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Ear Surgery Otoplasty

Information in spanish

Reshape, diminish, glue or reposition the ears, taking into account the general balance of the face

Ear surgery or Otoplasty is the cosmetic plastic procedure that is used to correct or improve the position, size, or shape of ears.  Otoplasty can also correct ears that have congenital deformities as well as those caused by trauma or disease.   Often, people with protruding ears endure ridicule and mockery while maintaining their own silence resulting in traumatic degradation of their own self-esteem.

Otoplasty is a surgical procedure that can resize the ears, making them smaller and setting them back closer to the head, according to the features of the patient.  As an otolaryngologist and a facial plastic surgeon, Dr. Espinosa takes some digital photos, which are the basis of the preoperative analysis for ear surgery.    Usually, ear surgery is done on an out-patient basis, and can be performed on children above the age of five because their ears are still growing.  Results from surgery may be observed one week after surgery.

The otolaryngologist and facial plastic surgeon can improve ears that are bent, as well as can correct ears damaged by trauma or birth defects.

If you or your child feels uncomfortable about his/her ears and feels that ears have an undesirable position, size or shape, it is possible he/she needs an Otoplasty. In the consultation, your surgeon will evaluate patient´s condition, and will recommend the most effective technique. The otolaryngologist and facial plastic surgeon considers both function and form, under scientific and anthropometric parameters.

At what age can otoplasty be performed?

Congenital or acquired ear deformities commonly include prominent and cupped ears and should be treated by surgery. Many children, who suffer dissatisfaction caused by prominent ears, may find an alternative in ear surgery. This procedure is usually performed after the age of 6-7, when ears are fully grown. A child’s ear reaches its final position by the age of 6; therefore patients under 6 years of age should not undergo ear surgery. Also, surgeons usually recommend parents to wait until after age 6, so child may understand what the surgery will do. A treatment performed before 6 may interfere with growing of ears. In any case, the decision to undergo ear surgery should come from the child, and nobody else. Parents should be informed about the process, as well as discuss their goals and expectations from otoplasty. Realistic expectations are prerequisites. Otoplasty for adults is also possible. However, firmer cartilage of fully developed ears does not provide the same molding capacity as in children. Having the procedure at a young age is highly desirable, because there is no risk that the cartilage “springs back” into its original position after surgery. If this occurs, a revision surgery may be needed. However, this is usually rare. In most cases, the results are very satisfying to the patient and family.

How otoplasty is performed?

The most frequent anatomical affection is the increase of the concho-mastoid or post auricular angle, followed by the bilateral loss of the antihelix, and (curved prominence of cartilage of ears). Otoplasty can correct these deformities through local or general anesthesia. The surgeon makes a small incision in the back of the ear (antihelix) to expose the ear cartilage. Then the cartilage is sculpted and bent it back toward the head.

This technique determines the symmetry and natural looking ear on each side. Occasionally, the surgeon may remove a piece of cartilage to provide natural shape. Ear surgery involves many operative techniques that are available to correct protruding ears. Most surgeons combine several procedures. Methods to perform surgery may vary. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage.

What kind of anesthesia will be used during the surgery?

Otoplasty may be performed with local anesthesia and on an out-patient basis. As most patients are children, the surgeon may recommend general anesthesia and intravenous sedation. For older children or adults, the surgeon may prefer to use local anesthesia, combined with a sedative. So patients may be perfectly comfortable and pain free during surgery. In any case, vital signs are constantly monitored, controlled and treated by the anesthesiologist, while patient is under anesthesia. These types of anesthesia provide the best and safest patient care possible. Specific anesthetic standards have been developed to ensure your safety. When the procedure is completed, the patient is taken to the recovery room, and later to a comfortable room. Some medications can be prescribed to minimize any discomfort. Patients are carefully monitored to observe any adverse side effect to anesthesia and stay in our medical center until Dr. Espinosa feels sure they have completed the recovery phase. Patients receive specific home-care instructions and medicine prescription.

What can be expected after surgery?

After the surgery, patients wake up quickly and comfortably, feeling no pain and experiencing no anxiousness. A pressure dressing will be placed around the head to compress the ears slightly, hold everything in place, and to promote healing. If the patient is an adult, he/she should arrange for someone to drive his/her home and to stay, at least for the first night following surgery. Patients should stay in our medical center until Dr. Espinosa considers they have completed the recovery phase. They should have also a prescription for pain medicine.

Bandages will keep on for at least 10 days following surgery. These bandages will promote the best molding and healing. As with most surgeries, there will be some bruising and swelling after the procedure. This is often normal especially after the first 24 hours.

It will be given prescriptions for use following surgery, including anti-inflammatory medicines to reduce swelling, oral antibiotics, as well as pain medications. Subsequent post-surgery visits will be scheduled to replace the head dressing and observe the healing process.

Frequently Asked Questions - Otoplasty

What to expect during your consultation?

During consultation, Dr. Espinosa may evaluate your general health status at the same time as he explains the way the procedure may be performed. In the first consultation, the surgeon examines and measures your face, takes digital photographs and analyzes them through computer, as he orders some lab testing. In a second visit, the results of your lab report will be evaluated and the physician will discuss with you the options available to you for otoplasty. In order to visualize the surgical possibilities, you and Dr. Espinosa will examine every angle of your face through the computerized images. He will be willing to solve any doubt. Good health and realistic expectation are prerequisites.

