Otoplasty

If you are considering surgery of the ear….

Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. For the most part, the operation is done on children between the ages of 4 and 14. Ears are almost fully grown by age 4, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

If you’re considering ear surgery for yourself or your child, the information below will give you a basic understanding of the procedure — when it can help, how it’s performed, and what results you can expect. All of your questions won’t be answered, however, since a lot depends on your individual circumstances. Scheduling an appointment with Dr. Paula Legere will be necessary so that you will have the answers to anything you don’t understand about the procedure.

All surgery carries some uncertainty and risk.

When ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

A small percentage of patients may develop blood clot on the ear. It may dissolve naturally or can be drawn out with a needle. Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

Planning For Surgery

Most surgeons recommend that parents stay alert to their child’s feelings about protruding ears; don’t insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

In the initial meeting, Dr. Legere will evaluate your child’s condition, or yours, if you are considering surgery for yourself, and recommend the most effective technique. She will also give you specific instructions on how to prepare for surgery.

Where The Surgery Will Be Performed

Dr. Legere performs most outpatient procedures, like this one, at Premier Surgery Center in Brunswick, Georgia. Premier is the only multi-specialty outpatient surgery center in the Golden Isles. Their dedicated staff will meet your needs with care, compassion and confidentiality that you expect and deserve. At Premier Surgery Center, they strive to provide a level of care with surpasses your expectations. You can visit their website at www.premiersurgeryctr.com.

Types of Anesthesia

If your child is young, she may recommend general anesthesia, so the child will sleep through the operation. For older children or adults, she may prefer to use local anesthesia, combined with a sedative, so you or your child will be awake but relaxed.

The Surgery

Ear surgery usually takes about two to three hours, although complicated procedures may take longer. The technique will depend on the problem.

With one of the more common techniques, Dr. Legere makes a small incision in the back of the ear to expose the ear cartilage. She will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, she will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.

Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.

In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for better balance.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include local, intravenous sedation or general anesthesia. Dr. Legere will recommend the best choice for you.

Step 2 – The incision

Correction of protruding ears uses surgical techniques to create or increase the antihelical fold (just inside the rim of the ear) and to reduce enlarged conchal cartilage (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within its folds to hide them. Internal, non-removable sutures are used to create and secure the newly shaped cartilage in place.

Step 3 – Closing the incisions

External stitches close the incision. Techniques are individualized, taking care not to distort other structures and to avoid an unnatural “pinned back” appearance.

Step 4 – See the results

Ear surgery offers near immediate results in cases of protruding ears, visible once the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

Getting Back To Normal

Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the hospital with a child until all the effects of general anesthesia wear off.

The patient’s head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication.

Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Be sure to follow Dr. Legere’s directions for wearing this dressing, especially at night.

Stitches are usually removed, or will dissolve, in about a week. Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work about five days after surgery. Children can go back to school after seven days or so, if they’re careful about playground activity. You may want to ask your child’s teacher to keep an eye on the child for a few weeks.

Other Ear Problems

Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: “lop ear,” when the top seems to fold down and forward; “cupped ear,” which is usually a very small ear; and, “shell ear,” when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases or wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury.

Sometimes, however, the correction can leave a scar that’s worse than the original problem. Ask Dr. Legere about the effectiveness of surgery for your specific case.

More Natural-Looking Ears

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly — perfect symmetry is both unlikely and unnatural in ears. If you’ve discussed the procedure and your expectations with Dr. Legere before the operation, chances are, you’ll be quite pleased with the result.