Ears, like noses, are best unnoticed and part of a balanced face. Although many children are born with outstanding or protruding ears, significant protrusion or asymmetry can be the source of humility and negatively impact self-esteem.

Otoplasty refers to changing the shape of the ears. This procedure is generally performed to correct outstanding or protruding ears.

In children, surgery is performed around age 5, just prior to beginning school but after levels of maturation, cooperation, and motivation have been established. Otoplasty in the adult population is not uncommon, particularly when ear irregularities continue to be bothersome and the source of self-consciousness.

Understanding the Procedure

Otoplasty on children is usually performed under general anesthesia. With adults, this procedure is conducted under local anesthesia with small amounts of sedation. An incision is made behind the ear and the excess skin, muscle and cartilage is carefully removed (Figure 1). When the ear lacks certain folds and definition, sutures are placed to recreate these anatomic landmarks for a more natural appearance. After the procedure, a bandage is placed around the head to protect and secure the ears.

What to Expect After the Surgery

The head bandages are changed after the first couple of days. Most children take one week off from school with special precautions to avoid inadvertent trauma to the ears. Participation in contact sports is off limits for four weeks. After the first week, many children wear a headband that keeps the ears flat but can be removed for bathing purposes. During this time, it is beneficial to wear the headband during evening and night hours to maintain the ears in a flat position.

Frequently Asked Questions

Will an otoplasty affect my hearing?
No. The change in shape is strictly external and hearing is not impacted one way or the other.

What is the appropriate age for otoplasty?
Otoplasty is usually not performed before the age of five but usually before beginning school. There is no urgency and these procedures can be performed during adulthood as well.

Are they always performed on both ears?
Most children have bilateral ear deformities and both ears are corrected at the same time. On occasion some people will have only one ear that is protruding or deformed. Under these circumstances, only the involved ear is operated on.

Will insurance pay for this?
Most insurance companies consider this cosmetic surgery in the sense that it is not an absolute medical necessity and there is no direct functional impairment from this congenital deformity. As a result, most insurance companies do not pay for the surgery.