Unusual physical characteristics can make us all self-conscious, and can be especially stressful for a child, often subjecting them to ridicule or teasing from their peers. This is especially true of ears that 'stick out' or protrude. Otoplasty, or 'ear pinning' can boost your child's self-esteem, especially if it is done before age six or seven, the age at which the opinions of one's peers tends to become more important. Around age five, the auricular or ear cartilage is at the optimal level to accept alteration, and is at the perfect stage of maturity to perform otoplasty.
Many people are self-conscious about ears that stick out, and feel that it undermines their attractiveness. When you are considering otoplasty to fix this problem, the best way to prepare is by looking at before and after shots of this procedure; this will give you a good idea of what can be done for ear reshaping. Otoplasty is often done along with other surgeries, and most surgeries can be combined with this procedure. Contouring and rejuvenating surgeries that are often done along with otoplasty are: blepharoplasty (cosmetic surgery on the eyelid), rhinoplasty (cosmetic surgery for the nose), chin or cheek implants, face or brow lifts, and lip augmentation and skin resurfacing. Sometimes only one ear is affected; in this case, surgery on both ears is still recommended so that the ears present a pleasing and symmetric appearance.
Before scheduling a consultation, begin by viewing our photo gallery to see the results enjoyed by our surgeons' actual patients.
1) People make fun of me because my ears stick out. Can you help me?
Although it is typical to see younger patients with this complaint, it is painful to be teased at any age. You might be surprised to know it's not uncommon for adults come to us each year to address this same complaint. They grow tired of adjusting hairstyles to cover their ears. It is never too late to correct what is referred to in the medical literature as "bat" ears. Otoplasty is a safe, outpatient plastic surgery procedure that allows us to "pin back" and, if indicated, reconstruct or reshape the cartilage so the ears are symmetrical and rest closer to the head.
2) I already had an otoplasty and I'm not happy with the results.
Although there may be many unexpected factors that can affect a final result such as wound healing or compliance with postoperative otoplasty routines, a good result is also based on the expert knowledge and experience and skill of the plastic surgeon. A board certified facial plastic surgeon comfortable with otoplasty weighs all of the following factors:
The plastic surgeon performing a revision otoplasty needs to be very experienced and skilled with the procedure for several reasons – not the least of which is that revision otoplasty is a much more difficult procedure because the original cartilage and original anatomical landmarks have been altered by the initial otoplasty.
At the Quatela Center for Plastic Surgery, not only do we have extensive experience working with auricular (ear) cartilage and revision otoplasty, a good deal of our research and scientific publications focus on auricular cartilage and ear deformity. Revision otoplasty is one procedure that we highly recommend extreme vigilance in the screening process of your board certified plastic surgeon.
3) What's the best age for my child to have an otoplasty?
There are a couple of factors to consider in determining the best age for your youth. First, ear development nears maturity around five or six years of age. Therefore, that age is an excellent time to have your child evaluated by a facial plastic surgeon. Another important factor is the psychological effect of peer pressure, which routinely starts around ages seven or eight. If the otoplasty is performed prior to the onset of peer pressure yet timed when the cartilage is mature enough to be reshaped, your child is not as adversely affected by the teasing of unknowing classmates. Typically we tell parents to schedule an initial consultation when the child is about age five or six.
4) Will I still look like "me" after surgery?
Before and After Photos
Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: "Gee you look great. Did you change your hairstyle?" or "Have you been on vacation?" Retaining your unique beauty is the sign of a successful procedure. Although the change may be significant to you, it's not uncommon that friends and family don't really notice the specific changes.
5) Yes, but I want to dramatically change the appearance of my ears. Can I do that?
This is an excellent question because it leads to evaluating realistic expectations. This question can only be answered on an individual basis. A sign of a good facial plastic surgeon is one who can tell the difference between realistic and unrealistic expectations and one who will be truthful about meeting each patient's desires. Our biggest referral source is from satisfied patients – ones who have had realistic expectations and were satisfied with results.
6) Will I be awake during otoplasty surgery?
Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during operation. Patients do not hear or feel anything and are comfortable during otoplasty surgery. Patients wake up very soon after the ear pinning surgery is completed. Intravenous sedation is a type of anesthesia; therefore all patients must have a responsible adult to stay with them through the night following surgery. Patients may not drive for 24 hours after their otoplasty procedure and this time may be longer, depending on the procedure.
7) Is otoplasty surgery painful?
After any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication two to three days after surgery and then switch to Extra Strength Tylenol. It is uncommon for patients to report unmanageable pain after otoplasty surgery.
8) How long does my otoplasty surgery take?
The length of your otoplasty surgery depends on several factors including the complexity of each person's ears. Many patients who have previously had an otoplasty are referred to the Lindsay House for revision surgery. Revision otoplasty can take a little longer because of corrections that need to be made as a result of the initial surgery.
