Having spent a long time in plastic surgery at Riley Hospital in Indianapolis, I have performed a lot of cosmetic otoplasty procedures for protrudung ears as well as ear reconstructions in children both with missing or partially missing ears. Parents frequently have a lot of questions about otoplasty in their child and many of these questions are fairly common. Here are the most typical ones.
AT WHAT AGE CAN AN OTOPLASTY BE DONE IN A CHILD?
Classic plastic surgery teaching is that an otoplasty should wait until the ears are nearly fully formed at around age 6. The theory is that scarring on the ear may not cause it to develop properly if done before that age. While this may be classic teaching, it has now been shown that otoplasty done as early age 2 does not result in any problems of ear growth. Therefore, I think age 2 and beyond is a safe time to do otoplasty from an ear development standpoint.
The more relevant question(s) in my mind in terms of otoplasty surgery timing is….when will the child be reasonably cooperative (they need to allow a head dressing to be on for a week after surgery) and when does it bother the child (from a social teasing standpoint). These are practical surgical issues and when these two question are put together, I find age 4 is reasonable. The child at age 4 is more cooperative than age 2 and I think you want to otoplasty surgery BEFORE they are teased to prevent any self-image issues. (i.e., before they formally go to school and are around a lot of other children)
IS RECOVERY AFTER AN OTOPLASTY DIFFICULT?
In general, no. The ears are somewhat tender but not acutely painful. Most bothersome (after 3 or 4 days) is the head dressings which gets itchy and does impede their hearing somewhat (they may have selective hearing anyway!) The head dressing is only there to prevent the ears being bent, twisted, or traumatized which may cause the sutures holding them back to come loose…with the ear ending up sticking out again.
HOW PERMANENT ARE THE RESULTS OF OTOPLASTY?
Once healed, an otoplasty result is fairly permament. Some studieds have shown that very long-term results of otoplasty shown some mild degree of relaxation but the improvememnt is so substantial thaty this minor ‘relapse’ is not even noticed.
Until an otoplasty heals, however, the ear is at risk of coming ‘undone’. For the first month or so, the new ear position is held there by the internal sutures. After that, the scar that forms takes over for the sutures which are no longer needed. Therefore, one must be careful during the first month to not disrupt the internal sutures which are temporarily playing a critical role.
As an Indianapolis otoplasty surgeon, this procedure remains one of the most satisfying of all cosmetic procedures…and its immediate improvement in a child or teenagers self-image is a joy to watch and hear about.
Dr. Barry Eppley
Indianapolis, Indiana