Ears (Otoplasty)

Otoplasty, cosmetic ear surgery

Otoplasty is a cosmetic surgery procedure which aims to correct various anomalies and deformities of the ear, the most common of which are:

• “Cabbage leaf” ears due to hypertrophy of the cartilage (the concha) which deploys forward.
• The “protruding” ears which give this impression due to too great a retro-auricular angle.
• Ears whose pinna has a too smooth appearance and a lack of relief resulting from a lack of plication of the cartilage (the antihelix).

Otoplasty permanently corrects these anomalies by remodeling the cartilage. The ears are “glued back” symmetrically and regain a natural size and appearance.

Who is otoplasty for?

This intervention is done for aesthetic and psychological reasons. People with these malformations are the target of derogatory remarks, mainly children at school. Otopasty can put an end to this problem.

At what age should you have surgery?

Otoplasty can be performed no earlier than the age of 5. The operation is also very often requested by adults who can do it at any age.
Whatever the age, it is important that the approach comes from the person themselves and not from those around them. If it is a child, you must carefully check that the decision does not come from parental pressure. Children who are teased are perfectly capable of expressing their desire to have surgery on their own.

Before the procedure

A careful examination of the ears is carried out by the surgeon. It analyzes anomalies and suggests modifications to be made taking into account the entire face.
10 days before the procedure, the patient must refrain from taking any aspirin or anti-inflammatories.
The hair must be washed thoroughly the day before the operation. For those with long hair, a ponytail is welcome, otherwise hair cut very short is ideal.

Hospitalization arrangements

The procedure is generally carried out on an “ambulatory” basis, meaning the patient returns home the same day after a few hours of monitoring.
Depending on the age and tolerance of the patient, several anesthesias are possible:

• pure local anesthesia,
• anesthesia with intravenous neuroleptanalgesic
• classic general anesthesia.

The choice will be made with the surgeon and the anesthesiologist.

What does otoplasty involve?

Otoplasty is an ear surgery that lasts on average half an hour to an hour and a half. It consists of four phases of incision, dissection, remodeling and suturing.
The skin incisions are made in the retroauricular groove, that is to say in the natural fold behind the ear; This is where the scar will be hidden. A few discreet additional incisions may possibly be made in the anterior surface of the pinna, but these will be hidden in the folds of the ear.
During the dissection phase, the skin is peeled off to access the cartilages which are thus revealed. These will then be grated in order to be softened so that they can be remodeled and recreate or improve the natural reliefs. The plications will possibly be maintained by fine sutures.
Finally, the pinna is brought back into the correct position and secured with stitches.
A bulky dressing is then applied.
Depending on the anesthesia, discharge is planned for the same evening or the next day.

Operative consequences

Following the procedure, the ears take on a swollen and swollen appearance. Fortunately, this aspect is only transitory and should not give rise to concern about the result because the edema and bruising will disappear quickly.
Normally moderate pain will be relieved by analgesics and anti-inflammatories.
The first dressing will be removed between the 2nd and 5th day. It will be replaced by a lighter bandage for a few days.
A support band should be worn day and night for around two weeks, then only at night for a few weeks.
During this period, physical activities with risks of contact with the ears should be avoided. Also extreme cold should be avoided because the sensitivity of the ears is temporarily reduced, there is a risk of frostbite.

Possible complications during otoplasty

An otoplasty, although carried out for aesthetic and psychological reasons, nevertheless remains a real surgical intervention with the risks associated with any medical procedure, however minimal. It therefore always involves a certain amount of hazards of which one must be aware.
Complications related to anesthesia will be discussed during the consultation with the anesthesiologist.
Regarding the risks associated with the surgical procedure, real complications are very rare. The vast majority of procedures go smoothly and patients are generally very satisfied.
Complications that may occur exceptionally are:

• Postoperative bleeding which may require further intervention.
• A hematoma that it is often preferable to evacuate.
• Skin necrosis. It is very rare and can result from circulation problems in skin that is too thin.
• Inflammation of the scars located behind the pinna which can then hypertrophy abnormally.

How long does it take to see the results?

You have to wait one to three months before being able to appreciate the final result, the time necessary for the tissues to soften and for the edema to be absorbed. The reliefs of the ear may then appear.
After this time, the scars will still be a little pink before fading.

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