Reconstructive Ear Surgery

Otoplasty, otherwise known as reconstructive ear surgery or auricular surgery, is a wide range of cosmetic surgery designed to correct ear deformities either from birth (congenital) or following traumatic events (such as accidents, bites and burns). Otoplasty is considered by some as the most difficult form of cosmetic surgery, as it requires a combination of perfect technique and creativity from the surgeon.

 

Ear deformity causes high psychosocial concerns among children due to the constant teasing and taunting that they are exposed to during their formative years. Left unchecked, the constant bullying could lead to life-long psychological and mental scarring. This is why paediatricians recommend that otoplasty is performed on children before they start kindergarten. Statistically, the median age for otoplasty is 7 years.

 

Is otoplasty worth the hassle?

 

Yes, otoplasty is worth the hassle. It allows children and adults to avoid damaging social stigmatisation and psychological problems. Almost overnight, otoplasty can allow young children to reintegrate with their peer group without problem. A study conducted by Saarland University conclusively demonstrated that children who underwent otoplasty experience a significantly improved quality of life following the surgery. Perhaps more importantly, if otoplasty is carried out before pre-school, the affected child will never have to experience the vicious bullying that many children with deformed ears have had to endure.

Before and after images of a minor otoplasty procedure. Image courtesy of Wikimedia Commons.

What to expect during and after otoplasty surgery?

 

Children will be sedated with general anaesthesia during surgery while adults may choose just a local anaesthetic (if you are squeamish though, opt for a general anaesthesia).

 

No two deformities are identical, so there is no fixed approach to otoplasty. However, in most cases, surgeons will manipulate the ear cartilage to create a frame for the ear which will be filled with flap and skin graft. Depending on the complexity of the operation, the procedure can take anywhere between two and six hours. Patients will usually stay for a minimum of two nights following the surgery for observations and post-recovery support.

 

Upon discharge, patients will be expected to wear a rather prominent protective bandage around their head and they won’t be able to wash their hair. The bandage will be removed after about a week, but a smaller bandage/headband still needs to be worn at night.

 

In most cases, patients can expect full recovery within two weeks. However, patients must avoid participating in any contact sport, such as football and basketball, for at least three months after that. Swimming is also not advisable during the period owing to the risk of infection.

 

Possible Risks and Complications

 

Although ears are not ordinarily considered a vital and fragile organ, the procedure does carry some inherent risk and potential complications, including:

 

• Infection: This is possibly the biggest post-surgical concern. Frequently, infections of the cartilage or skin can be treated with antibiotics. However, if the problem is detected too late, it could necessitate another round of surgery.

 

• Bleeding: The formation of a blood clot (hematoma) under the surgical incision may lead to severe pain and inflammation. Painkillers can be used to manage the pain, but for small children, the risk of them ripping the bandage off is very real.

 

• Sutures: Complications may arise during the removal process if the suture breaks or falls apart.

 

• Asymmetry/Collapse: Owing to the high degree of subjectivity involved in the surgery, there is a risk of the surgery failing. The patient will have to undergo a second surgery to resolve the issue.