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Probably no other physical characteristic cries out for facial plastic
surgery more than protruding ears. Children, long the victims of cruel
nicknames like Dumbo or Mickey Mouse, are the most
likely candidates for otoplasty, but this surgery can be performed at
any age after the ears have reached full size, usually around five to
six years of age. Even if the ears are only mildly distorted, the condition
can lead to self-consciousness and poor adaptation to school. When it
comes to otoplasty, conventional wisdom is the earlier the better.
Adults may also
benefit from this procedure, which improves self-esteem with relative
ease. Often, adults choose this surgery in conjunction with other facial
plastic surgical procedures. Not only is it possible to pin back
ears, but ears can also be reshaped, reduced in size, or made more symmetrical.
If you are wondering
how otoplasty can improve the way you look, you need to know how otoplasty
is performed and what you can expect from this procedure. This pamphlet
can address many of your concerns.
Successful facial
plastic surgery is a result of good rapport between patient and surgeon.
Trust, based on realistic expectations and exacting medical expertise,
develops in the consulting stages before surgery. Your surgeon can answer
specific questions about your specific needs.

General good health
and realistic expectations are prerequisites. It is also important to
understand the surgery. Otoplasty will not alter hearing ability. What
is important for successful otoplasty is that the ears be in proportion
to the size and shape of the face and head.
When considering otoplasty, parents must be confident that they have their child's best
interests at heart. A positive attitude toward the surgery is an important factor in all facial
plastic surgery, but it is especially critical when the patient is a child or adolescent.
Adult candidates for otoplasty should understand that the firmer cartilage of fully
developed ears does not provide the same molding capacity as in children. A consultation
with a facial plastic surgeon can help parents decide what is best for their child, not only
aesthetically, but also psychologically and physically. Timing is always an important
consideration. Having the procedure at a young age is highly desirable in two respects:
the cartilage is extremely pliable, thereby permitting greater ease of shaping; and
secondly, the child will experience psychological benefits from the cosmetic
improvement.

Your choice of a qualified facial plastic surgeon is of paramount importance.
During the consultation, the surgeon will examine the structure of the
ears and discuss possibilities for correcting the problems. Even if only
one ear needs pinning back, surgery will probably be recommended on
both ears to achieve the most natural, symmetrical appearance.
After the surgeon
and patient decide that otoplasty is indicated, your surgeon will discuss
the procedure. Following a thorough medical history, your surgeon will
explain the kind of anesthesia required, surgical facility, and costs.
Typically, your surgeon will suggest a general anesthesia for young patients
and a local anesthetic combined with a mild sedative for older children
and adults. Under normal conditions, otoplasty requires approximately
two hours.

Surgery
begins with an incision just behind the ear, in the natural fold where
the ear is joined to the head. The surgeon will then remove the necessary
amounts of cartilage and skin required to achieve the right effect. In
some cases, the surgeon will trim the cartilage, shaping it into a more
desirable form and then pin the cartilage back with permanent sutures
to secure the cartilage.
In other instances,
the surgeon will not remove any cartilage at all, using stitches to hold
the cartilage permanently in place. After sculpting the cartilage to the
desired shape, the surgeon will apply sutures to anchor the ear until
healing occurs to hold the ear in the desired position.

Soft dressings applied to the ears will remain for a few days. Most patients
experience some mild discomfort. If you are accustomed to sleeping on
your side, your sleep patterns may be disrupted for a week or so because
you cannot put any pressure on the ear areas. Headbands are sometimes
recommended to hold the ears in the desired position for two weeks after
the surgery.
The risks are minimal.
There will be a thin white scar behind the ear after healing. Because
this scar is in a natural crease behind the ear, the problem of visibility
is inconsequential. Anything unusual should be reported to the surgeon
immediately.
Facial plastic surgery
makes it possible to correct many facial flaws that can often undermine
one's self-confidence. By changing how you look, cosmetic surgery can
help change how you feel about yourself.
Insurance does not
generally cover surgery that is purely for cosmetic reasons. Surgery to
correct or improve birth defects or traumatic injuries may be reimbursable
in whole or in part. It is the patient's responsibility to check with
the insurance carrier for information on the degree of coverage.
This section © Copyright 2000 American
Academy of Facial and Reconstructive Plastic Surgery
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