Ears that stick out too far or are too prominent can be a great source of embarrassment, especially for children in school. Children can be called “Dumbo” or have other derogatory comments made about them. Fortunately, there is a relatively simple procedure called Otoplasty to correct this problem. Other names for this procedure include “pinning back ears”, “correction of protruding ears”, “ear reshaping”, “cosmetic ear surgery” and “ear reduction surgery”. This is one of the few cosmetic surgeries that can be done on a child.
The primary goal of an otoplasty (ear pinning back surgery) is to bring the ears back closer to the head. Usually when the ears are excessive and noticeable, it is because they protrude from the scalp. Normally the ears should be at a certain angle with respect to the scalp and should not protrude more than about 1.8 centimeters (2/3 of an inch) from the scalp. If the ears “stick out” excessively they appear larger than normal. It is actually quite rare for the ears to be truly larger than normal, most often they look that way because they are not in the proper position.
Usually ears that protrude also lack a certain characteristic called the antihelical fold. This is a natural crease in the ear that runs just inside the ear near the outer rim. When this fold is absent, the ears will protrude. Part of the surgical correction of the ear is to create an antihelical fold.
Another part of the protruding ear is the chonchal bowl. This is the cup part of the ear near the ear canal. This is often large and protruding and part of the surgical correction of the ear is to bring the conchal bowl back closer to the head.
Sometimes the ears are uneven, with only one ear protruding. We can pin the protruding ear back and make it more similar to the other ear.
Fortunately, the ears are essentially fully grown by age 7 or 8. This means the surgery can safely be performed at an early age. Usually we recommend an otoplasty as early as age 7. This is so the patient can have the ears corrected and avoids the trauma that can occur in school regarding the protruding ears. Young school children can be tactless. Often patients will report that they have been called names such as “dumbo” or “monkey ears,” etc. Because of this, we try to perform ear reshaping surgery (otoplasty) before a patient reaches first or second grade. However, the surgery can be performed at any age and we actually perform cosmetic ear surgery (ear reduction surgery) more on adults than on children.
As with any surgery, Otoplasty (ear reshaping surgery) varies slightly with regard to the different shapes and positions of the ear. In adults otoplasty (ear reshaping surgery) is usually performed under local anesthesia with or without some sedation. In children otoplasty (pinning ear back) is usually performed under general anesthesia of IV sedation.
A small elliptical incision is made along the back of the ear and some skin is removed from the back of the ear. Special permanent mattress sutures are placed into the ear cartilage. The permanent sutures are used to bend the ear cartilage back towards the head and at the same recreate the deficient antihelical fold. Sometimes after surgery it may be possible to feel the sutures. There is little we can do about this and the patient must be willing to accept this as the sutures must be permanent and remain behind the ear under the skin. Usually the chonchal bowl is also enlarged or protruding (the deep cup part of the ear). Usually a permanent or dissolvable suture is placed to pin the cartilage of the cup part of the ear back to the scalp. The incisions are closed behind the ear. After ear reshaping surgery (otoplasty or ear pinning back surgery) there will be a small thin scar located behind the ear.
The recovery after otoplasty (ear reshaping, ear reduction surgery) is one of the easiest of any cosmetic surgery. The pain is usually mild and pain pills are only needed for a couple of days after otoplasty (cosmetic ear surgery). The ears will be a little bruised and swollen for 5 to 14 days. Typically it is not noticeable unless specifically looked for. Usually patients who have ear reshaping surgery (otoplasty) are used to hiding their ears behind their hairstyle. The patient may return to work or school after only a few days unless their work involves strenuous physical activity. We do ask the patient to wear a strap around the ears continuously for three days and at night for an additional three weeks after ear pinning back surgery (ear reduction surgery). This is to prevent the patient from rolling over while asleep and accidentally pulling the ear forward and tearing the sutures in the early healing phase.
Dr. Lane Smith, a board-certified surgeon, is known as one of the best plastic surgeons in Las Vegas and the western united states.* Ear reshaping surgery (ear reduction surgery) is a common procedure and Dr. Smith has performed hundreds of these procedures (Otoplasty). If you are concerned about your ears and would like to know if ear reshaping surgery (ear reduction surgery) is right for you the best thing is to schedule a consultation with Dr. Smith. This can be done by calling (702) 838-2455 or by filling out the contact form section on this website.