Ear surgery

An operation in which prominent ears are re-sculpted and re-positioned closer to the head. No-one has perfect or symmetrical ears, so the goal of surgery is to de-accentuate and set back the ears, not to get both ears to match perfectly.

Generally, on children after the age of 4 to preserve ear growth. For children with one or both ears prominent, their appearance becomes a constant source of teasing and heartache. Correcting it makes a vast difference to their self-confidence and body image. I would generally aim to do this for a child before the age of 5.

Some people summon up the courage to have the surgery as adults; there are no added risks and the operation is technically less challenging.

Otoplasty takes about 90 minutes and can be done under local or general anaesthetic. Incisions are hidden in the crease behind the ear, and I use soluble skin stitches – so nothing needs to be taken out. Your head will be bandaged for a week and then you will need to wear an elasticated, head band (like some tennis players wear) at night for 4 weeks or so.

Scars are hidden behind the ear and usually fade to be almost unnoticeable after a year. Prominent ear correction is one of the most heartening operations to perform, because almost every patient is delighted.

The commonest complication is failure to achieve the desired result – but this is usually easily corrected by re-operating. I will always do this without charge if I think I can improve an operative result.

Despite precautions, occasionally ears become infected, and rarely, but significantly, if this infection spreads and cannot be controlled by antibiotics, damage and destruction of the cartilaginous framework of the ear may result which can leave the affected ear deformed.

Bleeding and bruising may complicate ear surgery, and this may require re-operation to find the origin of the bleeding. Occasionally, the blood supply to the skin of the ear can be damaged resulting in a skin ulcer – this usually heals with dressings and is most common with a technique that I do not use (for this very reason!)

Finally, especially in dark skinned races, there is a risk of adverse scar formation and especially of keloid scarring – which is a bulky, sometimes painful scar which spreads beyond the incision margins.

Ear lobes generally split for two reasons: first, when earrings get caught and are torn out of the ear lobe traumatically; and secondly, every few years, as fashion demands heavy, dangling ear rings, the inevitable result is that the weight enlarges and finally pulls through the ear piercing in a proportion of  ears.

The operation usually takes an hour and is usually done under local anaesthetic. The cleft is repaired and the piecing obliterated. Skin stitches will need to be removed after 7 days and I usually ask you not to re-pierce your ears for 6 months.

Generally, very good, so far, I have yet to have a patient who wasn’t pleased with the results of their reconstructive surgery.

The commonest complication is infection, which is usually controlled and treated with antibiotics. The second common complication is adverse scar formation and especially of keloid scarring in patients from dark skinned races.