The size, shape, and position of the normal ear is most often a familial characteristic. This can be observed by comparing parents, grandparents, and siblings of any patient under examination. Deformities of the ear are also of similar nature, including those which show variations of cartilage contour and the protruding ear, particularly when both sides are involved.

The child with protruding ears is often subjected to unkind remarks that can be a source of significant distress. Feelings of self-consciousness, rejection, and hostility are underlying reactions to lack of peer acceptance. While adults generally do not express such attitudes openly, the grown individual frequently maintains the same sensitivities that were present during childhood.

Ear correction surgery can be performed quite effectively as early as the fifth year. By that time, the ear itself has already reached almost adult size so that there will be little if any subsequent change. The operation is performed by repositioning or otherwise altering the flexible cartilage structures. There are several variations of deformity, each of which must be treated in a different manner. Basically, the surgical objectives are to reduce the protrusion and at the same time to provide a soft natural curve of the anti-helical fold when the ear is viewed from the side. Surgical incisions are ordinarily placed behind the ear where any remaining surface scars will not be visible. Sutures are absorbable and do not require removal.

What To Expect

The operation is usually performed under general anaesthetic at a day clinic. In certain adult cases, it can be performed under local anaesthetic with sedation.

Application of a turban head dressing is necessary so that both ears can be protected, swelling minimized and discomfort limited. The head dressing will also permit the patient to turn from side to side when asleep without painful pressure. In this case, the surgical head dressing is worn for seven days after which time the patient returns to Dr Efraim’s rooms for it to be removed. The purpose of the head dressing and careful padding is to avoid fluid collection and therefore it should not be disturbed.

After removal of the dressings, the patient is requested to wear a bandage at night only for a period of three weeks. Some variations in management should be anticipated, depending largely upon the specific correction under consideration.

Because the cartilage is still relatively soft and pliable in the young child, very little pain is experienced by children. In adult patients however, where the cartilage is harder and less conformable, the pain might be significantly more. Dr Efraim will prescribe adequate pain killers which should be taken at regular intervals.

The hazards or risks in this procedure are few. Probably the most common is residual irregularity in the cartilage when the ear is viewed from either frontal or lateral planes. It should be noted, however, that both ears are never exactly alike, even in the normal state and that perfect symmetry is therefore not a reasonable expectation.

Sometimes, the permanent sutures placed to keep the shape of the cartilage, might extrude after a few months. Should it happen, just return to Dr Efraim, and it can be removed, without any effect on the permanent result.

Minor adjustments in earlobes may also be desirable afterwards. Finally, the operation has no adverse effects upon the hearing mechanism, which involves the inner ear structures.

The otoplasty operation is generally most successful and can truly provide satisfaction with improved personal confidence and self-esteem.