The goals of otoplasty are to reshape and reposition the ears to give them more normal and symmetric appearance. There are three objective criteria and one subjective criterion to assess the ears and decide, whether our ears are considered well developed or not.
The objective factors are size, shape and especially angle, at which the prominent auricle stands out. The normal size of an ear is roughly one third of the head’s size. The shape should be regularly developed in all parts of the auricle, the relief should be distinct and it should not be deformed. If the angle, at which the auricle stands out, is too big, it may be the source of teasing from the others and prominent ears may be a frustrating problem not only in childhood, but also later in life. The evidence that it is a really serious problem is also the fact, that until 10 years of age the otoplasty is a procedure fully covered by health insurance. Once older than 10 years, the otoplasty is considered aesthetic surgery and therefore the health insurance does not cover it anymore.
The consultation and detailed examination should precede every ear surgery. The surgeon will settle the goals of the surgery; he or she will also assess the shape of the auricle, quality of the skin and the cartilage (especially its elasticity), and discuss the angle. Then the surgeon will plan the operation and tactics.
During the surgery the cartilage is remodelled and the excess skin behind the auricle is removed, possibly the size of the auricle corrected. Most surgeries do not require stay in hospital and are performed under a local anaesthetic. The particular operation technique depends on the extent of defect, cartilage elasticity, and individual skills of the surgeon. The incisions are generally placed behind the ear and at the end of the surgery the wound is closed with absorbable sutures, which will not require removal. The cartilage is remodelled by excision, notched, abraded, and remodelled by inner or outer stitches. The patient’s head is wrapped in an elastic bandage immediately following the surgery to hold the ears in position by gentle pressure.
The bandage will be removed in 10 to 14 days. In the meantime the bandage is replaced by a lighter head dressing similar to a headband.
The patient is recommended to wear the elastic headband for some time, at night, eventually during the day. It depends on the operating technique.
The patients usually tolerate the procedure very well and are satisfied with its results. The complications are rare and not serious. Most frequently it is bleeding, but the need of surgical revision is very scarce.