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Cosmetic ear surgery

  • Definition
    • Cosmetic ear surgery is a procedure to improve the appearance of the ear. The most common procedure is to move very large or prominent ears closer to the head.

  • Alternative Names
    • Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty

  • Description
    • Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under local anesthesia, which numbs the area around the ears. You may also receive medicine to make you relaxed and sleepy. Or, it can be done under general anesthesia, in which you are asleep and pain-free. The procedure usually lasts about 2 hours.

      During the most common method of cosmetic ear surgery, the surgeon makes a cut in the back of the ear and removes the skin to see the ear cartilage. The cartilage is folded to reshape the ear, bringing it closer to the head. Sometimes the surgeon will cut the cartilage before folding it. Sometimes skin is removed from behind the ear. Stitches are used to close the wound.

  • Why the Procedure is Performed
    • The procedure is often done to reduce self-consciousness or embarrassment of the unusual shape of the ears.

      In children, the procedure can be done after they are 5 or 6 years old, when ear growth is almost finished. If the ears are very disfigured (lop ears), the child should have surgery early to avoid possible emotional stress.

  • Risks
    • Risks of anesthesia and surgery in general are:

      • Reactions to medicines
      • Breathing problems
      • Bleeding, blood clots, or infection

      Risks of cosmetic ear surgery include:

      • Areas of numbness
      • Collection of blood (hematoma)
      • Increased feeling of cold
      • Recurrence of the ear deformity
      • Keloids and other scars
      • Poor results
  • Before the Procedure
    • Women should tell the surgeon if they are or think they are pregnant.

      For the 1 week before surgery, you may be asked to stop taking blood thinners. These are medicines that make it harder for your blood to clot, and may cause increased bleeding during the surgery.

      • Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
      • If you are taking warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs.

      During the days before your surgery:

      • Ask which medicines you should still take on the day of your surgery.
      • Always let your health care provider know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery.

      On the day of your surgery:

      • You will most often be asked not to drink or eat anything after midnight the night before your surgery. This includes using chewing gum and breath mints. Rinse your mouth with water if it feels dry. Be careful not to swallow.
      • Take the medicines you have been told to take with a small sip of water.
      • Arrive on time for the surgery.

      Be sure to follow any other specific instructions from your surgeon.

  • After the Procedure
    • The ears are covered with thick bandages after surgery. Usually, you can go home after you are awake from the anesthesia.

      Any tenderness and discomfort can be controlled with medicine.

      The ear bandages are removed after 2 to 4 days. A head wrap or headband needs to be worn for 2 to 3 weeks to help the area heal.

  • Outlook (Prognosis)
    • Scars are very light and are hidden in the creases behind the ears.

      A second procedure may be needed if the ear sticks out again.

  • References
    • Adamson PA, Doud Galli SK, Kim AJ. Otoplasty. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 31.

      Thorne CH. Otoplasty. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 22.