External ear surgery usually involves surgery of the outer ear, either following trauma or to correct congenital problems such as prominent ears or a deformed or absent ear. Ear surgery to correct hearing or inner ear problems is done by ear, nose, and throat (ENT) surgeons.
Prominent ears in children can be psychological painful as children with this condition often suffer from teasing and self-consciousness. Otoplasty surgery ("ear pinning") is a procedure to correct prominent ears
Many newborns' ears look prominent but most of these will correct on their own by one week of age. If a newborn's ears still look prominent at that point, special molding splints or taping can be used. It is thought that the maternal estrogen present in a baby after birth makes the ear cartilage more pliable and the ear softer, so application of tape or a splint can permanently change the shape of the ear. This will often lessen the prominence of the outer ear, frequently preventing the need for future otoplastic surgery. That effect starts to wear off soon after birth, so it works best if started within the first 5-7 days after birth and is reserved for babies less than 6 months old.
Timing is important for children. Otoplasty surgery is often done at age 4-5, before the child enters school, in order to avoid the psychological teasing that often occurs in school-aged children. If surgery is done earlier than this, there is a potential risk of disturbing the growth of the ear but by age 4-5, the outer ear has reached 85%-90% of adult size, and so otoplasty surgery can be safely performed. Though otoplasty surgery can be done at any age after 3, in adults it's considered a cosmetic surgery, which is not covered by most insurance providers.
Otoplasty surgery uses a small, hidden incision along the back of the ear. The cartilage (firm part) of the ear is recontoured so there is less prominence and then the ears are pinned back with buried permanent stitches. In young children, the surgery is performed under general anesthetic, but in older children or adults, it can be done with them awake under local anesthetic. Patients go home the same day as the surgery is performed.
The pain is often minimal following otoplasty surgery, although some patients need to take painkillers by mouth for a couple of days after. Patients wear a large bandage that wraps around the head and ears for up to two weeks after surgery; it's important to keep this bandage on at all times as it helps maintain the shape of the newly-shaped ear and prevents injury, bleeding, or swelling.
Adults are able to return to work within a couple of days as long as they keep the bandage in place. Children can go to school with their bandage on. It's important not to get the bandage wet so sponge baths are required during the first two weeks after the surgery and swimming should be avoided for the first month
Complications following otoplasty surgery are rare. General risks of surgery include anesthetic reaction, infection, bleeding, wound healing problems, and excessive scarring. Risks specific to the surgery include asymmetry, relapse of the ear shape (8%), and injury or deformation of the ear cartilage from infection or excessive bleeding (but the last is very rare).