San Francisco Bay Area Facial Plastic Surgery in Walnut Creek, CA
Otoplasty (Cosmetic Ear Surgery) by Board Certified San Francisco Bay Area Plastic Surgeon Joseph Mele, MD, FACS, in Walnut Creek, CA
Otoplasty literally means ear changing, and for someone embarrassed by prominent ears, it can also be life changing. Prominent ears can draw undesired attention. Protruding ears can cause problems for young children vulnerable to taunting by peers, and adults who may feel uncomfortable wearing their hair back or getting a short haircut.
Otoplasty is the cosmetic plastic surgery procedure used to correct prominent or large ears. Also referred to as Ear Pinning, Otoplasty brings protruding ears back against the side of the head. The exact method used will depend on what makes the ear protrude.
Every Otoplasty needs to be individualized; however, there are three main areas that need to be considered in every case. Three anatomic variations can lead to prominent ears, and each has it's own set of maneuvers used to correct them. While any of these can cause the ears to protrude, it is not unusual for two or even all three factors to be present.
Additionally, asymmetry is the rule rather than the exception. It is common for one ear to be affected more than its partner, and each ear needs to be evaluated separately.
The ear is a very complex piece of anatomy. The external ear alone arises from six different swellings on the side of the embryo's head. Failure of these swellings to form or fuse together leads to a wide variety of ear deformities. Even when the pinna (the soft external ear) forms normally, a series of folds are required to give the ear its final shape.
Failure of the edge of the ear to fold backwards is the most common cause of prominent ears. Folding problems may involve the entire pinna, but can also be isolated to the top of the ear. Without this fold, the central cup of the ear extends out to the edge, projecting the ear's edge further away from the head. Formation of the fold is key to the formation of a less prominent, cosmetically pleasing ear.
Sometimes the ear is prominent because the ear is too large. Most commonly, it is the central cup of the ear that over develops. The result is a prominent central cup that either overpowers a normally folding ear, or the large central ear cup adds to the problems caused by a lack of a fold in the rim. The two problems compound each other to increase the overall prominence. With large ears, just forming a normal fold may not be enough, and some cartilage may need to be removed.
The least common cause of prominent ears is when the ear develops normally, but is rotated forward and away from the head. This anatomic variation can further compound the folding and size problems listed above, but requires additional treatment for optimal results. Like most plastic surgery, the results depend on making the correct diagnosis, and carefully correcting each problem.
Otoplasty is an outpatient procedure that can be performed under local anesthesia, with or without sedation. For children, general anesthesia is frequently employed to avoid complications associated with movement during surgery. Anxious adults too can benefit from general anesthesia. For adults, the option of performing otoplasty with only local or local with mild sedation can speed recovery, and avoid the tiredness and occasional nausea that some experience with general anesthesia.
The procedure is performed through an incision placed in the fold behind the ear. This keeps the scar out of sight, and allows for the removal of some skin from behind the ear to help keep the ear closer to the head.
Otoplasty can be performed at any age, but it is one of the few cosmetic plastic surgery procedures that is often performed on children. By five years of age, the ear size already approximates the adult ear size, so otoplasty can be performed safely and with predictably good results.
To learn more about otoplasty, either for yourself or your child, please call our San Francisco Bay Area Plastic Surgery office in Walnut Creek, CA, or submit your request or questions via the contact form on this page.