Abnormally protruding ears can make a child of any age the object
of cruel remarks by his or her peers. For any child whose appearance causes
concern, otoplasty, "ear pinning" should be considered before peer pressure
begins to play a significant role in the child's self-esteem, typically age six
or seven. When otoplasty is performed at about age five the development the
auricular (ear) cartilage is at an optimal state of maturity to accept the
modified projection. Otoplasty (OH-TOE-PLASTY) is a safe, effective procedure
performed to achieve a less noticeable appearance while maintaining function.
Because of its potential to foster a child's self-esteem, otoplasty is a most
satisfying facial plastic surgery.
When discussing otoplasty and cosmetic surgery the best place to
start is by looking at before and after
photos to see just what can be accomplished. Adults often tell us that their
protruding ears detract from their beauty and ask to combine otoplasty with
another surgery. Most rejuvenation and contouring surgery can be combined with
otoplasty including facelift, browlift, blepharoplasty (eyelid surgery), chin implants, cheek implants, rhinoplasty (nasal surgery), lip surgery and skin resurfacing.
A board certified facial plastic
surgeon, trained to perform cosmetic and reconstructive surgery exclusively
on the head and neck, knows that his responsibility is to evaluate not only the
areas of concern but also the motivation behind the requests. For adults
considering otoplasty, it goes without saying that cosmetic surgery won't save a
failing marriage. Patients not ready for cosmetic surgery are better served with
conservative measures, such as Botox for fine lines and
wrinkles or Collagen for crows feet. Adults that educate themselves about
cosmetic surgery know when and if the time is right to proceed.
At the
initial consultation, your surgeon evaluated the bony
and soft tissue architecture as well as the form and function of the ears.
Assessment of the head and neck along with the ears themselves provides the
basis for what one may expect from otoplasty. Skin type, ethnic background and
age, along with the degree of deformity and function are important factors
influencing the outcome of surgery. As with all facial plastic surgery, a
thorough health assessment and realistic expectations are prerequisites. The
family's understanding of procedures and routines is essential to a successful
final result.
BEFORE OTOPLASTY SURGERY
At your preoperative
appointment our nurse will provide all the instructions for you to follow before
and after surgery. On the business day prior to the operation we ask you to call
to confirm your arrival time for surgery. Upon arrival for your surgery, you and
your family will talk with a nurse to discuss anesthesia (local anesthesia with
IV sedation keeps you asleep and comfortable) and meet with your doctor before
going to the operating room. Depending on the child's age and development, IV's
are typically started after the child is asleep. Otoplasty takes about one to
two hours depending on the structure and tissue prior to surgery. If you are
having a combination of procedures your surgery will take longer. Recovery time
from the anesthetic takes about an hour and adults will be discharged about four
hours from the time of admission. It may be necessary to watch a youth a bit
longer to be sure she is eating, drinking, voiding and awake enough to go
home.
PREOPERATIVE OTOPLASTY INSTRUCTIONS
- Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil,
Aleve, etc.) for one week prior to and two weeks following your surgery. See
"Medication List" for details about products to avoid prior to surgery. If you
are on any medications that affect bleeding (such as coumadin/warfarin) notify
the office immediately.
- Please refrain from tobacco products and alcohol for one week prior to
surgery. Along with delayed wound healing, persistent skin redness and other
complications may persist when tobacco and alcohol are not discontinued.
- Please notify us of all routine medications and significant health history.
We ask that you remain on your daily medications unless instructed otherwise. At
the preoperative appointment, our nurse will tell you which daily medications to
take with just a sip of water on the morning of surgery.
- At your preoperative appointment you will be given prescriptions for use
following surgery including an oral antibiotic and pain medications. We will
also provide instructions to obtain a wide ski-type headband. Please obtain
these prescription medications and supplies before your surgery so you will have
them ready for use when you return home after surgery.
- Please call the Lindsay House Center for Cosmetic and Reconstructive Surgery
before noon on the business day prior to your procedure at 244-1135 to confirm
your arrival time.
- You may not eat or drink after midnight the evening before the procedure
unless instructed otherwise. You may brush your teeth. Your procedure will be
cancelled if you do not follow these instructions.
- Do not bring valuables (cash, credit cards, watches, jewelry, etc.) to the
Lindsay House on the day of surgery. Remove all make-up and nail polish before
arriving for your procedure.
- It is not required that a family member or friend stay at the Lindsay House
during your surgery. However, someone must be available by telephone at all
times while you are here at the Lindsay House for surgery. Someone will need to
drive you home after your surgery and stay with you that evening. Transportation
to the office for head dressing removal three to four days following surgery is
also required.
AFTER OTOPLASTY SURGERY
When you wake up from surgery
you will notice a snug head wrap dressing that covers your ears. This helps to
minimize swelling and reinforce the new position of the ears. The head wrap
dressing may temporarily affect your hearing.
Following otoplasty, the
nurses will ask assist you to meet the discharge criteria: to drink liquids,
walk with a steady gait, void, manage your discomfort, and to see that you can
make your needs known. The nurses will teach you how to keep the head wrap
dressing dry and intact for about three to four days.
You will be asked
to come to our Lindsay House office (not the Surgery Center) three days after
surgery for removal of the head dressing with replacement of the ski-type
headband. It is essential that you bring the headband with you to this
appointment. Most patients tell us removal of the head dressing is a big
relief.
POSTOPERATIVE OTOPLASTY INSTRUCTIONS
Activity
Sleep
with head of the bed elevated or use two to three pillows for one week after
surgery. Absolutely no bending, lifting or straining. For adult otoplasty
patients, if you have little children, sit on the floor to let them climb on to
your lap. We recommend no driving for one week following surgery while the head
dressing is in place due to decreased hearing and range of motion of the head
and neck. A minimum of one week off work is recommended.
Diet
Advance diet from liquids to soft food
to your regular diet as tolerated.
Wound care
For three to four days after
surgery, keep the dressing dry and intact. Bathing is OK, but do not get the
dressing wet.
Medications
Use pain medication (Tylenol
with codeine/hydrocodone) as needed. Most patients complain of discomfort more
than pain. Do not take additional Tylenol or acetaminophen while taking Tylenol
with codeine. For adult otoplasty patients, do not drive or drink alcohol while
taking pain medication. Side effects of pain medications can include nausea and
constipation. Taking pain medication with food helps minimize nausea.
Over-the-counter laxatives are indicated if constipation persists.
Start your antibiotic (Keflex/cephalexin) when you get home. It is
not uncommon to have a low-grade fever for 24 hours following surgery.
Please Remember!
Bruising, swelling and
disrupted sleep are very normal postoperative symptoms and will decrease as the
healing process occurs. Since hearing is temporarily compromised, assistance
with daily activities is recommended.
Final Result
Following otoplasty, it takes
time for the swelling to subside and for the skin to heal. Most patients return
to school one to two weeks following surgery, depending on temporary bruising
and swelling. We recommend a minimum of two weeks out of physical education and
a written excuse will be provided.
Final results following otoplasty are not assessed for one full
year following surgery. After three months, the changes are ever so subtle,
although still important. Being perfectionists about our work, you may tell us
you are pleased long before the one year anniversary. However, we request that
you follow-up with us at that time for postoperative photographs and so that we
can enjoy your final result.
Please notify the office 244-1000 and ask for our
nurse for any concerns. For an emergency, please contact our office or
professional answering service at 258-4851. Remember, we are all here to help in
any way we can.