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Cosmetic ear surgery

Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty

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.

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. It can also be done under general anesthesia, in which you are asleep and pain-free. This is the preferred method of anesthesia in children. The procedure usually lasts about 2 hours.

Medicine to make you relaxed and sleepy

Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedur...

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General anesthesia

General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...

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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.

Stress

Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...

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Risks

Risks of anesthesia and surgery in general are:

Reactions to medicines
Breathing problems
Bleeding, blood clots, or infection
Blood clots
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
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Risks of cosmetic ear surgery include:

Areas of numbness
Collection of blood (hematoma)
Infection
Increased feeling of cold
Recurrence of the ear deformity
Keloids and other scars
Keloids
A keloid is a growth of extra scar tissue. It occurs where the skin has healed after an injury.
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Poor results

Before the Procedure

Women should tell the surgeon if they are or think they are pregnant.

For the one week before surgery, you may be asked to stop taking blood thinners. These medicines may cause increased bleeding during the surgery.

Some of these medicines are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
If you are taking warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these medicines.

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 likely 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. Typically, you can go home after you are awake from the anesthesia.

Any tenderness and discomfort can be controlled with medicine. The ear bandages are usually removed after 2 to 4 days, but may stay on longer. A head wrap or headband needs to be worn for 2 to 3 weeks to help the area heal.

Be sure to call your surgeon if you have severe ear pain. This can be due to infection of the ear cartilage.

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.

Open References

References

Adamson PA, Carniol ET, Gantous A. Otoplasty. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 31.

Thorne CH. Otoplasty and ear reduction. In: Rubin JP, Neligan PC, eds. Plastic Surgery: Volume 2: Aesthetic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.

Text only

Ear anatomy - illustration
The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.
Ear anatomy
illustration
Medical findings based on ear anatomy - illustration
The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including earlobe creases, preauricular pits, and preauricular tags.
Medical findings based on ear anatomy
illustration
Eardrum repair - series
Presentation

<strong>Eardrum repair - series</strong><p>The tympanic membrane (eardrum) separates the outer ear from the middle ear. The membrane vibrates when sound waves strike it, beginning the process that converts the sound wave into a nerve impulse that travels to the brain. </p>

<strong>Indication</strong><p>Ruptured or perforated eardrums are usually caused by middle-ear infections or trauma (for example, an object in the ear, a slap on the ear, explosions, or repeated, excessive ear pressure from flying or diving). If healing does not occur with antibiotics or other non-operative treatment, surgery may be necessary. Chronic middle ear infections are described as 5 or more ear infections in a year, or 3 or more ear infections a year over a two-year period. Signs of chronic ear infections include persistent ear pain, ear drainage, or hearing loss (over a 3-month period).</p>

<strong>Procedure</strong><p>While the patient is deep asleep and pain-free, (general anesthesia), the surgeon grafts a small patch from the fascia of the forehead muscle (temporalis) onto the eardrum. This graft is used to repair the tear. For problems with the small bones (ossicles), the surgeon will use an operating microscope to view and repair the chain of small bones using plastic devices or ossicles from a donor.</p>

<strong>Aftercare</strong><p>In most cases, the operation relieves pain and infection symptoms completely. Hearing loss is usually minor. However, if the ossicles require repair, outcome may be less optimal. Patients usually leave the hospital the same day. After surgery, it is important to avoid getting water in the ear. Use a hair cap when showering for a few weeks.</p>

Ear surgery - series
Presentation

<strong>Ear surgery - series</strong><p>This image demonstrates normal appearance of the ears in relation to the face.</p>

<strong>Indication</strong><p>Ear surgery may be performed to set disproportionately large or prominent ears closer to the head.</p>

<strong>Procedure</strong><p>Thousands of ear surgeries (otoplasties) are performed successfully each year. The surgery may be done in the surgeon's office-based facility, in an outpatient surgical facility, or in a hospital. The surgery is performed while the patient is awake but pain free (local anesthetic) or deep asleep and pain free (general anesthetic). The procedure usually lasts about two hours, depending on the extent of the correction needed. The most commonly employed technique is one in which the surgeon makes incisions in the back of the ear and removes skin to expose the ear cartilage. Sutures are used to fold the cartilage to reshape the ear. Other surgeons choose to forgo sutures in favor of cutting or abrading the cartilage before folding it. The ear is brought closer to the head by creating a more pronounced fold (called the antihelix) in the central portion of the ear.</p>

<strong>Aftercare</strong><p>The ears are covered with a bulky, moderate pressure dressing following surgery. There is usually some tenderness and discomfort, that is easily controlled by medication. Most patients leave the hospital on the same day, or shortly thereafter. Within two to four days, the outer pressure dressings are removed but the patient is asked to wear a light head dressing for two to three weeks to promote healing. Faint scars are concealed in the flexion creases behind the ears; there are no incisions in front of the ears. </p>

Ear anatomy - illustration
The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.
Ear anatomy
illustration
Medical findings based on ear anatomy - illustration
The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including earlobe creases, preauricular pits, and preauricular tags.
Medical findings based on ear anatomy
illustration
Eardrum repair - series
Presentation

Ear surgery - series
Presentation

Review Date: 12/10/2021

Reviewed By: Tang Ho, MD, Associate Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Cosmetic ear surgery

Description

Medicine to make you relaxed and sleepy

General anesthesia

Why the Procedure Is Performed

Stress

Risks

Blood clots

Keloids

Before the Procedure

After the Procedure

Outlook (Prognosis)

References

Ear anatomy - illustration

Ear anatomy

Medical findings based on ear anatomy - illustration

Medical findings based on ear anatomy

Eardrum repair - series

Ear surgery - series

Ear anatomy - illustration

Ear anatomy

Medical findings based on ear anatomy - illustration

Medical findings based on ear anatomy

Eardrum repair - series

Ear surgery - series

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