One of the most rewarding procedures that I undertake is ear reshaping (pinnaplasty / otoplasty) as it is technically challenging but often also resolves the persistent teasing that these people have had to endure as the result of their prominent or misshapen ears.
It can be undertaken in both children and adults although it is widely accepted that the outcome is more predictable in children as the cartilage framework of the ear is softer and easier to mould and shape.
A 2 inch incision is made behind the ear and the cartilage is exposed. This is then weakened to help it fold into a more acceptable position and is held in place by non-dissolvable stitches under the skin. The skin is then closed with a dissolvable stitch and a head bandage is wrapped over the ears to protect them and keep them in the correct position. The bandage is removed after 5-7 days but it is sensible to wear a headband in bed for the following 6 weeks to help healing.
It is advisable that children have this procedure under a general anaesthetic but it can be carried out under local or general anaesthesia in adults.
Achieving perfect symmetry is very difficult but usually there is a fairly close approximation
• Keeping the head up in bed is important as this reduces the potential for pain and bleeding. If there is persistent pain not responding to painkillers, the bandage should be removed to make sure that there is no haematoma (blood clot) under the skin.
• Infection is uncommon and can be resolved with antibiotics in the form of tablets or cream.
• Slight numbness is usually present but wears off over 2-3 weeks.
• Despite efforts made to weaken the cartilage framework of the ear, sometimes they gradually spring back to their original position. If this occurs, they can be re-set back performing a small revision procedure.
• Some of the non-dissolvable stitches occasionally work their way out – this causes very few problems and the skin plus cartilage usually settles well.