How long does an ear surgery take?

An ear surgery normally takes about two to three hours to perform, although complicated procedures may take longer. This will depend on the problem and techniques to perform.

Will there be any visible scar?

In ear surgery to correct deformities such as “shell ear”, an incision is made at the back of the ear, and the scars are hidden behind it. In most cases, ear surgery will leave a faint scar in the natural back fold of the ear, which is not very visible. In reduction otoplasty, scars will be less evident depending on the incision site, though surgeon’s ability.

What should I expect from ear surgery?

The patient´s head will be wrapped in a bandage for the first days following surgery, so immediate results will be seen when the bandages have been removed. The final outcome of ear surgery will not be visible for at least 6 months following surgery. Patients should keep in mind that swelling may persist for some time, but this will dissipate within days. Ears will gradually assume their new shape, as swelling resolve. Although rare, bruising may occur.

In each individual, the two ears are never equal or symmetric. In spite of all surgeon´s efforts, minor differences in shape or size may occur. Remember, the ear surgery goal is improvement, not perfection. Plastic surgery must be considered as an art and not as an exact science.

Can ear surgery make ears smaller?

Yes. Ear surgery can make large ears smaller by altering their size and shape.The facial plastic surgeon can create a more natural-looking ear.

Is there a risk of hearing loss after otoplasty?

No. Otoplasty is a surgery that is performed on the pinna or auricle, the visible and external part of the ear, which is completely separated from the ear cavity. Therefore, there is no risk of hearing loss after otoplasty.

How long does it take to recover from otoplasty?

Most people usually can be back to normal activities after one week. Patients should avoid strenuous activities for several weeks after surgery as well as contact sports. Three weeks after surgery bandages are removed and patients may see a more normal appearance of ears. Final results will be evaluated 6 months after surgery.

Dr. Espinosa´s special instructions:

Instructions before surgery:

  • Parents and the child should talk about what surgery involves,what will happen during and after surgery, and what are the expected results, in appropriate language.
  • Avoid taking aspirin (acetyl salicylic acid) or anti-inflammatory medicines.
  • Stop smoking at least one month before your surgery (adults).
  • Inform your surgeon about drug allergies, medical treatments, and current medications.
  • Both parents and the child should have realistic expectations about surgery.

Instructions after surgery:

  • Before you leave the medical center, make sure you have your surgeon’s prescriptions, medical certification, and date of your first post-operative visit to the office.

  • Your diet has no restrictions.

  • Although patients report minimal pain, they are discharged with post-operative analgesia. Please follow the dosage instructions. If you have severe pain, inform Dr. Espinosa immediately.

  • Avoid taking Aspirin (acetyl salicylic acid) or anti-inflammatory medicines.

  • You should be able to read or watch television after surgery.

  • You must rest at home at least during the first 3 to 5 days.

  • You must keep your head still as much as possible during the first 7 days. Do not turn your head from side to side. Move your whole body, if you must move.

  • Avoid strenuous activity, including exercise. Do not carry or lift heavy objects for 3 weeks. Light aerobic exercise is allowed just 3 weeks after surgery. Return to normal aerobic exercise after 6 weeks. However, Dr. Espinosa will observe your recovery and will let you know when you can resume your usual physical activities.

  • You can gradually resume your normal daily activities in about 15 days, as long as, you do not expose yourself to drastic changes in temperature. Avoid prolonged exposure to very cold or very hot temperatures.

  • Keep your head elevated during your recovery. Sleep on your back with your head elevated at least for 15 days. It is necessary to sleep strictly on your back so as to prevent swelling on one side or other complications. Sleep on two pillows to keep head elevated or use a wedge-shaped foam pillow. You must sleep face up.

  • During the first 14 days after surgery, it is recommended to sleep in a semi recumbent position. Sleep on your back and elevated 30-40 degrees. Do not sleep on your side. You cannot put any pressure on the ear areas.

  • As a surgical procedure has been performed on your ears you should not wear earrings at least for the first 6 weeks.

  • Avoid sun exposure as much as possible during the first two months. You must wear sun block and a covering to minimize sun exposure. Excess sun exposure may cause undesirable alterations.

  • You may gently shampoo your hair 72 hours after surgery, avoiding any strong rubbing or combing trauma to the incision around ear. Do not blow dry at least 5 days after surgery. Postpone any planned permanent or hair coloring for 4 weeks following surgery.

  • Post-operative swelling and ecchymosis around the treated area are very common until approximately 15 days, and should not be considered a complication. Any unexplained development of pain, facial swelling or fever should be reported to us immediately.

  • You may feel changes in sensation, including numbness of the ear lobules. This sensation will dissipate within weeks.

  • Subsequent post-surgery visits will be scheduled until the healing process is complete. It is very important for you to keep these appointments since they are vital to ensuring the best possible results from surgery.

The information provided here is not a substitute for a consultation. Please, do not hesitate to communicate with us if you are concerned about something you consider significant. Remember, the success of your surgery depends very much upon post-operative care. It is crucial that you follow your surgeon’s instructions.
Ear Surgery - Otoplasty

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