Cosmetic Ear Surgery or Otoplasty Information

Cosmetic ear surgery or otoplasty can be performed to reshape the ears in many different ways. The most common procedure is ear pinning to correct ears which stick out by setting them back closer to the head; although ear surgery can also be used to reduce large ears, reshape the cartilage in ears with unnatural shapes, reduce large or stretched earlobes, rebuild new ears for people born without lobes or after an injury, reduce large creases and wrinkles in the ear or increase the size of very small ears. Otoplasty is usually performed on children between 5 and 14 years of age, as having the procedure at a young age is highly desirable and recommended. The operation can be performed under a local anaesthetic; however, some people are given their anaesthetic via an intravenous drip or a general anaesthetic, (this is particularly common when children are having the surgery). Most people find that they can go back to work or school after one to two days and it is usually around a couple of months before normal contact sport activities can be resumed. Private costs for ear surgery can range from approximately £1,000 - £3,000. In some cases children can have this procedure via the NHS.

Product Brands

earFold™

earFold™ is marketed as a ‘simple and effective treatment for the correction of prominent ears’. The procedure takes around 20 minutes, is performed under local anaesthesia, and carries a lower risk and fewer side effects, including less pain and discomfort, than traditional otoplasty.

Background

Otoplasty (cosmetic ear surgery) background information

Cosmetic ear surgery or otoplasty can be performed to reshape the ears in many different ways. The most common procedure is to correct ears, which stick out by setting them back closer to the head. Cosmetic ear surgery can also reduce large ears, reshape the cartilage in ears with unnatural shapes, or increase the size of very small ears. Surgery can also reduce large or stretched earlobes, or large creases and wrinkles in the ear. Ear surgery can even involve rebuilding new ears for patients born without lobes or after an injury.
 
Otoplasty is usually performed on children between 5 and 14 years of age, and when considering otoplasty, parents must be confident that they have their child's best interests at heart. For instance, the timing of the operation is always an important part of the decision. Having the procedure at a young age is highly desirable and recommend in two respects. First, the cartilage is extremely soft, so it can be reshaped quite easily and second, the child will experience psychological benefits from the cosmetic improvement and feel better about themselves and their appearance.

Adults who have otoplasty should understand that the firmer cartilage of their fully-grown ears will not be as easily moulded as in children.

Otoplasties are the 11th most common cosmetic surgery procedure in the U.S. with 36,547 procedures performed in 2016, a decrease of 0.5% on 2015 figures, according to statistics from the American Society for Aesthetic Plastic Surgery (ASAPS).

Similar statistics are not readily available for the United Kingdom, but we know that these operations are carried out very regularly and successfully here.

If you're considering an otoplasty for yourself or your child, the following information will give you a basic understanding of the procedure for correcting ears that stick out unnaturally. It can't answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a surgeon about anything you don't understand.

Procedure

What happens during an Otoplasty operation?

In your first appointment with a surgeon, you should clearly explain your expectations of the surgery and how you or your child would like to look afterwards.

Careful discussions regarding your reasons for Otoplasty or cosmetic ear surgery are very important at this stage. Make sure that you obtain as much information as is necessary to enable you to make a fully informed decision about whether to go ahead with the surgery and feel comfortable about the operation.

The surgeon should also ask for a medical history, to make sure that there are no reasons why you shouldn’t have an otoplasty. At this point, you would also normally be asked to sign a consent form which means that you have understood the future benefits and possible risks associated with the procedure.

Photographs of your ears may also be taken by the practitioner for a “before and after” comparison later.

The surgeon may wish to write to your G.P. giving details of the operation so that if there are any problems associated with it in the short or long-term, the G.P. is aware of the surgery and can help you if you require any further treatment after the operation.

Anaesthesia

The operation can be performed under a local anaesthetic. However, some patients are given their anaesthetic via an intravenous drip. Sometimes a full general anaesthetic may be used and this is particularly common when children are having the surgery

As in any surgical procedure, the use of a general anaesthetic carries a small additional risk which your practitioner will discuss with you. No form of anaesthetic will be given to you without your surgeon discussing it with you first.

