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Overly protruding ears are often a center of attention and can
result in unnecessary ridicule. Ears that are excessively large
or otherwise malformed are difficult to hide owing to their prominent
position. Children are often victims of being labeled with unkind
names such as "Dumbo" or "Mickey Mouse". Even the mildest distortion
in size or shape can lead to self-consciousness and, particularly
in children, to low self esteem and difficulties with social adaptation.
Otoplasty refers to any of a number of procedures aimed at correcting
the size, curvature, angles or prominence of the ears. If only one
ear is involved, the surgery can match the affected ear to the unaffected
ear; if both ears are involved, well established norms of size,
angles and prominence are used to set the ears in a more aesthetically
pleasing position.
Otoplasty surgery is best performed before socialization and after
the ear has grown to nearly adult size. This generally corresponds
to age 4 to 6. By this time, the ear has achieved 95% adult size
and it is still early enough to spare children the potential for
mockery upon commencing school. Additionally, the ear cartilage
is much more pliable in childhood allowing for easier shaping into
a more desirable form. Occasionally, the procedure is delayed until
the child is older, particularly if the ears can be covered with
long hair styles.
Protruding ears not corrected in childhood can be addressed in
adulthood although the more rigid adult cartilage often requires
additional techniques to be adequately molded.
The procedure may require various combinations of cartilage "folding",
placement of sutures under the skin, molding of the cartilage and
techniques to set the ears closer to the side of the head. Surgery
usually lasts 1 to 2 hours. In adults, the procedure can be performed
under local anesthesia while in children general anesthesia is required
because of a child's fear and inability to fully cooperate.
After surgery a compressive dressing is placed. There
is very little discomfort associated with the procedure. The compressive
dressing is removed in 24 hours and a lighter dressing is applied
with a protective plastic "shell" which protects the ear during
sleep. This can be removed for showering or cleaning the ears but
should be worn at all other times for 3-7 days.
The results are generally quite dramatic. The incision created
in the crease behind the ear heals to a fine white line and is nearly
invisible. The properly performed otoplasty results in a natural
appearing ear with smooth curves and angles and with excellent symmetry
between sides. The ears no longer dominate the frontal view of the
face and better facial harmony is achieved.
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