Protruding ears, or ears that stick out, are a frequent source of embarrassment for patients. This is most common in children who can undergo a lot of ridicule during the early school years which can lead to psychological damage and negative self-image development. However, I have seen similar issues in much older patients as well. I most recently did a 72 year-old patient’s ear correction and when asked why now…she stated it had bothered her her entire life and now she was able to do it!
The good thing about the correction of protruding ears, known as otoplasty, is that it is a very simple and easy procedure to go through that creates an instantaneous change. Otoplasty is done through an incision on the back of the ears. (actually some skin is removed from the back of the ears as well) Through this approach, permanent sutures are placed to reshape the outer cartilage of the ear, specifically to create the ear fold that is missing known as the antihelix. Sometimes the size of inner cartilage known as the concha or bowl of the ear may be reduced as well. Permanent sutures may also be placed from the concha to the skull bone behind the ear (mastoid) to help further pull back the position of the ear. Both suture manuevers help change the angle of the ear from the side of the head so that the entire ear lays back further. Dissolvable sutures ares used to close the wound and a wrap around head dressing is then applied at the end of surgery.
The results of otoplasty surgery are immediate. While there will be some mild swelling and soreness to the ears, the change is dramatic as the dressings are removed. In children, the ear dressing is worn up to one week to prevent inadvertent bending of the ears which could pop the sutures. In teenagers and adults, the ear dressing is worn for just one day. The only precaution is not bend or twist the ears as the sutures are all that is holding the ears back in the first few weeks after surgery. After several months, the ears are held in their new shape permanenetly by the development of scar tissue. The sutures no longer play a critical role at that point.
Complications are few with otoplasty. Cosmetically, the goal is to get as much symmetry between the ears as possible, although exact perfect symmetry is rarely achieveable. The only long-term complication I have seen has been an occasional suture extrusion over time through the skin on the back of the ear. This could occur after months or years. I have even seen one lady who had a suture come through 35 years later!
Otoplasty is a wonderfully gratifying procedure that can dramatically change a patients self-image. If one has a concern about protruding ears, one should not put it off out of fear of pain or a long recovery. It will be a life-changing 1 hour of surgery!
Dr. Barry Eppley
Indianapolis, Indiana