Ear plastic surgery can help patients born with underdeveloped, protruding, or drooping ear(s) due to weak or poorly formed cartilage. A partially formed exterior ear is called “microtia,” while a completely undeveloped ear is referred to as “anotia.” Traumatic malformations of the ear also occur due to torn earlobes, automobile or other accidents, animal attacks, and more. Deformity of the ears may cause social anxiety and make children vulnerable to teasing. Regardless of the origin of the ear distortion, many ear conditions can be surgically corrected. These procedures do not alter the patient’s hearing, and may improve appearance and self-confidence.
Interruptions during the formation of the ear can result in different ear shapes, with the most severe being total absence of the ear and possibly the ear canal, or mild folding differences of the ear. The fold of hard, raised cartilage that gives shape to the upper portion of the ear does not form in everyone. This is called “lop-ear deformity,” and it is inherited. The absence of the fold can cause the ear to stick out or flop downward.
Some infants are born without an ear canal. Hearing can be restored with a bone-anchored hearing aid, or it can be surgically opened, and the outer ear reshaped to look like the other ear. 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.
To correct prominent ears that lack folds, an ENT (ear, nose, and throat) specialist, or otolaryngologist, places permanent stitches in the upper ear cartilage and ties them in a way that creates a fold to prop up the ear. Scar tissue will form later, holding the fold in place. Corrective surgery, called otoplasty, may be considered on ears that stick out more than 4/5ths 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-old. Having the surgery at a young age has two benefits: (1) the cartilage is more pliable, making it easier to reshape, and (2) the child will experience the psychological benefits of the cosmetic improvement.
An ENT specialist begins the surgery with an incision behind the ear where the ear joins the head. In addition, ears may also be reshaped, reduced in size, or made more symmetrical. The reshaped ear is then secured in position 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 beyond that for a month following surgery.
A torn earlobe can be easily repaired surgically, usually in the ENT specialist’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, repaired earlobes can be pierced four to six weeks after surgery to support light-weight earrings.
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.