Otoplasty, also known as ear surgery, is a plastic surgery procedure designed to permanently alter the shape of the ears, often to improve the appearance of protruding or asymmetric ears. Patients young and old may have the surgery as long as they are healthy and their goals can be acheived through the surgery. Parents considering otoplasty for their children can read more about pediatric otoplasty here. Also, you may view the before and after photos of patients who have had otoplasty with Dr. Moynihan in our Otoplasty photo gallery.
My Philosophy:
The procedure is performed by the use of permanent sutures and cartilage excision to allow set back and reshaping of the ears. An incision in the back crease of the ear allows placement of the sutures.
Below is a list of the most commonly asked questions that I have encountered when meeting with patients. The answers below nicely illustrate and summarize the information necessary for a patient to be well informed.
How much does an Otoplasty cost?
Adult Otoplasty:
There are two fees. Surgeon’s Fee $4000-$5000
Facility Fee: 2 hours of time. Cost depends on the facility used.
Child Otoplasty:
Surgeon fee $4000-$5000
Facility Fee: 2 hours of time.
Anesthesiologists Fee: 2 hours of time.
Can you use insurance to pay for an otoplasty?
Years ago with much hard work, it was sometimes possible to have the procedure covered by your health insurance. Insurance unfortunately insurance companies will no longer cover the procedure. It is considered a cosmetic procedure.
What type of anesthesia is used to perform an otoplasty?
For patients under the age of 15 years, the procedure is always performed under general anesthesia or sedation/twilight. For those older than 15 years, the procedure can performed with just numbing medicine (local anesthesia) or with sedation or twilight anesthesia.
What is the ideal age to perform an otoplasty?
Typically, between the ages of 4-6 years are thought to be the ideal age. This was based on two observations first that a child’s cartilage is soft at this age and nearly adult size which should allow ideal shaping of the ear cartilage. Second, performing the procedure at 4-6 years of age is generally prior to the onset of teasing by other children.
It was also thought that performing the procedure during the childhood years would result in less re-occurrence of the prominent ears. When using traditional techniques this is in fact true. It was especially true when performing the procedure in adults. The reoccurrence in adults was due to the memory of the cartilage. I have changed my techniques over the years to prevent reoccurrence of the prominent ear. Therefore in my practice, I no longer have a recommended age other than to avoid the psychological injury that occurs from teasing in the early childhood years. See technique section.
What causes prominent ears?
In the vast majority of patients, the prominence is caused by either underdevelopment of the antihelical fold which is responsible for keeping the top 1/3 of the ear close to the head or by the shape; firmness and angle of the conchal bowl against the mastoid bone. Patients can either have one or both of these congenital findings in the external ear which dictates which techniques are necessary. See techniques/anatomy section.
Can I have just one ear set back or do I need to do both?
In some cases, there is only one ear affected and the contra lateral (other) ear is in the ideal anatomical position. These patients can have just one ear set back. In the vast majority of cases, both ears are affected to varying degrees. If only the most affected ear is set back and not the less affected ear than the postoperative result will be very distracting and cosmetically asymmetric. It is often recommended to perform the surgery on both ears so that the position the ears are set back to will match and result in a very symmetric and natural result.
Does the procedure hurt?
The ear is one of if not the only place that some real discomfort can be experienced after surgery. Children will oft tolerate the discomfort much better than adults. The first day following the procedure is when most of the discomfort is experienced. This is due to the need to have a compressive dressing worn over night to prevent the accumulation of blood. Once the dressing is removed a vast majority of the discomfort is relieved.
Do I have to wear a dressing?
Yes. The first night you will wear what I refer to as the ‘Princess Leia’ dressing.
This is removed the morning after surgery. During the first week of surgery, you wear a sweat band over the top half of the ear 24 hrs/d. After the first week you will wear a sweat band just at night for 4 weeks.
Is there much bruising or swelling?
Typically there is not a significant amount of bruising following surgery. The ears will have a significant amount of swelling during the first 4 days following surgery. By day seven the ears will retain approximately 20 % of the swelling but will be cosmetically acceptable with regards to public viewing. By week two the ears have less than 5% of swelling and have an excellent cosmetic appearance.
Will the prominence reoccur in the future?
When the correction of the ears is accomplished solely by a suture technique, there is some expected reoccurrence in the adult ear only. Because of this fact, often the adult ear is overcorrected with the expectation that they will relax and settle into the ideal position eventually. Because of this uncertainty and the need to weather a postoperative appearance that is slightly unnatural, I have developed a technique to prevent reoccurrence of the prominence and allow the ears to have an natural appearance during the entire postoperative period.
What are the possible complications following otoplasty surgery?
Hematoma which is a collection of blood under the skin. The dressing worn overnight helps prevent this complication.
Infection:
Skin- prevented by the use of antibiotics during the first week of surgery and performing the procedure in a sterile environment. (not the office setting)
Cartilage- – prevented by the use of antibiotics during the first week of surgery and performing the procedure in a sterile environment. (not the office setting)
Cosmetic asymmetry – The ears are typically within millimeters of other following the procedure. It is possible to have asymmetry which is a normal finding in ear anatomy especially if it is significant preoperatively.
Numbness – temporary following surgery and should resolve within months of surgery.
