Otoplasty (Prominent Ears) Newport Beach
Otoplasty is a commonly performed procedure, particularly for school-aged children aged 6 to 8. The prominent ear variant (we don’t like the word “deformity,” and we really don’t like “dumbo ears”) is a condition where the ear cartilages mature with certain features overdeveloped and others underdeveloped. Kids often tease each other over their physical features, unfortunately, and children with prominent ears often experience self-esteem issues. Accordingly, otoplasty is often performed early in school-age when the ears have grown sufficiently to be able to be operated on safely without affecting their maturation, but at a time when the patient is young enough to hopefully not have developed too much self-consciousness. Some patients who grow into adulthood with uncorrected prominent ears may still benefit from efforts to correct the prominence, although results are a bit better when the surgery is undertaken at a younger age. Otoplasty is often referred to as “ear pinning,” although the procedure is quite a bit more complex and nuanced than simply setting back the ears closer to the head. Understanding otoplasty requires understanding some of the key landmarks of the ear.
Otoplasty surgery usually is offered to help correct one or more of these features of the prominent ear:
- An excessively deep ear hollow (the conchal bowl, or the area where you can put your fingers in to safely clean)
- A poorly defined antihelix – the Y-shaped cartilage that gives the ear some of its texture and shape
- A flanged out earlobe (kind of like a telephone shape to the ear)
- An usual angle between the ear and the head which makes the features of the ear more visible from the front
Otoplasty surgery is usually done under general anesthesia and requires that the patient wear a special dressing to protect the ears in the first week or two. The results of otoplasty are almost immediately apparent although sometimes we “over-correct” the pinning to account for some relaxation that happens as the ears heal. It is common to perform this procedure during a summer break for school-aged children so that they have time to fully heal before returning to school. This may also make for a more seamless return to activities with other children.
Preparation for an otoplasty begins with measuring and examining the landmarks of each ear and taking photos in multiple positions to determine which maneuvers are required. Otoplasty techniques may include removal of a portion of the deep conchal bowl, placing stitches to define the antihelical fold, anchoring the conchal bowl against deeper internal structures to set the ears back, removing a portion of the earlobe or changing its orientation, and other steps taken to improve ear shape and projection. The ear is carefully marked preoperatively and the surgeon will turn the patient’s head several times during surgery to try to make the ears as symmetrical as possible. Mild differences may persist but these are rarely very noticeable to others.
1. How do I know if I am a candidate for otoplasty surgery?
Some of our selection criteria to include you or your child as a otoplasty candidate include:
- Prominent ears (one or both), including possible conchal bowl excess, poorly defined antihelical fold, protruding earlobe, and excess ear show from the front
- General good health, meaning the patient does not have major uncorrected cardiovascular, respiratory, kidney or other major organ conditions and – if the patient is an adult or a child with medical problems – the patient is able to get medically cleared by a primary care doctor or a designated internal medicine/pediatric physician who will perform a comprehensive physical examination and review preoperative laboratory studies. Most otoplasty patients have no problems with hearing but if there is any prior history of hearing loss, a consultation with an Ear/Nose/Throat doctor and/or audiologist might be requested (this is very rare)
- Nonsmoker or willing to commit to NO NICOTINE IN ANY FORM for at least 3 weeks preop and for the duration of your recovery (obviously this is not applicable to most school-aged kids)
- Available support system of friends, family, caregivers or others who can help the patient to keep your appointments, complete your preop and postop tasks, and emotionally bolster the patient through this exciting journey – parents especially may need some support as their child’s features change a bit with pinning of the ears, and the child may need special help to make sure the surgical site is treated carefully
- Reasonable expectations of how much correction is possible with specific techniques – sometimes the ears will looks a bit overcorrected in the beginning, and there is a small risk of some prominence returning (though it is rare that the ears would return to their fully prominent preoperative position)
2. How long does otoplasty surgery usually take?
Most otoplasties can be done in three hours or less, under general anesthesia. Older adults might be candidates for surgery under local anesthesia but Dr. Sayed prefers not to have to inject too much medication, which may swell the ears, when performing such a delicate and nuanced procedure.
3. What is recovery from otoplasty surgery like?
Most otoplasties are performed on an outpatient basis in a AAAASF-certified operating room, meaning the facility is up to very high standards of accreditation. Patients usually spend up to a couple hours in the postoperative suite before being discharged in the care of a companion, family member (commonly a parent as these are usually young children), or friend. Dr. Sayed gives a 24 hour phone number to all patients who can reach him for urgent questions, and we also issue access to a patient engagement application that allows the patient or companion/caregiver to send SMS messages, photos, video and other content to our team in a secure, private digital format. This keeps us mutually informed on your recovery and allows us to update your instructions while requiring a respectful number of face-to-face visits in the office.
Early postop recovery findings can include ear bruising and swelling, mild discomfort, muffled hearing from wearing the protective dressings, a small amount of drainage, dryness, and some mental adjustment to the process of healing which most patients undergo. Usually the majority of swelling subsides within a couple of days and bruising is either resolved or easily concealed within 7-10 days. The surgery is best done during school breaks so the patient does not have to miss school. Stitches are often dissolvable although some sutures may need removal in 10 days or so. Incisions require minimal application of topical antibiotics. The main precaution has to do with keeping the patient out of certain exercises/sports while the ears are healing, in order to reduce the risk of pulling through sutures.
We ask that the patient abstain from exercise for 2 weeks and then return to light fitness routines after that. If possible, the patient may need to be kept out of a season of organized sports depending on the timing of surgery. Dr. Sayed and his team provide close postop care in the office and with our remote engagement tools. You will be asked to take some supplement medications to aid in your recovery, which may include medications fo pain, bruising, swelling, and dietary optimization.
4. How long do otoplasty results usually last?
Otoplasty is one of the most satisfying operations for surgeon, patient and family alike. This can be quite transformative. Many patients have permanent correction of the ear prominence. A small minority of patients may need touchup surgery if the ear relaxes somewhat after surgery. This is often easy to do under local anesthesia for adults, but may require some sedation in younger children. We aim to not have to perform revisions but in the interest of full disclosure and honesty, all plastic surgeons have to do occasional revisions to optimize satisfaction. Our revision rate for otoplasty is under 5%.
5. How can I prepare for my (or my child’s) otoplasty surgery?
- Have a reasonable expectation of what surgery can accomplish
- Look at before and after photos and understand what kinds of techniques may be employed
- Don’t expose the patient to smoke or nicotine in any form for at least 3 weeks and ideally longer before (and after) surgery
- Stay well rested and well hydrated and eat a nutritious diet balanced with plenty of protein
- Designate a caretaker who will help the patient through the first 5 to 7 days after your otoplasty. Parents in co-parenting situations should confer and discuss a postoperative plan well before surgery.
- If you are a parent of a child considering otoplasty, have an honest and direct conversation with your child about the child’s wishes, what to expect, and how the process will work. We can help educate you through this process
6. How much does an otoplasty cost in Southern California?
We don’t like to publish pricing as it is subject to market changes and dependent on the types of procedures you consider. We do have a fee schedule available in the office after your consultation, and we can give you an estimate through virtual consultation tools available on this site like our Zwivel® page. Feel free to contact us for a pre-consultation and we are happy to provide more information. We understand that for parents of young children considering otoplasty, this is a complex decision-making process, and we promise you will never feel pressured to push your child to undergo this surgery as your child is beautiful with or without correction of prominent ears. We do participate in financing programs that can ease your concerns about paying for surgery if you decide it is in the best interest of your beloved child. Either way, we can promise you our team will treat your child like we were treating our own children!