Otoplasty, or ear reshaping surgery, is a cosmetic procedure performed to reshape the ears into a proper position, improving the confidence level of patients who are suffering from mental and psychological issues due to deformed ear shapes.
It is performed for the following conditions:
- Prominent ear: This occurs when the ear is bent forward, creating a larger distance between the ear and scalp. The ear appears more projected forward from both the front and lateral views, and its shape may not be ideal.
- Bat ear shape
- Constricted ears
- Stall ear: A condition where an extra cartilage piece is present.
Evaluation and Preparation
The patient visits the clinic for a detailed assessment, which includes a thorough history and examination of the ear and the patient’s concerns. Examination is performed from the front, side, and back views to assess the ear’s position and the shape of various structures, including the helix, antihelix, concha, and lobule. Any extra or deformed cartilage is also examined.
After the assessment, the procedure, expected recovery, and any potential side effects are discussed with the patient. Baseline blood tests are advised to assess the patient’s fitness for anesthesia.
Procedure
- Prominent or deformed ears: If the patient visits after birth, the condition may be managed without surgery by using headbands to maintain proper ear position. However, after six months to a year, when the cartilage elasticity reduces, surgery is usually required.
- Surgery timing: Ear reshaping surgery is typically performed after the age of 4. In young children, it is performed under general anesthesia, while adults can undergo the procedure under local anesthesia.
After anesthesia, the ear is painted and draped to maintain a sterile environment and prevent infection. Markings are made on the back of the ear, and infiltration is done. An incision is then made, and the skin flap is elevated to expose the cartilage. Markings are redone on the cartilage to create the shape of the antihelix, which is usually absent in these patients. Using non-absorbable proline sutures, the antihelix shape is created.
The concha is assessed, and if necessary, a portion of it is removed. The prominent concha is repositioned and sutured to the mastoid area. The lobule’s position is then assessed and adjusted if required. Hemostasis is secured, the skin is closed, and dressing is applied.
Postoperative Care and Recovery
- Hospital stay: The patient is kept for one day in the hospital if the procedure is performed under general anesthesia and is discharged the same day. If performed under local anesthesia, the patient is usually discharged on the same day.
- Head positioning: The patient is advised to keep their head elevated with pillows and lie straight to avoid pressure on the ears.
- Headband usage: After one week, the dressing is removed, and the patient is advised to wear a headband to keep the ear in its new position. The headband should be worn for 4-6 weeks for the ear to set properly into its new shape.
- Stitch removal: Stitches are removed from the back of the ear after 7-10 days.
- Recovery: Swelling and bruising will generally subside within 1-2 weeks. The proper shape is usually achieved after 6-8 weeks.
Benefits and Side Effects
Benefits
- Proper repositioning of the ears.
- Ability to wear short haircuts or styles of choice, as patients no longer need to hide their prominent ears with long hair.
- Females can wear their desired hairstyles without covering their ears.
- Increased confidence levels.
- Relief from psychological stress.
- Reintegration into society with a positive outlook.
Side Effects
Though side effects are minimal with an experienced surgeon, potential risks include:
- Swelling
- Bruising
- Recurrence of the problem if proper care is not taken
- Asymmetry in 5-10% of cases between the two ears
- Hypertrophic scarring
Costs
The cost of otoplasty or ear reshaping surgery in Pakistan is variable, typically ranging from 70,000 to 1,10,000 Pakistani rupees.