EAR SURGERY (OTOPLASTY) 

Ear surgery is often performed on patients with prominent ears or ears which appear to protrude too far from the head. Other reasons for ear surgery include overly large or small ears, ears disproportionate to the head or oddly placed, or ears that have been damaged by injury. Usually this trait derives from a specific congenital anomaly where one of the upper ear folds (called the “antihelix”) does not form, causing the ear to “stick out” as a result. This is often seen on both sides but can sometimes be on one side only.
 

Good candidates for this procedure: 

  • Patients born with overly large or protruding ears

  • Patients whose ears are disproportionate to their heads or oddly placed

  • Patients with ears that stick out prominently

  • Patients who have suffered an injury that has negatively impacted the shape or positioning of their ears

What to expect: Consultation

All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for ear surgery.

During the consultation, Dr. Hsu will first ask about any events affecting the appearance of the ear, such as whether it was present from birth, or whether a previous injury had changed the appearance.  He will examine both ears for symmetry and also determine exactly what anatomic factors are responsible for the appearance.  

He will also ask about your medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. If he determines that you are a good candidate for the procedure, Dr. Hsu will then explain the next steps in going forth with the procedure. In order to reach your aesthetic goal, both you and Dr. Hsu will work together to decide all the necessary details that will ultimately give you the best results.
 

Surgery Details:

On the day of surgery, arrive early to fill out paperwork, meet the anesthesiologist, and be prepared for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.

Dr. Hsu will perform ear surgery with the patient under general anesthesia for approximately two and a half hours. Depending on your anatomy and desired changes, Dr. Hsu will either make an incision hidden inside or behind the ear. He may also remove excess cartilage or soft tissue that cause the ear to protrude too much. If your ear lacks normal folds, Dr. Hsu will recreate them by shaping the cartilage with permanent sutures or scoring the cartilage in order to contour it. Sometimes, he uses a combination of techniques to achieve the desired result.  This requires some judgment at the time of surgery to determine which maneuvers are appropriate for the end goal.
 

Recovery & Post-operative Instructions:

After the surgery, Dr. Hsu will place special dressings around the ears for approximately a week to keep the ears well protected and cover them with surgical “earmuffs”. The special earmuffs will prevent any accidental movement or bumping so the newly created ear fold can heal in place.

It is very important that you keep your head elevated at all times during your recovery period. An easy way to maintain the elevated position during rest is to sleep on two pillows at night. We also highly recommend wearing a handkerchief or shawl to cover the area so that you will be more comfortable going outside. For most patients, bruising and swelling has subsided substantially after a week, so they can cover any remaining bruises with concealer. During the recovery period, walking assists with healing and minimizing blood clots.

The surgical area should stay dry until Dr. Hsu indicates that it is permissible to shower.  In the meantime, to clean the rest of your body, you can bathe from the shoulders down. Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will gradually decrease in about two weeks. Most patients return to work after two weeks, but many return even sooner -- especially those who work from home. The biggest limitation for post-operative patients is driving, which should be avoided when on pain medication. Patients are usually off their pain medication after five days, so plan your work schedule accordingly. Six weeks post-operation, most patients can return to their normal routines including any exercise and going back to the gym.

Dr. Hsu will be available 24 hours following the surgery to address any immediate concerns that may arise. He will continue to follow patient progress for an extended period of time to ensure the patient is healing well. Follow up appointments are scheduled immediately after surgery and for up to a year afterward.
 

Dr. Hsu's view on Ear Surgery.

There are a variety of reasons why patients come to plastic surgeons for correction of ear issues.  Although we do perform ear surgery for correction of all sorts of issues, in practice the most common requests I see are:  earlobe reduction for aging, droopy earlobes; keloid excision for earlobe keloids after piercings, and closure of earlobe gauge holes.  I also do get some requests for ear pinning, but mostly these are in teenagers who did not have them pinned back when they were children.

Each of these procedures has its own individual set of considerations that I discuss with patients when they come to see me.  I personally enjoy the earlobe reduction and earlobe keloid cases most.  The earlobe reductions give very nice, predictable results, and the earlobe keloids are fun for me because of their challenge (sometimes they can grow to be incredibly large and disfiguring).  Most of these cases can be done under local anesthesia, depending on the extent of surgery required to be done.