10) Do I go home after otoplasty surgery?
Most otoplasties are done on an outpatient basis. Because you will go home after receiving sedation, you will need to make arrangements for a responsible adult to drive you home, to stay with you overnight and to drive you to our office for your first postoperative otoplasty appointment. Patients having ear pinning surgery must stay in the immediate Rochester area overnight within 30 minutes of our East Avenue facility.
11) I'm from out of town. Where can I stay overnight in Rochester, New York?
Accommodations are comfortable and convenient for Quatela Center for Plastic Surgery clients. The Strathallen, located "just down the street" provides upscale, affordable accommodations for Lindsay House visitors. For added convenience following otoplasty surgery, some patients elect to stay in our Carriage House, located adjacent to the Lindsay House. For guests without the benefit of family or friends in the Rochester area, our staff will be happy to assist you with arrangements for a smooth, restful experience following your otoplasty procedure.
12) How long should I stay in Rochester following otoplasty surgery?
Most patients stay in Rochester about seven to ten days following otoplasty surgery. After that it's ok to fly or travel long distances.
13) How long will bruising and swelling last?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.
14) When can I go back to work or school?
Most patients take three to four days off work but occasionally a patient returns after one week. After two weeks, any residual bruising and swelling can easily be camouflaged with make-up. Patients who are more concerned with privacy prefer two weeks off work. Children may return to school after three to four days but should remain out of physical education and contact sports for three weeks.
15) When can I "work out?"
Aerobic activities should be avoided for three weeks following otoplasty surgery. It's important to avoid bending, lifting or straining during the postoperative period as these activities can increase swelling and delay healing.
16) I really want to do this but I'm nervous. What if I get stressed?
It's ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other patients have gone through. We are interested in having your experience be positive – whether you ever have otoplasty surgery or not!
1) What do I do to prepare for my otoplasty surgery?
Although the preparation for otoplasty surgery is pretty simple, it is an essential element in a successful outcome. To prepare for ear pinning surgery, a preoperative appointment will be scheduled with one of our experienced nurses.
2) What happens at the preoperative otoplasty appointment?
Many things! To name a few, you will meet with our nurse to review your health history, answer your questions, instruct you on how to prepare for ear pinning surgery, receive the prescriptions for use after surgery and tell you what to expect. Most of the instructions are listed here. This list of questions, however, will not take the place of a preoperative visit, which is essential in determining a patient's understanding and readiness for surgery. We will be sure you are signing for informed consent.
3) What does informed consent mean?
Informed consent means you have an excellent understanding about the benefits of plastic surgery as well as any risks, and all the preoperative and postoperative information. You are making an "informed" decision as to whether plastic surgery is right for you.
4) What are the benefits and risks of the otoplasty procedure?
As part of your initial consultation, your physician will review your expectations for surgery. At that time, he can provide a realistic picture of what surgery can and cannot accomplish. We will provide you with a list of risks reported in the medical literature associated with any procedures you are considering. Although risks from cosmetic surgery are uncommon, every patient should be fully informed of any risks associated with surgery.
6) What if I have a history of bad scars?
If you have pierced ears, the way you healed there is a good indication of how you will heal from your plastic surgery. Scars on the rest of the body typically are not an indication for how patients heal following facial plastic surgery. At the time of your consultation, it's important to show your physician any previous scars (sometimes called keloid scars) that are of concern so he can give you a realistic assessment of your healing potential following facial plastic surgery.
7) What are some of the other things to do to prepare for otoplasty surgery?
We review your health history and any daily medications you may be taking. Because tobacco abuse impedes wound healing, you will be asked to stop for two weeks before otoplasty surgery and two weeks following surgery. Our nurses will be happy to discuss over-the-counter aids to help you with this.
8) What about my daily medications before otoplasty surgery?
You will have a preoperative appointment well in advance of your otoplasty surgery when our experienced staff will review all mediations with you. If you are on "blood thinners," you will be asked to stop them approximately one week prior to otoplasty surgery. See also our Medication List" for instructions on medications and supplements to avoid prior to otoplasty surgery.
9) I take vitamins and supplements. Do I need to stop them before my otoplasty surgery?
Most vitamins and supplements have few side effects. However, there are some that can such as vitamin E and ginko-bilova affect bleeding during otoplasty surgery. Our "Medication List" reviews medications and supplements to avoid one week before plastic surgery.
10) Do I need any special prescriptions before plastic surgery?
Most patients do not need any special prescriptions before otoplasty surgery. Please let us know of any special medical concerns you may have. We do ask you to start Vitamin C (which promotes wound healing) three times a day with food one week before your otoplasty surgery. The prescriptions needed after otoplasty surgery are discussed below. You will be asked not to eat or drink anything after midnight the night before your plastic surgery.
