Background Information:

What are the other Names for the Procedure?

• Cosmetic Ear Surgery

What is the Otoplasty surgical procedure?

Otoplasty is a reconstructive surgical procedure that involves changing the shape, location, or size of the ear cosmetically. It is also known as an Ear Plastic Surgery.

What part of the Body does the Procedure involve?

The Otoplasty surgical procedure involves the ears.

Why is the Otoplasty surgical procedure Performed?

An Otoplasty procedure is performed for the following reasons:

• To improve visual appearance of the outer ear
• Repair missing or a severely injured ear

What are some Alternative Choices for the Procedure?

Some ear deformities in very young children may be treated with splints, within a few weeks of birth. There are no alternative choices available presently, to rectify ear deformities in adults.

What are the Recent Advances in the Procedure?

• The artificial creation of ears using tissue culture and tissue engineering are being developed
• Experiments are also being made to create artificial ears using 3-dimensional bioprinting technology

What is the Cost of performing the Otoplasty surgical procedure?

The cost of Otoplasty procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused by the information regarding Otoplasty surgical procedure on what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
• Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5^th Edition, New York, 2006

http://www.surgeryencyclopedia.com/La-Pa/Otoplasty.html (accessed on 10/19/2014)

Prior to Otoplasty surgical procedure:

How is the Otoplasty surgical procedure Performed?

Otoplasty procedure may be done under general or local anesthesia. The procedure depends on the reason for the surgery.

Otoplasty to treat microtia:

• In microtia, the visible part of the external ear is missing either partly or in whole
• The surgeon performs a series of corrective operations. This involves removing a piece of cartilage (the firm elastic tissue) from the ribcage and shaping it as desired
• The reshaped cartilage is then placed under the skin on the side of the head where needed
• Further operations are performed (in future), until the auricle (visible portion of the external ear) is fully shaped and formed

Otoplasty to treat protruding ears:

• The surgeon makes an incision behind the ear, over the area where it meets the head
• The surgeon may then either remove a piece of cartilage, or reshape it by folding and suturing it. Any excess skin may be removed after this
• The skin incision is then closed and the wound is covered with dressing

Where is the Procedure Performed?

An Otoplasty (Ear Plastic Surgery) procedure is usually performed in an out-patient surgery center facility, a hospital, or a well-equipped physician’s clinic/office.

Who Performs the Procedure?

The Otoplasty procedure is performed by any of these medical personnel, with or without assistance from an anesthesiologist:

• Plastic surgeon
• Reconstructive surgeon

How long will the Procedure take?

An Otoplasty procedure may be performed in about 2-3 hours.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Otoplasty surgical procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
• Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
• Blood tests may be performed to determine, if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Otoplasty procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Otoplasty surgical procedure?

Before an Otoplasty procedure, the patient has to undergo certain tests, such as:

• Routine blood and urine analysis

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is an Otoplasty (Ear Plastic Surgery)?
• Why is this procedure necessary?  How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• What are the costs involved?

During the Otoplasty surgical procedure:

What kind of Anesthesia is given, during the Procedure?

Local anesthesia by injection or general anesthesia by injection and inhalation is administered for the Otoplasty procedure.

How much Blood will you lose, during the Procedure?

In a majority of the individuals undergoing the Otoplasty procedure, the blood loss is minimal.

What are the possible Risks and Complications during the Otoplasty surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

• Obesity: Generally greater the degree of obesity, greater is the surgical risk
• Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
• Advancing age
• Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
• Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
• Poorly functioning liver, as evidenced by increased blood liver function tests
• Hypertension (increased blood pressure), especially if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• Poor lung function, as evidenced by abnormal lung function tests
• History of bleeding disorders
• Longstanding illness, such as autoimmune disorders, chronic infections
• Poor immune system due to a variety of causes
• The possible risks or complications that may arise during the Otoplasty (Ear Plastic Surgery) procedure are:
• Excessive bleeding
• Infection in the surgical wound
• Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Otoplasty surgical procedure?

At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise. 

After the Otoplasty surgical procedure:

What are the possible Risks and Complications after the Otoplasty surgical procedure?

Post Otoplasty procedure, the following complications may arise:

• In rare cases, excessive bleeding
• In rare cases, infection in the surgical wound
• Cold weather sensitivity
• Excessive scarring, called keloid formation, might occur
• New/recurrent ear deformities

What is the Prognosis after the Surgery?

A complete recovery from Otoplasty procedure is usually achieved. The prognosis is often excellent without any serious complications being observed.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

• Pain that worsens and swelling around the surgical wound
• Bleeding or fluid drainage from the surgical wound
• The occurrence of any symptom that causes uneasiness, such as nausea or vomiting
• Signs of an infection
• Dizziness
• Muscle aches, headache
• Fever, feeling sick
• Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Otoplasty surgical procedure?

At home, the following post-operative care is recommended, after an Otoplasty procedure:

• Slowly resume regular/daily activities as early as possible, which aids in faster recovery
• Resume bathing and showering and wear a shower cap to keep the wound clean and dry. Usage of the hair dryer close to the ear must be avoided
• The physician may advice the use of a headband to cover the ears for a few weeks after surgery
• Contact sports may have to be avoided
• Complete the course of prescribed medication, under advice of the physician
• When resting or sleeping at night, keep the head elevated, which helps offer more support
• Take antibiotic medication to help combat or prevent infection (per the physician’s advice)
• Avoid all activities that are physically strenuous for about 6 weeks or advised by your physician

How long does it normally take to fully recover, from the Procedure?

It takes approximately 2 weeks to fully recover from the Otoplasty (Ear Plastic Surgery) procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Otoplasty surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The outpatient facility or a physician’s office/clinic
• An anesthesiologist (if anesthesia was administered)
• An otolaryngologist, reconstructive surgeon, or a plastic surgeon

The patient is advised to inquire and confirm the type of billing, before the Otoplasty (Ear Plastic Surgery) procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA