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Question: My ears stick out much too far. What is done during otoplasty surgery to bring them closer to the head?

Answer: There are a few different approaches to otoplasty. The otoplasty procedure that will work best for any individual depends on a few different variables. The age of the patient and the overall shape and size of the ear, just to name a few. When a patient is very young, cartilage abrasion through small incisions in the ear and a proper fitting dressing may be all that is needed to correct the shape of the ear. Most patients require more than that.

There are a few schools of thought in how to best correct the shape of the ear. There are those who use cartilage cutting techniques, and those who use cartilage folding and suturing techniques. Sometimes a combination of the two techniques is necessary in very prominent ears. I tend to favor cartilage folding techniques. During the otoplasty procedure the poorly formed anti helix is created in the pinna using a Mustarde technique. If after the normal contour of the ear is corrected the ear still is sticking out, then I use a Furnass setback suture in order to bring the ear closer to the head on front and back views. I like the cartilage sculpting and folding techniques because they are reversible in the early stages and adjustable. More importantly, they leave the ear looking natural without any of the sharp transitions in the ear architecture that is so apparent in the cartilage cutting technique.

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Question: Is it possible for otoplasty to cause cauliflower ears?

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Answer: Otoplasty is a term used to sculpt an otherwise deformed ear. Otoplasty techniques can be used to correct a cauliflower ear. Otoplasty requires cutting, thinning, and suturing the cartilage of the ear. If an accumulation of blood or fluid in the cartilage of the ear should occur following an otoplasty procedure and goes unrecognized for a period of time, then theoretically a cauliflower ear can result from the otoplasty procedure. Cauliflower ear occurs when an auricle is damaged and blood or fluid accumulate between the cartilage of the ear and the blood supply to the ear, resulting in cartilage death and eventually disfigurement.

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Question :
Is an overnight stay in the hospital required for children undergoing ear surgery?

Answer :
I assume that you are inquiring about otoplasty surgery of the ears in children. I do not keep children overnight for corrective surgery of the ears. The otoplasty procedure is usually completed in about 90 minutes for both ears and the child is sent home the day of surgery.

Posted by Dr. Philip Schoenfeld

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Question :
I heard of a technique for otoplasty called an incisionless otoplasty. Are there really no incisions made? How is the ear changed? Are there no scars?

Answer :
There is a procedure called incisionless otoplasty.  I do not perform this particular type of otoplasty as the results are not nearly as predictable and reproducible as the type of otoplasty that I do perform.  All of the incisions that I use in otoplasty are on the backcrease of the ear and are difficult to see post operatively.  The otoplasty results I am able to achieve are extremely pleasing with very little post-operative discomfort.

Posted by Dr. Philip Schoenfeld

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Question :
How long does it usually take for children to recover from otoplasty surgery?

Answer :
Children recover from surgery significantly quicker than adults. The biggest issue that I have with children who have undergone otoplasty is not pain, or post operative fatigue, but, trying to keep them less active during the healing phase of their otoplasty surgery. I put a protective and compressive dressing on each child after otoplasty. The dressing will stay on for about 6 days after the otoplasty. Children like to return to normal activity before the first post operative visit and I instruct the parents to be vigilant in protecting their ears for the first week or two after their dressings are removed.

Posted by Dr. Philip Schoenfeld

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Question :
How do I know if I’m a candidate for otoplasty?

Answer :
I believe the only way to tell if you are a candidate for otoplasty is if you do not like the appearance of your ears, or more specifically, your ears appear different from the ears of others. The most common reason for otoplasty surgery is because of prominent ears or large protruding ears. However, otoplasty is not a single procedure and different deformities of the ears are all addressed with otoplasty surgery. I would be happy to see you in consultation to discuss with you what improvements could be made to your ears with otoplasty if you are concerned with the appearance of your ears.

Posted by Dr. Philip Schoenfeld

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Question :
Is it possible for me to have my ear surgery performed with local anesthesia?

Answer :
I have performed otoplasty under local anesthesia. Once the ears have been injected with local anesthesia, there is no pain and otoplasty is well tolerated. My choice in adults, however, is to give twilight anesthesia or IV sedation. The procedure can take a couple of hours for both ears and given the safety of IV sedation I see no reason to not be completely comfortable during the otoplasty surgery. Also, my experience is that when procedures are longer than an hour and somewhat invasive, patients become nervous as the case progresses and the sedation will really take the edge off.

Posted by Dr. Philip Schoenfeld

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Question :
I’m considering otoplasty for my son but I’d like to know if ears that stick out ever improve as children age.

Answer :
If you are considering otoplasty for your son and he is older than 5 years of age, it is extremely unlikely that the prominant ears that you see now will become less prominant as he ages. You may not notice his prominent ears as much and will elect to wait prior to otoplasty, but, the ears will likely stay in the same anatomic configuration that you are seeing today.

Posted by Dr. Philip Schoenfeld

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