What is otoplasty?

Otoplasty is a type of ear correction surgery that aims to correct some irregularity or improve your ears' appearance. According to 2018 figures, surgeons performed nearly 23,000 otoplasty procedures in the United States. Otoplasty does not seek to enhance your hearing; instead, it involves the visible part of your outer ear, referred to as the auricle. 
For some, the auricle fails to develop correctly, leaving them with ears that are either too small, too large, incorrectly shaped, or positioned. Although the outer ear plays only a minor role in hearing, it is an integral part of our physical appearance. Understandably, some people may feel embarrassed about having ears that are too prominent.
Over time, embarrassment can grow into shame, may lower self-esteem, and even destroy self-confidence. Dissatisfaction with the outer ear's esthetic appearance is one of the primary reasons people opt for otoplasty. 
In general, the earliest doctors perform otoplasty is after age five. This age limit is because ears reach their full size by around that time. Naturally, it is best to wait with an ear correction surgery until after the ears finished their development. It is, however, not uncommon for parents to have their children undergo the procedure before they start school. 

What are the most common types of otoplasty?

The three main types of otoplasty most frequently performed are ear pinning, ear augmentation, and ear reduction.  
Pinnaplasty or ear pinning involves bringing the ears closer to the head. If your ears prominently stick out from the side of your head, you may choose to get this procedure. During ear pinning surgery, doctors make small cuts behind each ear cartilage to reshape and fold them or remove parts of the cartilage to give your ears a shape that you are happy with. 

Ear augmentation is for those who have small ears or ears that haven't fully developed. Although it is not possible to make your ears bigger without surgery, a plastic surgeon can perform otoplasty to increase the size of your outer ear.
Ear reduction is a type of otoplasty that surgeons use to resolve macrotia - abnormal enlargement of the auricle. When your ears are larger than usual, this is the type of otoplasty you may choose to reduce the size of your ears.

Am I a good candidate for otoplasty?

If you want to have your ears pinned back, reshaped, enlarged, or made smaller, you are probably contemplating otoplasty. It could also be that you have already undergone the procedure, but your ears still stick out. If you are not happy with the results of your past otoplasty, you may choose to have another one done. 
You are a good candidate for ear reconstruction surgery if you are older than age five, in good overall health, and do not smoke. Being a smoker is particularly problematic because it slows the healing process by reducing the blood flow to the area. 

What can I expect before, during, and after otoplasty?

Before otoplasty

Regardless of how eager you are to have your ears pinned back or reshape your ears, it is vital to research the procedure and find the right plastic surgeon for you. You don't want to rush, make the wrong decisions, and potentially face negative consequences. 
When you are ready to proceed with cosmetic ear surgery, start by finding a board-certified plastic surgeon for otoplasty in your area. Board certification gives you a reasonable assurance that your doctor is highly trained in the area of ear corrections. Once you made your selection, call the office and schedule a consultation with your plastic surgeon. 
At the time of your appointment, your doctor will conduct a complete medical history review and collect all necessary information from you. Be sure to share all relevant information, including types and dates of past surgeries, medications you are taking, and current or past medical conditions. 
The surgeon will also examine your ears, discuss the risks and benefits of the procedure, and share with you how much the ear surgery will cost. We recommend asking plenty of questions. It is a good idea to make a list of any questions you want answers to in preparation for your consultation. This way, you can be sure you don't forget anything and have all your questions answered.  
By the end of the consultation, your doctor should be able to determine whether you are a good candidate for ear reconstruction surgery, and you should feel more prepared to take the next step. 

During otoplasty

Although otoplasty is generally an outpatient procedure, also called same-day or office-based surgery, it can take anywhere from sixty minutes to over three hours. The amount of time your surgeon will need to perform the ear reconstruction successfully depends on your case and procedure's complexity.
As part of the surgery, your doctor will give you some form of anesthesia or medication to keep you from feeling pain during the procedure. Most patients receive local anesthesia as a one-time injection to numb the area. It is, however, not uncommon to receive general anesthesia, which causes you to become unconscious during the procedure. 
Depending on the type of otoplasty you need, the plastic surgeon will use different surgical techniques. However, most otoplasty procedures involve doctors making a small incision either behind the ear or inside the ear folds, folding and shaping the ear cartilage, and closing the incision with stitches.
If you are apprehensive about incisions, scarless otoplasty - incisionless or no-incision otoplasty - may be the best fit for you. This method utilizes sutures that the doctor places discretely behind your ear to manipulate the ear cartilage to a different position. Unfortunately, incisonless otoplasty surgeries are not appropriate for major adjustments. They are typically used for children and teenagers needing minor changes. 

After otoplasty: Recovery

While recovering from otoplasty is often faster than from other plastic surgical procedures, there are a few things to be mindful of to ensure your recovery goes smoothly. 
Although it may be tempting to show off your ears to the world immediately after surgery, you will have to be patient and wait a couple of weeks. Your doctor will place a dressing over the surgical site right after the procedure, which you will need to keep on for several days post-op. 
After the surgical dressing is removed, you will be getting a lighter dressing with an elastic headband, which you will need to wear for about four to six weeks. Be sure to follow the instructions provided by your physician and avoid rubbing or touching your ears. 
While otoplasty aftercare is not overly complicated, there are a few additional steps you should take to ensure a speedy recovery. 
  • Do not smoke and avoid people who smoke around you for at least two weeks after otoplasty surgery. Smoking can cause poor healing and a slow recovery. 
  • If you see discharge coming out of your ears during the first few days after surgery, stay calm. It is not uncommon for the ears to drain a small amount of fluid. If you notice this happening, apply hydrogen peroxide with a cotton swab and clean the outer part of your ears. 
  • To minimize swelling, keep your head elevated at night while you sleep. 
  • As days pass, incisions may become itchy. Itchiness is a normal part of healing, do your best to avoid scratching them. 
Don't be alarmed if you experience some side effects post-surgery. Many people notice redness, swelling, bruising, numbness around the surgical site, all of which are considered a normal part of otoplasty surgery recovery

How much does cosmetic ear surgery cost?

According to 2019 data available from the American Society of Plastic Surgeons, the average cost of otoplasty is around $3,220, not including fees for anesthesia, operating room, and other expenses. Insurance companies do not typically cover otoplasty as it is considered a cosmetic procedure. 

However, you should never assume and reach out to your insurance provider and discuss your specific case. You might find that otoplasty is on the list of covered services when it is needed to alleviate a medical condition. If you learn that you do need to pay out of pocket, you may want to find out if your plastic surgeon offers a payment plan. 
Make an appointment with a hearing specialist today to learn more about otoplasty.