OTOPLASTY (EAR PINNING)

Otoplasty is specifically designed to "pin back" or reposition protruding ears and create natural-looking folds and convolutions. Otoplasty is very rewarding because of the visual improvement and psychological satisfaction. It is one of the few cosmetic surgery procedures performed on children; they can be as young as kindergarten age. This procedure also has great appeal for men, because most wear their hair short. As with any surgical procedure, it is extremely important to be informed. Some important facts about otoplasty:

• Sometimes only one ear protrudes. However, surgery may need to be performed on both ears to attain maximum results if any change to the convolutions and/or folds is necessary.
• Perfect symmetry is rarely achieved.

ALTERNATIVES TO SURGERY
The only alternatives to surgery are those that hide or partially cover the ears. The use of headbands or a hairstyle worn over the ears can lessen the appearance of protruding ears. Only surgery will permanently alter the positioning of the ears.

PREPARING FOR SURGERY
Your physician evaluates and assesses the folds and convolutions of your ears in conjunction with their position. Be absolutely clear and in agreement with your doctor about your desired look. You will also be given pre-and postoperative instructions which will include information on eating and drinking and what prescription medications to take and those to avoid. Be sure you and your physician agree on the surgical approach and understand the potential risks and complications involved with the procedure.

THE PROCEDURE
Incisions (two to three inches long) are made in the natural creases behind the ears. The cartilage of the ear is weakened and bent into its new shape. Cartilage may or may not be removed. Permanent sutures are then placed in the cartilage to hold it in its new positionand bring the ear closer to the head.

Anesthesia
The type of anesthesia used during Otoplasty is dependent on the extent of the procedure to be performed, the doctor's choice, and the patient's medical history or desires. If the patient is a young child, general anesthesia is primarily recommended. For older children and adults, most surgeons prefer to use local anesthesia along with oral or intravenous sedatives.

Length of Procedure
Otoplasty is usually performed on an outpatient basis, though children may be required to stay in the surgical facility for twenty-four hours to be monitored. In most cases, the surgery takes one to two hours, although complicated procedures may take longer.

Level of Pain/Discomfort
Generally, with otoplasty there is minimal to moderate discomfort during the postoperative period. However, be aware that your ears come in contact with many objects as you go about your day-combing your hair, dressing, hugging, and sleeping. Patients are cautioned that any bump can be quite uncomfortable.

PRE- AND POSTOPERATIVE INSTRUCTIONS
The following suggestions are intended to make you feel more comfortable and help you heal:

• Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and postoperative is usually recommended). Check with your doctor regarding any other medications (including homeopathic/herbal products) that you are currently taking.
• If you want to color or have a permanent, have it done a minimum of ten days prior to surgery. It could be about four to six weeks until you can color or have a permanent again.
• Have someone stay with you the first night after surgery (the first twenty-four hours, optimally).
• Dressings, if the procedure requires them, should be applied by the doctor/nurse immediately after the procedure.
• No contact sports for six weeks.
• Expect some numbness in and around your ears. Be careful when using a hair dryer or curling iron because you cannot feel the heat.
• Eyeglasses should not be worn for a week or two after surgery.

RECOVERY
Both adults and children are usually up and around within a few hours of surgery, although you may be tired from the anesthesia. Your head will be wrapped in a stocking cap or turban dressing that will cover your ears. A headband-type wrap will replace this in a few days. Your ears may ache immediately after surgery but this sensation usually dissipates within a few days and can be relieved by Tylenol or prescribed pain medication. Any stitches if they were not dissolvable will be removed in approximately one week.

RISKS/COMPLICATIONS
Although problems are unlikely, you need to be aware of what can happen and what action you should take. Most risks/complications will be avoided if you make an informed decision, choose a qualified physician, and follow your physician's instructions. The types of complications to be aware of include; nerve damage (although any loss of sensation is usually temporary), infection, scarring, reaction to the stitches, and asymmetry

STILL YOU…ONLY BETTER
The visual and psychological outcomes of otoplasty are very gratifying. If performed on a child before entering school, teasing will be avoided. Otoplasty is one of the simplest operations with recovery times at a minimum.