The size and shape of our ears is genetically predetermined and can vary significantly between individuals, as well as between the two sides on any one individual. The normal size of the ear is about 1/3 of the face, and forms an angle of 23-30^o with the scalp. Any situation where the ears appear to be particularly prominent or the shape seems to be out of the normal, can be the source of teasing and ridicule, leading to significant psychological morbidity.

Ear correction or otoplasty is a surgical procedure to set prominent ears back closer to the head or to reduce the size of large ears.

When can otoplasty be performed?

Otoplasty is usually performed after the age of 4 years, when the ears have completed 90% of their growth, and before the child begins school, where it can become the target of continuous taunts and teases. It could also be performed at a later age, even in adult life, if the appearance of the ears continues to be a problem.

How is otoplasty performed?

In young children, a general anaesthetic is usually recommended, while in older children and adults a local anaesthetic may be used.

The procedure is usually performed through a small incision in the back of the ear to expose the ear cartilage. The cartilage is then sculptured to achieve the desired form and shape and a number of sutures may be used to help maintain the new shape. Occasionally a small incision may be placed in the front of the ear to address difficult problems.

What can I expect after the operation?

The procedure takes approximately 1 to 1 ½ hours. Hospitalization is not usually required, but an overnight stay at the hospital may be a good idea. After the operation the ears are wrapped with a bulky head bandage for 3-5 days to promote the best molding and healing. After the bandage is removed, it is advised that a head band is worn at night and in crowded places for a further 3-4 weeks, to protect the ears.

Pain is usually well tolerated and easily managed with regular painkillers. An antiemetic is usually prescribed in children as the bandage may cause nausea. The sutures used for the skin are usually dissolvable and need not be removed.

Significant bruising and swelling should be expected when the bandage comes off, but these subside over the next couple of weeks and the ears assume their final shape.

When can I resume my normal activities?

You should be up and about within a few hours of surgery, but bending and strenuous activities should be avoided for a couple of days. Adults can return to light duties within 1-2 days, and more demanding activities can be assumed after 5-7 days. Full recovery to your previous activities can be expected after 3-4 weeks.

Children can go back to school after 1 week. Swimming is allowed after 2 weeks and contact sports should be discouraged for 4 weeks. The ideal period for the operation would be during the Easter, summer or Christmas vacations.

It should be emphasized that any activity in which the ear might be bent should be avoided for a month or so.

Pictures (c) ASPS, ASAPS, AAFPRS, ADAM