The operation

The surgery can be performed in an outpatient surgical centre, which may either be separately run by your surgeon, or may be part of a hospital.

The procedure can take between 2 - 3 hours, but depending on the extent of the procedure, it can take longer.

Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The surgeon will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the surgeon will also trim the cartilage, shaping it into a more attractive form and then pin the cartilage back with stitches that remain permanently.

The initial cut is then closed, usually with dissolvable stitches, and bandages are placed around the head to cover the ears.

Recovery

How long will it take to recover from cosmetic ear surgery?

Most patients find that they can go back to work or school after one to two days. It is usually around a couple of months before normal contact sport activities can be resumed.

Side Effects and Risks

What are the risks and potential complications from Otoplasty surgery?

Ears will be sore and tender immediately following an otoplasty or cosmetic ear surgery operation, with some mild bruising and swelling.

Odd sensations of "tightness", or "pulling", of the ears may be noticed during healing, but these usually disappear after a week or so.

Other rarer risks or side effects include bleeding underneath the skin, a reaction to the anaesthetic, infection and sometimes skin numbness that can occasionally be permanent.

There will be a thin white scar afterwards which is rarely noticeable as it is hidden in the ear crease. Occasionally, however, excess scar tissue can form and this can appear quite lumpy.

There is also the possibility of slightly lop-sided ears which may require another operation to put it right.

Post-Surgery Advice

What should you do after an Otoplasty operation?

It is very important that you follow the advice of your surgeon carefully after your treatment.

Post - surgery advice may include:

  • using recommended painkillers as required;
  • for the first few days after the operation, the patient should sleep in bed with the head in a raised position;
  • reminding yourself (or children) not to touch the ears throughout the healing process as bending them forward in the first few months after the surgery can destroy even the finest surgical result;
  • bandages will be removed in about 5 - 10 days;
  • avoiding all sports and physical activity for at least 6 weeks to prevent the permanent stitches from breaking open during the recovery period;
  • contacting your surgeon immediately if you notice any signs of infection or if you experience increased bleeding or a sudden increase in pain.

Contra-indications

Who should not have cosmetic ear surgery?

There are few reasons why you shouldn’t undergo this procedure, but you should be in good general health and have realistic expectations of the outcome of the surgery.

If you are prone to keloid (red, angry, raised) scars, or have a history of problems with wound healing your surgeon may not recommend this procedure or may caution you that scars could be raised and very visible.

Who Can Do It

Who can perform Otoplasty?

Only fully trained and qualified surgeons should perform cosmetic ear surgery. These would normally be plastic or cosmetic surgeons and ear, nose and throat (ENT) specialist surgeons.

For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.

 

NHS Availability

Is cosmetic ear surgery or ear pinning (Otoplasty) available on the NHS?

It is becoming increasingly unlikely that anyone considering cosmetic ear surgery would be able to access this free of charge on the National Health Service.

However certain regions do make special cases, especially for children, and we would always recommend that you visit your General Practitioner before embarking upon a cosmetic procedure involving surgery.

As well as their advice and guidance they may also be able to refer you to a local NHS Hospital for a consultation.

The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:

"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.

NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.

To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."

Price

What is the average cost of Otoplasty?

Prices for private otoplasty or cosmetic ear surgery can range from £1,000 - £3,000 depending upon the type of operation required.

Conclusion

Summary of advice for Otoplasty

You should have realistic expectations of an otoplasty or cosmetic ear operation and accept that there are limits as to what ear surgery can achieve physically and emotionally for you or your child.

Most patients who go into the surgery with this positive attitude experience a successful outcome following an otoplasty procedure, which is performed by a skilled surgeon.

Before you have this surgery, you should realise that most people's ears are not perfectly symmetrical or perfect to begin with.

Also, although the results are usually permanent, there is always some small amount of forward movement of the ears after the operation. This is because ear cartilage is very elastic and so the ears will move naturally.

Before and After Pictures

Before and after photographs of Otoplasty

Results vary enormously depending upon both the patient and the skill of the individual surgeon, so outcomes for cosmetic surgery procedures will always be more variable than those for less invasive non-surgical treatments.

We currently do not have any before and after images for cosmetic ear surgery procedures.