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Otoplasty New York Metro Area
If you’re considering ear surgery
Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears.
Ears that appear to stick out or are overly large can be helped by ear surgery or ear pinning.
For the most part, the operation is done on children between the ages of four and 14. Although many adults come for the surgery when they are emotionally and financially able. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child or adult will have to endure. Ear surgery on adults is common, and there are generally no additional risks associated with ear surgery on an older patient.
If you’re considering ear surgery for yourself or your child, this information will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask Dr. Weinstein if there is anything you don’t understand about the procedure.
All surgery carries some uncertainty and risk
When ear surgery is performed by a qualified, experienced, gentle and meticulous surgeon like Larry Weinstein,MD FACS, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle.
Reported in the literature are other rare complications such as infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area. Recurrence of ear deformity is rare, as is asymmetry, actual results cannot be guaranteed. There are nonsurgical pinning techniques which offer dubious results. Otoplasty or ear pinning in Dr. Weinstein’s hands has a 99% chance of success.
Planning for surgery
Most surgeons recommend that parents stay alert to their child’s feelings about protruding ears; don’t insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.
In the initial meeting, Dr. Weinstein will evaluate your child’s condition, or yours if you are considering surgery for yourself, and recommend the most effective technique. He will also give you specific instructions on how to prepare for surgery.
Where the surgery will be performed
Ear surgery is usually performed as an outpatient procedure at Morristown Medical Center under general anesthesia or at the Chester Surgery Center with conscious sedation and/or local anesthesia. Dr. Weinstein has never recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight in the hospital.
Types of anesthesia
If your child is young, Dr. Weinstein may recommend general anesthesia, so the child will sleep through the operation. For older children or adults, Dr. Weinstein usually prefers to use local anesthesia, combined with a sedative, so you or your child will be awake but relaxed.
The surgery
Ear surgery usually takes Dr. Weinstein one to three hours. Dr. Weinstein usually uses a combined technique for ear pinning. He addresses the lack of an anti helical fold with the Mustarde technique of permanent sutures behind the ear cartilage to pin the ear posteriorly. The concha or cup of the ear may be hypertrophic (large) or protuberant in that case a special Furnas stitch will be used to bring the ear back closer to the mastoid process, the bone behind the ear. Sometimes conceal cartilage needs to be removed to get a better result. The upper ear or lower ear may need their own special suture to avoid a telephone look to the ear.
With one of the more common techniques, Dr. Weinstein always makes an incision in the back of the ear to expose the ear cartilage. He will then sculpt the cartilage and bend it back toward the head. Non-removable stitches are used to help maintain the new shape. Occasionally, Dr. Weinstein will remove some cartilage to provide a more natural-looking fold when the surgery is complete.
An incision is made in the back of the ear so cartilage can be sculpted or folded. Stitches are used to close the incision and help maintain the new shape.
Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.
Creating a fold in the cartilage makes the ear lie flatter against the head and appear more normal.
In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.
Getting back to normal
Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the hospital with a child until all the effects of general anesthesia wear off.
The patient’s head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication.
Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Be sure to follow Dr. Weinstein’s directions for wearing this dressing, especially at night.
Stitches are usually removed, or will dissolve, in about a week. It is best to wear a headband for the better part of the first month and at night for the second month to help prevent memory recurrence of the protrusion.
Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work about five days after surgery. Children can go back to school after seven days or so, if they’re careful about playground activity. You may want to ask your child’s teacher to keep an eye on the child for a few weeks.
Other ear problems
Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: “lop ear,” when the tip seems to fold down and forward; “cupped ear,” which is usually a very small ear; and “shell ear,” when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Dr. Weinstein can even build new ears for those who were born without them or who lost them through injury. Split ear lobes are a common problem Dr. Weinstein fixes under local anesthesia in his Chester Surgery Center. Dr. Weinstein has extensive and successful experience in the treatment of ear keloids, congenital and acquired ear deformities. Dr. Weinstein was a Chief resident in Plastic Surgery at Kings County in Brooklyn and has donated his time to the treatment of congenital and acquired ear deformities in Plastic Surgery Camps in India.
Ask Dr. Weinstein about the effectiveness of surgery for your specific case.
More natural-looking ears
Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly-perfect symmetry is both unlikely and unnatural in ears. If you’ve discussed the procedure and your expectations with Dr. Weinstein before the operation, chances are, you’ll be quite pleased with the result.
