Plastic Surgery of the Ear
Protruding and drooping ears or torn earlobes can be surgically
corrected. Exceptionally large ears or those that stick out make
children vulnerable to teasing. These procedures do not alter the
patient's hearing, but they may improve appearance and self-confidence.
What is Involved in "Pinning Back" the Ears?
Corrective surgery, called otoplasty, should be considered on ears,
which stick out more than 4/5 of an inch (2 cm) from the back of the
head. It can be performed at any age after the ears have reached full
size, usually at five or six years of age. Having the surgery at a
young age has two benefits: the cartilage is more pliable, making it
easier to reshape, and the child will experience the psychological
benefits of the cosmetic improvement. However, a patient may have
the surgery at any age.
 The
surgery begins with an incision behind the ear, in the fold where the
ear joins the head. The surgeon may remove skin and cartilage or trim
and reshape the cartilage. In addition to correcting protrusion, ears
may also be reshaped, reduced in size, or made more symmetrical. The
cartilage is then secured in the new position with permanent stitches,
which will anchor the ear while healing occurs.
Typically otoplasty surgery takes about two hours. The soft
dressings over the ears will be used for a few weeks as protection, and
the patient usually experiences only mild discomfort. Headbands are
sometimes recommended to hold the ears in place for a month following
surgery or may be prescribed for nighttime wear only.
Can Ear Deformities Be Corrected?
The "fold" of hard, raised cartilage that gives shape to the upper
portion of the ear does not form in all people. This is called "lop-ear
deformity," and it is inherited. The absence of the fold can cause the
ear to stick out or flop down. To correct this problem, the surgeon
places permanent stitches in the upper ear cartilage and ties them in a
way that creates a fold and props the ear up. Scar tissue will form
later, holding the fold in place.
Some infants are born without an opening in their middle ear. These
ears can be surgically opened, and the outer ear reshaped to look like
the other ear. This procedure will restore hearing if the inner ear is
intact.
Those who are born without an ear, or lose an ear due to injury, can
have an artificial ear surgically attached for cosmetic reasons. These
are custom formed to match the patient's other ear. Alternatively, rib
cartilage or a biomedical implant, in addition to the patient's own
soft tissue, can be used to construct a new ear.
What About Torn Earlobes?
Many mothers have had their earlobes torn by a baby's tug on their
earrings. Earrings also catch on clothing and other objects, resulting
in torn earlobes. These tears can be easily repaired surgically,
usually in the doctor's office. In severe cases, the surgeon may cut a
small triangular notch at the bottom of the lobe. A matching flap is
then created from tissue on the other side of the tear, and the two
wedges are fitted together and stitched.
Earlobes usually heal quickly with minimal scarring. In most cases,
the earlobe can be pierced again four to six weeks after surgery to
receive lightweight earrings.
Does Insurance Pay for Cosmetic Ear Surgery?
Insurance usually does not cover surgery solely for cosmetic
reasons. However, insurance may cover, in whole or in part, surgery to
correct a congenital or traumatic defect. Before cosmetic ear surgery,
discuss the procedure with your insurance carrier to determine what
coverage, if any, you can expect.
© 2004 AAO-HNS/AAO-HNSF
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