Otoplasty is either a surgical or non-surgical procedure that corrects deformities and defects of the external ear, caused by congenital conditions or trauma. The repair creates a new ear having natural proportions, contour, and appearance, by reshaping, moving, and augmenting the framework of the pinna or the outer ear. Depending on what the patient needs, the procedure may cover one or both ears.
Several ear deformities exist, and each are often different for every patient. There are various surgical and non-surgical approaches to address a particular defect. Common types include:
Cup Ear – Parts of the external ear don’t develop evenly, which causes the ears to stick out or resemble a cup figure
Lop Ear – Also known as “Bat Ear”; the inner part of the ear, called “concha“, grows perpendicularly instead of a parallel manner with respect to the ear
Cauliflower Ear – Caused by inflammation and injury, taking the appearance of a cauliflower
How is Otoplasty Performed?
Depending on the deformity, the Otoplasty method used can either be surgical or non-surgical.
Surgical Approach
Surgical techniques can repair torn earlobes and ears with some slight damage from the pinna, but some may be required to undergo multiple surgeries. The surgical approach covers many external ear problems as its the more flexible option.
Otoplastic surgery can be done with the patient under local anesthesia, local anesthesia with sedation, and general anesthesia (common for children). A Lop Ear with a small helix (outer rim), for example, can be addressed by making an incision on one side of a flat cartilage piece to allow evolution of the ear contour. This incision, which is along the new anti-helical fold, can be a technical component in the procedure. Without the incision, the surgeon punctures a needle through the skin to model the cartilage and emplace retention sutures that will hold the anti-helix and conchal bowl areas together.
Surgical Otoplasty can consist be done through anti-helical fold manipulation, conchal alteration, correction of earlobe prominence, alteration of the auricular upper pole position, or a combination of the mentioned techniques.
Non-Surgical Approach
Usually, congenital or acquired ear deformities are self-correcting on an infant, but if they still appear the same after a week from birth, aid from non-surgical corrective devices is required for the ear to develop normally.
During the early weeks of infancy, the cartilage of the pinna is highly malleable. By using non-surgical corrective devices (tissue molding), deformed ears can become normal over time. The taping method uses a tape with or without a splinting device to flatten the ears into their normal position. The EarWell and Ear Buddy devices are basically technical versions of the splint-and-tape appoach.
Risks of Otoplasty
Because non-surgical methods are virtually problem-free, there are no complications involved. However, for surgical Otoplasty, there may be hematoma, infection, suture complications, and development of an unnatural contour due to overcorrection.
Who Can be Considered for Otoplasty?
Individuals with ear deformations, most especially infants who are less than six weeks old. They must also be capable of drawing realistic expectations from the procedure and aware of its limitations. Patients with a history of hypertrophic scarring and keloids may re-experience them, which can affect the results of surgery.
Facts on Otoplasty
Congenital ear deformities sometimes occur with medical conditions; therefore, Otoplasty is also performed by an oro-maxilofacial surgeon and an otolaryngologist, apart from a plastic surgeon. The malleability of the infant ear, made possible by the remaining maternal estrogen that circulate within the body of the child, continue to linger until the first six weeks of life is exceeded.
