Published in February 1st, 2009
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The external ear, also called the Pinna, is one of the most overlooked components of facial appearance. These paired structures come in all shapes and sizes and both the size and shape can change over time. Most cultures instinctively have recognized the importance of the appearance of the ear as adornment with jewelry is almost universally accepted. Yet, the ears can also be a source of great psychological pain when their size and shape vary from socially accepted norms. This is especially true of young children who have to endure the taunts of playmates.
The size and shape of the ear is dependent on the underlying cartilage. Cartilage is the rubbery, semi-rigid, substance the body uses to give various structures, such as the nose, their shape and flexibility. The ear cartilage is made up of a series of folds and cup-like structures, all of which contribute to its final shape. If a person is born with too much cupping or not enough folds, the ear will be forced away from the side of the head and give the appearance of protruding. Once one gains understanding of the problem, you can then understand the treatment. The surgical procedure to correct this problem is called an Otoplasty, but may be more commonly known as an “ear pinning” or “ear reshaping.”
The first step is always to seek out a consultation with a board certified plastic surgeon. He or she will perform a thorough consultation. After a careful evaluation, he or she will describe, in detail, the proposed treatment plan and answer all of your questions. For children, the consultation should take place at about the age of three, with anticipation of treatment occurring at about the age of 4 or 5, prior to entering school. This will allow the child to avoid unnecessary teasing and the psychological consequences.
The goal of treatment is to create pleasing, symmetrical ears which are well shaped and well positioned in relation to the head. Each patient requires an individualized treatment plan carefully designed to fit his or her specific needs. An Otoplasty is designed to reshape the cartilage framework. This is done by a combination of creating new folds with permanent sutures, reducing excess cartilage and repositioning the whole ear complex closer to the side of the head. Incisions are usually placed in the groove behind the ear, thus making them well camouflaged.
Plastic surgeons usually perform the procedure in an outpatient setting. Most adult patients have their choice of undergoing the operation under either local or general anesthesia, while most children require general anesthesia. The procedure usually takes approximately 2 to 3 hours to perform. There is very little pain or discomfort associated with this operation and most swelling resolves in 10 to 14 days. Sutures are usually removed 7 to 14 days after the procedure. Patients are asked to avoid all exercise and lifting for two weeks after surgery. The operation is generally thought to be quite safe, but like all medical treatment there are risks, including the risk of infection, bleeding, asymmetry and the risk of anesthesia. However in the hands of the highly skilled surgeon, great care is taken to significantly minimize these risks.
The results of otoplasty are usually immensely satisfying to the patient. Years of psychological baggage can be wiped away, leaving one with a renewed sense of well-being, self-esteem and self-confidence. For children the procedure, when performed at an appropriate early age, can prevent years of difficulty in school and social situations.
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