Otoplasty (Ear Surgery)

Otoplasty is a reconstructive ear surgery procedure that modifies the shape, size, and prominence of the ears in children and adults. Dr. Darrell Perkins offers ear surgery at our practice in Sydney and Sutherland Shire, and has performed otoplasty surgery on many patients from across New South Wales to help make their ears appear less prominent.

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Overview

Prominent ears are a congenital condition in that they are present from birth and are developmental in nature. They are evident from an early age and become more evident as a child grows. Because of this, we offer reconstructive ear surgery to young children from Sydney, Sutherland Shire, and nearby areas.

There are several advantages to correction of the ear at a relatively young age. The main one is to avoid the issues of a child being teased at school.  We generally recommend otoplasty for children who are between four to six years old. Children are not body-conscious until age six or seven, and thus correction at an earlier age prevents children from being teased.

Children at this age also tolerate reconstructive ear surgery well and can bounce back with few problems. In addition, a child’s ear cartilage is very soft, pliable, and easily mouldable at this age, which helps in some of the technical aspects of the reconstructive ear surgery.

However, otoplasty can be performed at any age on any patient at our practice. Dr. Darrell Perkins has operated on numerous patients of all ages. For more information about reconstructive ear surgery at our practice serving Sydney, the Sutherland Shire, the South Coast and New South Wales, please contact the office of Dr. Darrell Perkins today.

The Surgery

Reconstructive ear surgery is comprised of two elements: removing some skin from behind the ear and re-shaping the cartilage to make the ears less prominent. During otoplasty, incisions are created behind the ear and an ellipse of skin is removed to pull the ears back. Scars are not readily visible, even from behind. Patients usually form an excellent scar.

The ear cartilage itself is elastic in nature and has a memory. The otoplasty technique used involves going through the posterior (back) aspect of the cartilage and scoring the anterior (front) surface to allow it to bow back permanently. Then, sutures are used to hold the outer fold of the ear. Otoplasty gives the ears a natural shape and brings the actual plane of the ear back to a position that is more parallel to the side of the head.

Otoplasty surgery is usually performed under a general anaesthetic as a day procedure, and generally takes 1 hour.  A compression bandage is applied upon completion of the procedure.

Recovery

Reconstructive ear surgery is routinely performed as a day operation. However, patients who wish to stay overnight are able to do so.

Once recovered and ready for discharge, post-operative instructions covering wound care, medications and follow up appointment will be given.

It is essential that a responsible adult collect the patient and stay with them for the first 24 hours following the surgery.

All of the sutures placed during otoplasty are dissolvable, though a weaving suture is usually tied over a bolster behind the ears to keep the repair in place for a period of about six days until the bandage is taken off.

When the ear surgery bandage is removed, the ears may have some degree of swelling and bruising, which normally resolves quickly in the following weeks.

Pain is not a major factor during otoplasty recovery as long-acting local anaesthetics are used at the time of the procedure. Simple analgesics  can be used for pain relief.

Recovery from otoplasty is usually straightforward and the operation has a very low complication profile. However, precautions should be taken during the post-operative period for about six weeks to avoid the ear being pulled forward, and thus contact sports such as rugby etc should be avoided unless the appropriate headgear is being worn.

Patients should avoid having a haircut, or specifically warn the hairdresser not to pull the ear forward for fear of pulling through the stitches or disrupting them.

Excessive exercise or activities can promote swelling and bruising, and are discouraged in the first week. Patients can usually return to work or school after a week.

Risks

Even with the highest standards of practice, all surgical procedures carry a level of risk and the potential for complications. In addition, every individual will have a different risk profile depending on their general health, age and the complexity of the procedure.

During the consultation Dr Perkins will explain the possible complications and risks of the specific procedure to provide the necessary information to enable patients to weigh up the benefits, risks and limitations of the surgery.  The following are some of the risks associated with this procedure.

General risks involved in any surgery include post-operative infection, excessive bleeding, pain/discomfort, adverse reaction to anaesthetic.

Specific risks of surgery include asymmetry, re-protrusion of one or both ears may occur and require further surgery, numbness, scarring.

Costs

For patients under the age of 18, otoplasty is classified as reconstructive surgery. As such, if the patient is in a private health fund with appropriate cover, a proportion of the costs will be rebated by Medicare and the health fund.

From the age of 18, otoplasty surgery is classified as cosmetic and as such no Medicare or private health fund rebates apply for the medical or day surgery fees.

An estimate of costs will be provided following the consultation with Dr Perkins.