Otoplasty Sydney

Ear Surgery (Otoplasty)

Otoplasty, also known as ear pinning surgery, reduces the prominence of the ears by setting them closer to the head and recreating the natural fold of the outer ear. It is often chosen by people who feel self-conscious about their ears standing out, and by parents seeking it for a child.

Prominent ears are usually present from birth. The cause is commonly a shallow or absent antihelical fold, a deep conchal bowl, or both, so surgery reshapes the underlying cartilage rather than simply drawing the ear backwards.

Ears reach close to adult size early in childhood, which is why otoplasty is commonly performed from around five or six years of age as well as in teenagers and adults. Dr Maryam Seyedabadi, Specialist Plastic Surgeon, MBBS FRACS, consults on ear surgery at her rooms in Paddington, Sydney.

Who it may suit

• Ears that project noticeably from the side of the head, on one or both sides
• An antihelical fold that is shallow or has not formed
• A visible difference in shape or position between the two ears
• Children from around five or six who are old enough to understand the surgery and cooperate with dressings
• Adults who have considered ear surgery for years and are now ready to discuss it
• Under-correction or relapse after previous ear surgery

What otoplasty involves

Otoplasty is performed in hospital under a general anaesthetic, usually as day surgery. Some adults are suitable for local anaesthetic with sedation.

1. An incision is made in the fold behind the ear, so the scar sits in a natural crease and is hidden in normal view.
2. The cartilage is exposed and weakened or scored where needed, so it can be reshaped without leaving a sharp edge.
3. Permanent sutures are placed to form an antihelical fold and, where the conchal bowl is deep, to reduce projection. A small amount of skin or cartilage is removed if required.
4. The incisions are closed and the ears are held in position with a supportive head dressing.

Recovery

Recovery is usually straightforward, though the ears stay tender and swollen for some weeks. The following is a general guide and differs between patients.

• A head dressing is typically worn for the first several days, often followed by a soft headband at night for some weeks.
• Discomfort is usually manageable with simple analgesia, and sleeping on the side is avoided at first.
• Children commonly return to school after about a week, while sport, swimming and any contact activity are held off longer, often four to six weeks.
• Oedema settles gradually and the position and shape become clear over several months, with the scar behind the ear fading over a year or more.

Risks and considerations

Risks include bleeding or haematoma behind the ear, infection of the skin or cartilage, altered sensation, and thickened or keloid scarring, particularly in those prone to it. Sutures can become palpable or work their way to the surface. The ears may not end up symmetrical, and some correction can be lost as the cartilage relaxes, which occasionally leads to further surgery. General anaesthetic carries its own risks, which the anaesthetist discusses with you.

Prominent ears are a normal variation rather than a medical problem, and there is no obligation to treat them.

Your consultation with Dr Maryam

A referral from a registered medical practitioner is required before your consultation, and a GP referral is preferred. Where the patient is a child or teenager, Dr Maryam wants to hear directly from the young person about whether this is something they want, not only from a parent.

Additional safeguards apply to patients under 18. Alongside consent from a parent or guardian, an assessment by an appropriate registered health practitioner is required, and the cooling-off period is at least three months rather than the minimum seven days that applies to adults. Fees are quoted after consultation, and otoplasty performed for appearance alone does not attract a Medicare item number. Dr Maryam operates at St Luke’s Hospital in Potts Point, Sydney Day Hospital and Double Bay Day Hospital. Call 1300 067 668 to arrange an appointment at 2c Heeley Street, Paddington.