgery and ensuring satisfactory results in just 20 minutes under local anesthesia. Earfold implants are U-shaped, made from a metal alloy, Nitinol, and covered with 24-karat gold. Before the procedure, they allow the patient to determine the location of the implant with their surgeon, to get an idea of the degree of correction to be achieved by drawing the location of the implant.

One of the advantages of ear folds is that we have a prefold to see the result before deciding on the procedure. These simulators are placed in the ear above the skin to see how it will look and decide the placement and position of the final implant, says Dr. GranadoTiagonce.

Tensioning wires

This technique offers excellent results without the need to make large incisions, it is a simple method, without scars, and much less invasive than conventional ear surgery. The tensioning threads are placed in 20 or 30 minutes, and it is done through mini-sutures behind the ears, as in a traditional intervention.

Frequent Asked Questions

• From what age can children have surgery on their ears? From 6-8 years old because it is when they start the second school cycle to avoid possible trauma originating in childhood. At this age the ears have already developed, practically reaching their final size.
• How long will I be off? Everything will depend on your work. If you work in front of the public, you must be of one week, while if not, you can go to work in 2 days
• What is scar-like? The scar is made on the back of the ear and will be hidden in the back crease and will be imperceptible over the months, even in patients with short or tied hair.
• How long does the intervention last? The approximate duration per ear is 1 hour, so in the case that the ear surgery is bilateral, the estimated time is 2 hours.
• What is otoplasty without surgery? A metal implant called an earmold is placed under the skin that folds the cartilage. In this way, the ears are glued.
• Is it possible to Earfold with an incision at the back of the ear instead of the usual front part? The ear fold device is placed anteriorly.
  Talk it over with your surgeon.

• What are yellow bubbles in ears?: It is a matter of a complaint in the context of tissues suffering from a vascular deficit. The content is serous, currently NOT purulent, and its course, depending on the thickness of the damaged tissue, is usually spontaneous evacuation. It is important to maintain a prophylactic application of the topical antiseptic ointment, interspersing oil anoints, to protect affected tissues. When there are doubts, which I repeat is NOT your case, samples can be taken for culture and antibiogram to identify the presumed opportunistic micro-organism.

• Lump in the ear after an otoplasty The scar response to the surgical procedures to which you have been subjected, requires experienced management in this type of complication, otherwise, successive untimely treatments may even worsen the current situation even more. Get honest and disinterested face-to-face information first, and then, unhurriedly, make the most timely decision.