11) Why will I be asked not to eat or drink anything after midnight before the otoplasty procedure?
Anesthesia medications can cause stomach upset. The best way to prevent after effects from anesthesia will be to avoid food or drink from midnight the night before otoplasty surgery. For patients with special concerns, such as a patient with diabetes, our anesthesia team will be happy to address special arrangements with you ahead of time.
12) Where do I check in on surgery day?
The check-in process is pretty easy and so confidential. Because all consultations, office visits, surgical and nonsurgical experiences take place at the same address, you'll already be familiar with where to come on surgery day. Privacy is the hallmark of the Quatela Center for Plastic Surgery.
13) What happens when I check in for my otoplasty surgery?
Our nurses will help you get ready for ear pinning surgery. Please let them know of any special needs you may have. Also, be assured that you have plenty of time for any last minute questions with your plastic surgeon.
14) Does someone have to stay at the Lindsay House while I have my otoplasty surgery?
No one needs to stay at the Quatela Center for Plastic Surgery during your otoplasty surgery. However, you must have someone available by telephone at all times during your ear pinning surgery.
15) I'm concerned about privacy.
During a recent independent study, privacy was found to be one of the advantages that attracted people most to the Quatela Center for Plastic Surgery. Because all consultations, office visits, surgical and nonsurgical experiences take place at the same address, the check-in process is confidential.
1) What do I look like when I wake up from otoplasty surgery?
Following the ear pinning procedure, you will have a snug dressing wrapped around your head covering your ears and keeping them in place. Because your ears are covered you will not notice the swelling and bruising. When the dressing is removed at the first postoperative appointment on the next day following otoplasty surgery, you may notice some bruising and swelling at that time.
2) What does it feel like when I wake up from otoplasty surgery?
You will feel the snug dressing around your ears. Hearing may be diminished while the dressing is intact. We will make sure you are not nauseated or queasy. Our nurses will be right there with you as you wake up from your otoplasty surgery to give you special attention.
3) When I'm awake enough, can I drive myself home?
No. Someone will need to drive you home after your otoplasty surgery and stay with you that evening. Someone will need to drive you back to the Quatela Center for Plastic Surgery the following morning for packing removal.
5) Will I need any special prescriptions following otoplasty surgery?
Yes. Postoperative prescriptions are provided well in advance of surgery day so you arrive home completely prepared. Postoperative prescriptions and over-the-counter medications for otoplasty patients include the following:
A) An antibiotic (usually Amoxicillin) to take after surgery to prevent infection.
B) Pain medication (usually Vicodin/hydrocodone) to minimize any discomfort following otoplasty surgery.
C) Swelling medication (Medrol dosepak/methyl prednisolone) minimizes swelling.
D) Peroxide and antibiotic ointment (Polysporin/bacitracin) to place on the incision after the dressing is removed.
E) Vitamin C daily with food daily for one week following otoplasty surgery.
7) How long will bruising and swelling last?
For most patients, bruising and swelling lasts about a week after otoplasty surgery. If you bruise easily, it could last up to two weeks, however, this is uncommon.
9) Are there any dietary restrictions following my otoplasty surgery?
No. Patients can eat whatever they want. Advance your diet from liquids to soft food to solids as tolerated. Please drink as much fluid as you can which will help you from becoming dehydrated.
10) When can I shower?
The head dressing must remain dry and in place overnight following your otoplasty surgery. Therefore, you should not shower until after the dressing is removed. You may take a bath any time following dressing removal and may wash hair three days postoperatively.
11) When is my first postoperative otoplasty appointment?
You will be asked to come to the Quatela Center for Plastic Surgery the next day following ear pinning surgery for dressing removal. Your second appointment will be at one week following otoplasty surgery for suture removal. Most patients describe suture removal as discomfort rather than pain.
12) Are there any instructions about regular daily activities?
Sleep with head of the bed elevated or use two to three pillows. Facial fullness and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Absolutely no bending, lifting or straining for one week after otoplasty surgery. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap.
13) When will I look normal?
Most of our patients tell us that they look "normal" at about ten days postoperatively. You will still notice swelling and your final result is still a ways off. However, at two weeks you know you are well on the way to recovery from your otoplasty surgery.
Compassionate and dedicated to personalized patient care, Dr. Quatela is a board-certified facial plastic surgeon recognized worldwide for his expertise in facial rejuvenation. He established the Quatela Center for Plastic Surgery in Rochester, New York to provide excellence in aesthetic surgery.
This is defined ordinarily as trauma from heavy or dangling earrings which produces a slit in the earlobe that starts at the point of piercing and continues to the very base of the lobe. Although split earlobe repair may be considered by most to be a minor cosmetic procedure, we include it here because the procedure is commonly requested.
