Q: My daughter is 14 years old and is bothered tremendously by her ears that stick out. While we are used to them and think she is beautiful, she clearly has a different opinion. She never wears her hair back and always has it so that her hair covers her ears. While we are not keen on her having to undergo plastic surgery, I think this is the only solution that will make her less self-conscious. What is a good age age for her to have ear pinning surgery?
A: Ear pinning, also known as otoplasty, is actually the number one teenage plastic surgery performed. It is a highly successful operation that can make a dramatic difference in the shape of the ears, changing it from one in which the ears are the most noticeable feature of one’s face to not noticing them at all. (which is how your ears should be) When evaluating teenagers for cosmetic plastic surgery, I always consider three factors; their physical maturity, their emotional maturity and their expectations. When it comes to ears, otoplasty can really be performed safely anytime after 2 years of age. It has been shown that the operation does not affect ear growth beyond that age. From an emotional maturity standpoint, the problem that otoplasty treats is very obvious as well as why it would bother someone so this is never an issue. I think almost any patient, teenagers not withstanding, have reasonable expectations with the goal of an ear that does not stick out as far. As long as the operation does not create the reverse problem (ear plastered against the side of the head), most patients are going to be very happy with the results. In conclusion, I think your daughter can have otoplasty at anytime and the sooner it is done the better she is going to feel about herself.
Dr. Barry Eppley
Spring brings forth many new growths as we emerge from winter. Warmer temperatures with rain and gusty winds fuel this growth. As the season changes into this rebirth time of the year, certain plastic surgery procedures emerge as well. Often called seasonal plastic surgery in this part of the country, one would most likely think of breast augmentation or liposuction as one prepares for greater summer exposure of one’s body. While the frequency of these procedures increases for sure, correction of prominent ears (otoplasty) also increases. (a common plastic surgery joke is the risk of flying away with the spring winds)
Protruding ears affects both children and adults alike. But otoplasties are done disproportionately more in children. This is likely because an adult has lived with their ears for a long time and may be less psychologically bothered by them. Or they have had them for so long that changing them may be emotionally disturbing. (as part of the theory that change is scary and that hanging on to the more familiar is less ‘risky’ than the potential benefit of the unknown) But the child’s self-image is still being developed and eliminating protruding ears is one simple and quick way to eliminate some potential psychological baggage.
Ear pinning, medically known as otoplasty, is one of the most satisfying of all facial plastic surgery procedures. When you factor in a very low risk of any problems after surgery, a dramatic improvement in appearance and when done early in life as a child or teenager, it offers some of the best value of any plastic surgery procedure that I know. Low risk, dramatic improvement, and permanent benefits is always a sure sign of a plastic surgery winner.
A fundamental principal of otoplasty surgery is to identify the cartilage problem that makes the ears protrude. In most cases, the absence of the fold between concha and the helix, known as the antihelical fold, is the main cause. When this backward fold is not there, the helical rim sticks way out. Bringing back the helical rim, through sutures placed from the backside of the ear, brings the protruding ear back in an immediate fashion.
But there are other cartilage deformities in the ear that can make them stick out. The concha or bowl that surrounds the ear hole can be too big, pushing the entire ear out too far. The concha helps capture sound to direct it into the ear canal down to the ear drum. It provides the foundation onto which the helix and antihelical fold sits. A big concha and the lack of an antihelical fold make for an ear that really sticks out.Without reduction of the large concha, other suturing methods will be unsuccessful. Removing a wedge of conchal cartilage and using sutures that pull back the concha towards the mastoid are needed to make the ear sit closer to the side of the head. Many otoplasty procedures require a combination of antihelical and conchal manipulations to create the best ear shape and position after surgery.
Otoplasty plastic surgery is a simple outpatient procedure that can be completed in just one hour. Most of the time it is done under anesthesia but some cases in adults can be completed with just local anesthesia. Dissolveable sutures are used on the back of the ear so suture removal is not necessary. A head wrap is used for just one day and one can shower the next day after surgery. Even in the face of some mild swelling and soreness, the change in the ears is immediate and quite dramatic.
Spring is a time when many parents begin to think about otoplasty for their child or teenager, planning for a summer surgery when out of school. But the simplicity of the procedure allows it to be done over winter or spring break as well without missing school. It is prudent, however, to avoid contact sports for the first month after surgery.
Dr. Barry Eppley