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Ear correction surgery or otoplasty is one of the few cosmetic surgical procedures permitted or recommended for children, because unusual ears can make a child a victim of bullying. Even in the absence of bullying, unusual ear shapes can make a child or adult self-conscious and affect self-esteem.

Otoplasty can pin back, reshape or reduce the size of ears, making them more symmetrical and proportionate relative to the size and shape of the face and head.

This article provides you with basic information you need before making a decision for your child (or yourself) to undergo ear surgery: Who should consider having it, how it is performed and what you can realistically expect as outcomes. This is not intended to be a comprehensive guide to ear surgery; nor should it be considered an alternative to a thorough and detailed discussion with your chosen facial plastic surgeon.

Successful outcomes in ear surgery, as with all surgery, are a result of teamwork and rapport between you and your facial plastic surgeon. Only your surgeon can answer questions about what specific changes might help improve your appearance.

Is Ear Surgery Appropriate for You or Your Child?

It is essential that you elect to have ear surgery with realistic expectations. A positive attitude to surgery is essential in all procedures, but is even more important if the patient is a child or adolescent who requires parental support, approval and guidance in the decision process.

Otoplasty does not change a person’s hearing ability. It only changes the aesthetics of the outer ear, which you can see. Parents should opt for otoplasty only if they feel that it is in the best interests of the child, not just in terms of appearance, but also in terms of physical and psychological wellbeing. A thorough and detailed discussion with a facial plastic surgeon may help you make an informed decision.

Ear correction surgery can take place at any age. In children it is best performed after the ear reaches its adult size, which usually occurs by the age of five or six years. At this point, the cartilage in the ear is still pliable, making reshaping easier. Rather than waiting until the child is older, early correction will help the child’s confidence and boost emotional wellbeing.

Ear correction surgery is performed on adults, but by that time ear cartilage has become firmer and does not possess the same moulding capacity or flexibility it had during childhood. A consultation with a surgeon should tell you what outcomes are possible in your situation.

As with all elective surgery you must be in good health at the time of surgery.

Before Choosing to Have Ear Surgery

Choosing a facial plastic surgeon you can trust is one of the most important decisions you have to make before electing to have ear surgery for your child or yourself. Your trust should be based on the verifiable qualifications and expertise of the surgeon, his or her reputation and past experience with this type of surgery. The rapport you develop with your surgeon during the initial consultation process is also very important.

After examining the structure of your child’s ears or your own, the surgeon will discuss the problems and possible corrections that can be made. The surgeon will discuss all the surgical options with you during this consultation, addressing the risks involved with the procedure. This discussion should be an open and honest exchange of ideas between you and your surgeon, which will help establish reasonable expectations for the outcomes of surgery.

Sometimes, only one ear needs to be pinned back, but your surgeon may recommend surgery on both ears to achieve a more natural and symmetrical appearance.

Ear surgery is sometimes combined with other facial plastic surgery as well as with non-surgical procedures.

When you have decided on the surgery, and you and your surgeon agree on the best course of treatment, your surgeon will describe the surgical facility where the procedure will take place and explain the type of anaesthesia that may be employed.

Most surgeons recommend general anaesthesia for young children. For older children, adolescents and adults, a local anaesthetic combined with a mild sedative will be recommended.

You will be asked to provide a thorough medical history to help your surgeon take into account any medical conditions that may increase the level of risk during surgery.

As part of the informed consent process, your facial plastic surgeon will also explain to you alternative means, if any, that are available to achieve the same outcome and inform you of the costs involved for those procedures.

Understanding the Surgery

The incisions for ear correction surgery are made behind the ear, in the natural fold where the head and ear join.

To reshape or change the size of the ear, the surgeon will remove the required amounts of skin and cartilage. In other cases, the cartilage will be trimmed and pinned back with permanent sutures to secure it in place. Where only pinning back the ear is required, little or no cartilage will be removed, but stitches will be used to ‘pin back’ the ears permanently. Your surgeon will use sutures to anchor the ear to the desired position until it heals.

A typical ear correction surgical procedure takes about two hours to complete.

What to Expect After Ear Surgery

Some mild discomfort is natural after an ear correction procedure. After surgery, your surgeon will apply soft dressings to the ears. These will have to remain in place for a few days.

Your surgeon will provide you with instructions on how to care for yourself or your child during the recovery period. It is important to follow these instructions closely in order to get the best results.

To avoid putting any pressure on the ear area, your child cannot sleep on his or her side after this procedure. That means sleeping on his or her back, which could cause temporary sleep disruptions. You can place pillows on either side of your child to prevent movement during the night

Your surgeon may recommend wearing headbands to hold the ears in the desired position for up to two weeks after the surgery.

Risks involved with otoplasty are minimal. There may be a thin whitish scar behind the ears upon healing. It rarely bothers people because it is barely visible. For many people the scar will be hidden by hair.

If you or your child experiences anything unusual after surgery, contact your surgeon immediately.

Additional information

In general, insurance does not reimburse costs of elective cosmetic surgery. But if ear correction surgery is performed to correct or improve birth defects or to treat traumatic injuries it may be reimbursed fully or partially.

Just to be sure, always check with your insurance plan on the specifics of coverage.

You can find accredited facial plastic surgeons who perform ear surgery among members of the Australasian Academy of Facial Plastic Surgery.