PREOPERATIVE SPLIT EARLOBE REPAIR INSTRUCTIONS
Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for one week prior to your surgery. At your initial visit, we will provide a medication list (separate page of instructions) which outlines in detail products to avoid prior to surgery. If you are on any medications that affect bleeding (such as coumadin or warfarin) please notify the office immediately.
Please refrain from tobacco products and alcohol for one week prior and one week following 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.
After your surgery is complete, you may be given prescriptions for use following Rochester split earlobe repair surgery including an oral antibiotic (typically Keflex/Cephalexin) and pain medication (typically Vicodin/hydrocodone). Occasionally for patients with significant swelling, you will be given an additional prescription (typically Medrol Dosepak/methyl prednisolone).
The day before your surgery, we will ask you to begin Vitamin C (ascorbic acid) 3000 mg daily for one week after surgery to help promote healing. To minimize bruising, you will also be asked to start Arnica (a natural supplement) the day before surgery and continue for one week following surgery.
Please call the Lindsay House at (585) 244-1000 before noon on the business day prior to your procedure to confirm your arrival time.
There are no dietary restrictions before the procedure unless instructed otherwise. You may brush your teeth.
Do not bring valuables (cash, credit cards, watches, jewelry, etc.) to the Lindsay House on the day of surgery.
It is not required that a family member or friend stay at the Lindsay House during your surgery. If you have local (numbing) anesthesia, you will be able to drive yourself home after your surgery.
AFTER SPLIT EARLOBE REPAIR SURGERY
Following your split ear lobe repair, the nurse will review all instructions you will need for postoperative care. Avoid putting the phone to the affected ear for one week following surgery. Avoid turtlenecks or tight fitting clothing for one week following split ear lobe repair.
When your surgery is complete, you will notice a few steri-strips (little white Band-Aids) that may feel a bit tight because of the swelling. This dressing helps to keep the sutures securely in place. The steri-strips must be kept dry and in place for five to six days following surgery. You will be asked to come to our Lindsay House Office on postoperative day five or six for suture removal. Although your ear lobe is not completely healed at this time, the sutures are removed to prevent permanent suture marks.
The morning of the suture removal, we request that you shower and get the steri-strips wet, which will help loosen the steri-strips for removal at your appointment. Most patients describe suture removal as discomfort rather than pain and do not take pain medication prior to this appointment. However, if you want to take pain medication about an hour prior to suture removal you will need to have someone drive you to this appointment. When sutures are removed, new steri-strips will be placed to reinforce the incision. These new steri strips must remain dry and in place for four days. You may then get them wet in the shower before your second postoperative appointment.
Fellowship trained in facial plastic and reconstructive surgery, Dr. Lee is dedicated to improving the lives of adults and children by using her surgical talents. She specializes in procedure of the face and head including facelift, functional and cosmetic nose surgery, blepharoplasty, and injectable treatments.
POSTOPERATIVE SPLIT EARLOBE REPAIR INSTRUCTIONS
Keep dressing dry and intact the evening after surgery and until the morning you return for suture removal. Notify your doctor if the dressings become loose or fall off.
Most patients complain of discomfort more than pain. Use pain medication (typically Vicodin/hydrocodone) as directed/as needed. Vicodin contains Tylenol. Do not take additional Tylenol or acetaminophen while taking Vicodin. Do not drive or drink alcohol while taking pain medication. Taking pain medication with food helps minimize nausea sometimes associated with pain medications.
Start your antibiotic (typically Keflex/cephalexin) when you get home and one at bedtime. It is not uncommon to have a low-grade fever for 24 to 48 hours following surgery.
Start swelling medication (typically Medrol Dosepak/methyl prednisolone) when you arrive home and again at bedtime. Take with food.
Vitamin C (ascorbic acid) 3000 mg daily for one week following surgery helps promote healing.
Sleep with head of the bed elevated or use two to three pillows for one week after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. Avoid putting the phone to the affected ear for one week following surgery. Avoid turtlenecks or tight fitting clothing for one week following split ear lobe repair. Patients typically do not need to take time off work other than the time for the surgery. You may wear clip on earrings beginning two weeks after split ear lobe repair.
Always protect your face from the sun. Following surgery, our staff will tell you when it is OK to apply sunscreen, cosmetics or facial creams to the surgical site. Avoid unprotected prolonged sun exposure for three months following split ear lobe repair to prevent pigmentation of incision lines.
Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs.
Following split ear lobe repair, it takes time for the swelling to subside and for the skin to heal. At ten days postoperatively, swelling and minimal bruising may be apparent to you but not to many of your coworkers and closest friends.
Final results following any cosmetic surgery are not apparent for one full year. 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 (585) 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.
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