Otoplasty is a cosmetic and or reconstructive surgery to change the appearance of a person's external ears. Otoplasty can take many forms, such as bringing the ears closer to the head (often called ear pinning), reducing the size of big ears, or reshaping various bends in the cartilage. Other reconstructive procedures deal with deformed or absent (microtic) ears or after excision of cancer or from traumatic injuries. Otoplasty surgery can involve a combination of moving, reshaping, adding, or removing structural ear elements. Many adults who wear ear rings often require repair of the ear due to lacerations or as a consequence of ear gages.
Anesthetic options depend on the problem to be treated and ability of the patient to cooperate and can include local anesthesia alone, local anesthesia with sedation, and under general anesthesia (which is generally the case for children). Most otoplasty surgery is performed as an outpatient surgery. The average procedure takes about 60 to 90 minutes.
Dr. Denys prefers the child is old enough to understand their condition so they may assist with post-operative care. In children the best time for surgery is from age 5 to 7, about the time they begin school and are noticed by other children. This is also a time when the ear has reached about 70 percent of the adult size and the cartilage is still pliable and easier to modify. Photographs are always obtained, and in some cases a mold is made of the ear to permit Dr. Denys to study the ear prior to surgery. To achieve the best results, careful analysis of the ear structure is needed. Many patients have more than one feature that requires modification in order to create an ideal result. It is common to require rotation of the ear and placement of a series of sutures to create natural ear folds. This operation is a fusion of artistry and technical skill. After surgery, a bandage is used to hold the ears in position for 24 hours. Once the bandage is removed, a headband or stretch hat is worn daily for two weeks except while at school, and for another 4 weeks at night.
The majority of cases have excellent outcomes. The most common problem is slight asymmetry and this may be impossible to prevent as most of the time ears are not the same shape or size prior to surgery.