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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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Otoplasty

We empower beauty. ®

Ear Surgery New York City

Ear deformities:

Img_EarsPeople with “normal” ears don’t think about them much, but anyone with ears that stick out, fold over or may even be just a fragment of an ear are all too aware of them. Children in particular can become hyper-sensitive to what they may see as a serious deformity. Even young children with “different” ears are often subjected to merciless teasing or bullying that can affect their overall self-esteem and subsequent ability to develop socially. They may be branded “Dumbo” or “mouse-ears” by their playmates.

Fortunately, corrections for ear deformities are among the very few plastic surgery procedures that can be performed on young children, starting as young as 5 to 6 years of age. In fact, for some, the earlier these conditions are addressed the better.

We offer procedures to make ears look more natural, treating a range of issues including:

  • Protruding ears
  • Lop ear – where the top of the ear bends over (more information below including non-surgical options when the condition is treated soon after birth)
  • Constricted ear – an ear that is extremely cupped and too small
  • Microtia – when the ear doesn’t form at all (more information below)
  • Split earlobes – a torn pierced earring hold that can be repaired

Otoplasty

Otoplasty is the surgical treatment for protruding ears. This is one of the few cosmetic procedures that can be performed on children. There are generally two problems with protruding ears: the first is a lack of formation of the “anti-helical fold.” The second deformity is an excessively deep cup of the ear called the “conchal bowl.” Otoplasty helps create or deepen the anti-helical fold by using a special suture technique called Mustardé sutures. The conchal bowl can be made less shallow by more sutures and sometimes removal of small ovals of cartilage. Otoplasty is individualized for each patient and accomplished through a small incision that is hidden in the crease behind the ear.

Otoplasty can be performed on children as young as 6 years old. By the age of 6, a child’s ears are 90% of the adult size. They are starting to socialize more in school and may be subjected to teasing. So, surgery at this young age is advisable for a child who is uncomfortable with negative “ear attention.” Also by age 6, children are aware enough to participate in the decision of whether surgery should be an option for them to address the pain of ridicule. However, we often find that young children may not be forthcoming about being teased, so it is important to talk to them about their experiences to determine if they are feeling ostracized or embarrassed because of their ears. If they aren’t bothered by their ears, surgery is not necessary or should be put off until it becomes a problem.

Opting for plastic surgery, especially on your child is never an easy decision. There are people who suggest that this should never be done. But, if your child is being teased and it is affecting their ability to develop self esteem, they may be a candidate for surgery. We don’t consider otoplasty “cosmetic” or “aesthetic” plastic surgery. Rather we believe it to be reconstructive plastic surgery for an inborn deformity almost akin to cleft lip surgery or even braces for buck teeth. One way to gauge if your child is ready for surgery is their reaction to computer imaging during the consultation. The smile we see when simulating otoplasty on the computer imager is often enough to convince you and your child that surgery can make a huge difference in their self-image which in turn can affect their entire future. This smile is only surpassed by the smile we see after surgery.

Otoplasty is very safe surgery with an extremely high success rate. For children, otoplasty is performed under general anesthesia. In adults, local anesthesia with sedation is used. Otoplasty is well received by patients. It’s heartwarming to see the look on a child’s face when the bandages are removed 5 days following surgery and they no longer have “dumbo ears.”

Lop ear and Microtia:

Lop ear deformity is when the top of the ear bends over. This is due to abnormal folding that occurs prior to birth. Lop ear may actually be treatable by an ear mold placed on the child’s ear at birth and worn for a number of weeks. The ear cartilage is soft and often moldable at this very young age, even without surgery.

Microtia is when a child is born with a poorly formed or almost no ear. A new ear can be rebuilt from the child’s own rib or by implanting synthetic framework to create a new ear. Microtia repair usually requires a series of operations to achieve the final result. The results of surgery are often life-altering and very satisfying for parents and children alike.

Split earlobes:

Are you unable to wear your expensive diamond stud earrings due to an enlarged hole; a “Pac-Man” deformity? A very common condition that Dr. Pearlman often repairs is tears in the earlobe as a result of earrings that pull through. These earring holes may also be elongated due to an accident. The most common culprits causing this condition are sweaters, hairbrushes and babies. Earlobes can be repaired under local anesthesia in the office. The procedure takes about 20 minutes per ear and patients often go right back to work after. Ears can be re-pierced in about 6 weeks. It’s a quick and relatively painless solution to a rather unsightly and often overlooked condition.

FAQs

Answers to frequently asked questions about the procedure

Q: Is there a scar after otoplasty and what is the downtime?

The incision for otoplasty is behind the ear, so it is well hidden. Patients wear a dressing over the ears for 5 days following otoplasty, the black and blue will last up to a week and a half.

Q: Will otoplasty affect my hearing?

Otoplasty will not alter hearing.

Q: What age is appropriate for otoplasty?

Otoplasty can be performed on children as young as 6 years old since their ears are 90% of the adult size. Also, by the age of 6 children are old enough to participate in the decision, understand why they are having surgery, but not old enough to have been teased for years in school.

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