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Cosmetic Ear Surgery ~ Otoplasty
Prominent or protruding ears can be a source of embarrassment and mental anguish for many people, especially children. In the past few decades, thousands of individuals have been physically as well as psychologically helped through a surgical procedure called otoplasty. Otoplasty, sometimes described as "ear pinning", is designed to change their shape and contour. It may be performed on anyone over the age of five or six years old, the age at which ear growth is almost complete. For those children with severely protruding ears, it is recommended that ear surgery be performed at an early age, before they are subjected to psychological stress related to the condition.
Before Ear Surgery
Prior to cosmetic ear surgery, a medical history is taken in order to evaluate the general health of the patient. A careful examination is also conducted. The cosmetic surgeon and patient or, in the case of a minor, a family member, discuss how the ears should look and what can realistically be expected. The type of anesthesia to be used, the procedure, and possible risks and complications are also discussed. Photographs are usually taken before and after surgery. Preoperative instructions may include the elimination of certain drugs which contain aspirin for several weeks before the procedure in order to minimize the possibility of excess bleeding. Patients may be instructed to shampoo their hair with an antiseptic shampoo the night before surgery.
The Procedure
 Otoplasty can be performed in a cosmetic surgeon's office, an outpatient surgical facility or a hospital, depending upon the cosmetic surgeon's and patient's preference. It can be done under general anesthesia with the patient asleep or under local anesthesia in which the area is numbed and the patient remains awake. Premedication may be administered to relax the patient.
There are several surgical procedures which are designed to bring the ears closer to the head.  A basic procedure involves an incision made at the back of the ear to expose firm, pliable tissue called cartilage. (Fig. A) The cosmetic surgeon may either fold down the cartilage and use sutures to keep the folds together (Fig. B) or remove excess cartilage. After reshaping the cartilage, the incisions are closed with small sutures and the ears are covered with bandages. The procedure can take up to two hours or more depending upon the extent of surgery.
Following Ear Surgery
Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bandages are removed within a few days but may be replaced with a lighter head dressing. Wearing a tennis headband for a period of time to hold back the ears may also be recommended. Bruising around the area occurs but fades within a few weeks. Some temporary swelling occurs but this condition can be alleviated by keeping the head elevated when reclining. Patients may be advised to sleep on a soft pillow but not directly on the ears. Six to eight days after surgery, patients may, be allowed to shampoo their hair. Scars from the incisions fade significantly in time and are, for the most part, inconspicuous because the incisions are made within the creases of the ears. Although patients are usually up and around one or two days after surgery, the decision as to when normal activities can be resumed is determined by the cosmetic surgeon and is based on the extent of surgery and the patient's hearing process.
Each year thousands of otoplasties are successfully performed. Occasionally a second procedure is necessary if an ear begins to protrude again. Complications of infection are rare; however there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the cosmetic surgeon prior to surgery. Patients can minimize complications by carefully following directions given by the cosmetic surgeon.
If you are interested in learning more about cosmetic ear surgery, contact Southcenter Cosmetic Surgery in Seattle and we will be happy to answer your questions.
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