Fourth Quarter 2009, Volume 23, Number 4

Contemplating ear surgery for your child? Timing is everything

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Contemplating ear surgery for your child? Timing is everything

Whether you have struggled for years to hide your ears or you are concerned that your child may have to endure ridicule from protruding ears, otoplasty (ear surgery) may be just the solution for you or your child. Otoplasty can reshape, reduce, or make your ears more symmetrical. Both children and adults can benefit; learn what is normal, what is involved in making the decision for surgery, and the details of the procedure and recovery.

Evaluation
How do you know if your ears are normal? Ears generally lie close to the head and extend from the level of the brow to the base of the nose. The grown ear protrudes approximately 2.0 centimeters at its midpoint; is between 5.5 and 6.5 centimeters long; and measures 3.0 to 4.5 centimeters in width. Earlobes may be curved and hanging or straight and attached to the side of the head. With age, earlobes become longer at the base. These guidelines cannot be applied perfunctorily to every patient. Your surgeon will evaluate your ears based on proportion and harmony with your total facial features, in addition to taking measurements.

Considerations
If you are contemplating otoplasty for your child, timing is important. Having the procedure at a young age, between five and six years old, is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping; and secondly, the child will experience psychological benefits from the cosmetic improvement. Surgery before five years of age is not recommended since the cartilage and outer ear are still growing.

Adult candidates seek otoplasty to correct congenital deformities, as well as abnormalities that may have occurred over time or as an adult. If you have experienced anxiety and stress from constantly camouflaging your ears, you will be amazed by how much your self-confidence will improve after otoplasty. This surgical treatment is minimal effort or risk with very big rewards.

The procedure
Otoplasty is performed on an out-patient basis, so there is no overnight stay required. Young children usually receive general anesthesia, while adults fair well with local anesthesia and intravenous sedation. The surgery begins with an incision just behind the ear, in a natural fold. The surgeon removes the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the cartilage is trimmed, shaped, and then pinned back with permanent sutures. In other instances, cartilage is not removed and stitches are used to hold the cartilage permanently in place. The goal is to reduce the shape of the ear and reposition it closer to the head. More complex, reconstructive procedures may require several steps; the average surgery lasts one to three hours.

Recovery
Maintain a positive attitude with realistic expectations. There will be some bruising and swelling around the ears after surgery. A soft padded bandage is placed around the head to protect the ears and hold them in place. When this is removed, you will wear a stretchy headband or stocking cap for a week or two, especially at night. Most people return to their daily routine within a week.