OTOPLASTY (EARS)

What is an otoplasty?
An otoplasty is an operation to correct prominent ears and place them closer to the head. Other problems can also be corrected, such as large ears or "lop" ears. The operation is usually performed through an incision behind the ear, although other incisions may be used depending on individual surgical requirements. Permanent or dissolving stitches may be used.

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When contemplating otoplasty for a child, the age when the operation is performed is dependent upon patient preference, but by and large the surgery is best performed when the child is old enough to request the surgery themselves.

Do I have to stay in hospital?
Otoplasty is usually performed as a day stay procedure under general anaesthetic. The procedure takes about one and a half hours.

What happens after surgery?
A fairly bulky bandage is usually used and needs to be kept in place for about one week. Stitches are removed after one week. The ears may throb or ache for a few days but this can be relieved by medication such as Panadeine or Panadol. Some oozing usually occurs following surgery and may be visible on the outside of the bandage, but providing this does not persist should cause no problems.

You should avoid any activity that might bend the ears, such as wearing glasses, for one month or so. Adults can return to work after about one week. Children can also return to school after about one week, although care should be taken to avoid trauma to the ears.

Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia are very safe and it is most unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery.

Bleeding: As with any operation, immediate post-operative bleeding is a potential risk but unusual complication which may necessitate return to the operating theatre. Likewise, early trauma to the ear after the bandages are removed may also cause bleeding. A small percentage of patients may develop a blood clot on the ear. This may dissolve naturally or can be drawn out with a needle.

Scarring: All operations leave a permanent scar. The scar following otoplasty is usually an excellent one and unnoticeable. If you have scarred poorly from previous surgery this may indicate that you form poor scars. Scars are often lumpy and red when immature. This is a reflection of normal healing. Maturation takes 12-24 months depending on age and skin type and during this time the pinkness and firmness of the scar gradually settles. This process can be helped by massaging the wound firmly with a moisturising cream.

Infection: Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics. Rarely, surgery may be required to drain the infected area.

Swelling and bruising: It is usual for the ears to be a little swollen and bruised when the bandages are first removed, and patients will commonly experience some numbness and abnormality of sensation which will usually, although not always, become normal over the next few months.

Anaesthetic: You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia. Anaesthesia today is very safe and the chance of any problem is very low. Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.

Important points to remember before proceeding with surgery

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Healing continues for some time following surgery as the skin shrinks and adjusts.
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There can be no absolute guarantee with any surgery. Remember, the realistic aim of this operation is improvement, not perfection. Don't expect both ears to match perfectly - perfect symmetry is both unlikely and unnatural in ears.
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In the hands of even the most experienced surgeon, a secondary operation to correct residual asymmetry or a minor irregularity may be needed subsequently.
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You should avoid smoking and taking aspirin or aspirin containing medications for at least three weeks before and after surgery to assist the healing process.

The above information mentions only some of the benefits and complications of otoplasty. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.