For the most part, the operation is done on children between the ages of four and 14. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child will have to endure.
Ear surgery on adults is also possible and there are generally no additional risks associated with ear surgery on an older patient.
Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: "lop ear" when the tip seems to fold down and forward; "cupped ear" which is usually a very small ear; and "shell ear" when the curve in the outer rim, as well as the natural folds and creases, are missing.
Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Dr. Patterson can even build new ears for those who were born without them or who lost them through injury.
(Otoplasty is occasionally covered by insurance).
Ear surgery is usually performed as an outpatient procedure in the surgery centre. Occasionally, the doctor may recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight.
The technique will depend on the problem. With one of the more common techniques, Dr. Patterson makes a small incision in the back of the ear to expose the ear cartilage. He will then sculpt the cartilage and bend it back toward the head.
Non-removable stitches may be used to help maintain the new shape. Occasionally, Dr. Patterson will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete. An incision is made in the back of the ear so cartilage can be sculpted or folded. Stitches are used to close the incision and help maintain the new shape.
Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.
Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.
Length: Ear surgery usually takes about two to three hours, although complicated procedures may take longer.
Anesthesia: If your child is young, Dr. Patterson may recommend general anesthesia so the child will sleep through the operation. For older children or adults, he may prefer to use local anesthesia, combined with a sedative, so you or your child will be awake but relaxed.
In/Outpatient: Usually outpatient.
Side Effects & Risks
Side-Effects: Temporary throbbing, aching, swelling, redness or numbness.
Risks: A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle. Occasionally, patients develop an infection in the cartilage which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.
HEMATOMA: A hematoma (collection of blood) is rare but possible. It could cause delayed healing or an infection. Dr. Patterson can remove the hematoma surgically.
RELAPSE: A relapse of the protruding ear(s) is possible if there is subsequent injury or if stitches loosen postoperatively.
SCARS: Scars behind the ear are usually unnoticeable, in the unlikely event the scars widen or become too thick, Dr. Patterson can revise them.
ASYMMETRY: The ears may be slightly different in size and shape (most ears are somewhat different to begin with).
INFECTION: Infection or even abscess formation (collection of pus) may occur.
FLUID COLLECTION: Fluid collections rarely accumulate under the skin and may require drainage or aspiration (withdrawal by needle).
Sometimes inside cartilage stitches may work their way out.
Getting back to normal: Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay until all the effects of general anesthesia wear off. The patient's head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days*, but this can be relieved by medication.
Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband.
Be sure to follow Dr. Patterson’s directions for wearing this dressing, especially at night. Stitches are usually removed or will dissolve in about a week. Any activity in which the ear might be bent should be avoided for a month or so*.
Most adults can go back to work about five days* after surgery. Children can go back to school after seven days or so*, if they're careful about playground activity. You may want to ask your child's teacher to keep an eye on the child for a few weeks*. Strenuous activity, contact sports: 1 to 2 months*.
Usually permanent results*. More natural-looking ears. Most patients, young and old alike, are thrilled with the results of ear surgery. This can be a real confidence booster. But keep in mind the goal is improvement, not perfection. Don't expect both ears to match perfectly. Perfect symmetry is both unlikely and unnatural in ears. In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time*.
Q. Should my child have his/her ears "fixed"?
A. This is largely up to the child. Parents should stay alert to their child's feelings about protruding ears. Don't insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome. In the initial meeting, Dr. Patterson will evaluate your child's condition, or yours if you are considering surgery for yourself, and recommend the most effective technique. He will also give you specific instructions on how to prepare for surgery.
Q. How long will the results last?
A. The results are usually permanent*. Recurrence of the protrusion, requiring repeat surgery is a possibility but rare.
Q. How soon can I resume our regular activities?