Ear Surgery (Otoplasty)

Welcome to Orange County’s best information resource for plastic surgery and, in particular, otoplasty / ear plastic surgery. Dr. Cruise, board certified plastic surgeon has filled every inch of this site with the most comprehensive ear plastic surgery information available. Patient education is a priority for Dr. Cruise. With this in mind, he was adamant that the information be highly relevant, easy to understand and, above all, have many before and after photos to view.

To give you a brief overview, here are some of the important topics that will be discussed. This is in addition to the many, many otoplasty before and after pictures available for your review.

• Will Otoplasty correct protruding ears?
  Cosmetic otoplasty is ideal for protruding ears. Understand what is and what is not correctable with ear plastic surgery.
• What is done during ear plastic surgery?
  Is the ear cartilage removed or simply folded backward. Different problems require different treatments.
• Do I have to go to sleep to have an otoplasty?
  For the most part, otoplasties are done under local anesthesia and do not require going to sleep.
• Otoplasty complications, risks, and safety
  Here we discuss wound healing issues, fluid collection, infections, etc.
• Otoplasty recovery time
  How long do I have to take off work or school for ear plastic surgery? When can I go out in public?
• Ear plastic surgery cost
  Is financing available?

Overview of Ear Surgery

In general, ears are not the center of most people’s attention. How often have you heard someone say: You know, he’s got the nicest ears I’ve ever seen. In fact, ears for the most part, should not be noticed. Most people could not draw an accurate ear from memory if their life depended on it. I think this is the point regarding ear plastic surgery. Ears are not meant to be noticed.

If they are noticed it is usually because there is something different about them; there is something about the ear that is unusual and brings one’s attention to it. Commonly, this is because the ear is protruding outwards. Normally, these ears are not bigger than normal. It is just that instead of staying close to the scalp, they bend outward.

This problem is more common in men than women and seems to be associated more with English descent. Many people with this problem aren’t bothered too much by it. Some people think it adds character. This is a healthy way to think about it. If, however, it does bother you, there are plastic surgery options that are very effective at correcting the problem.

The problem starts at birth and is due to a congenital lack of curvature of the cartilage within the ear. Normally, the ear cartilage bends backward toward the scalp, but in people with protruding ears this curvature never occurs and the ear remains protruding outward. If noticed within 6 weeks of birth, it is possible to reshape the cartilage by just molding it into proper position without surgery. In fact, this is often done with certain breeds of dogs.

After 6 weeks, however, the cartilage becomes too firm and is no longer amenable to non- surgical readjustment. At this point, it is best to wait until the age of 4, at which time the ear has grown to about 85% of its adult size, before considering surgery. Of course, after 4 years of age it can be done at any time and is commonly performed during the summer months when children are out of school.

Correction of this failure of cartilage curvature requires surgically removing skin and applying sutures strategically to re-create this bending of the cartilage.

Often, there is too much cartilage and some of it must be removed. In the vast majority of Dr. Cruise’s cases, the incision is located completely behind the ear.

Once it heals, it is virtually unnoticeable for two reasons. One, this area behind the ear heals exceptionally well with little scar tissue; and, two, the location of the incision is hidden.

This patient’s protruding ear is caused by both an excess of cartilage as well as failure of the ear to curve backward. Both problems must be corrected to obtain the optimal result.

A completely different type of problem is the underdeveloped ear or one that has never developed at all. These two types of problems are called “microtia” and “anotia” respectively. These are much more difficult problems and may very well be associated with other congenital problems.

The nice thing about correcting protruding ears is that the ear is easy to numb with lidocaine. This allows correction to be done under local anesthesia with minimal discomfort. Local anesthesia, however, may not be possible with children under 10 years of age or children who cannot sit still well. It depends on the child. This is something that must be discussed during consultation.

Typical incision site. The incision is located behind the ear. This area heals exceptionally well and is well hidden allowing the incision to be virtually unnoticeable.