Cosmetic/Reconstructive Surgery Of The Ears (Otoplasty Surgical Instructions)

Cosmetic and reconstructive surgery of the external ear is often performed to repair defects resulting from injury. The most common procedure is otoplasty, which corrects prominent ears in children. The goal of this surgery is to improve both the functional and cosmetic appearance of the ears. Psychological trauma is often associated with these features.

You should freely discuss your cosmetic concerns and expectations with your doctor. Your surgeon will then discuss their recommendations and any limitations set forth by the preoperative structure of your ears, face, and skin. Preoperative and postoperative photographs will be taken to aid in planning and to document results.

The following instructions will help you or your child recover from otoplasty as easily as possible. Proper care can prevent complications. It is crucial that you read and follow these instructions carefully.

What are risks and complications of cosmetic ear surgery?

Your surgery will be performed safely and with care to obtain the best possible results. The following complications have been reported:

1. Infection of the skin or cartilage (chondritis) of the ear.
2. Bleeding or hematoma formation.
3. An unfavorable result that does not meet your expectations. This can include inadequate correction, recurrence, contour distortions, or asymmetric correction, which may require secondary surgery.
4. Permanent or temporary numbness of the skin of the ear or face.
5. Scar or keloid formation, an overgrowth of scar tissue.
6. Prolonged pain, impaired healing, and the need for hospitalization.
7. Narrowing of the external ear canal.
8. Suture extrusion. Permanent sutures used to maintain shape may eventually require removal.
9. If the surgery is done because of a tumor, there can be recurrence and the need for additional surgery or other therapies.

What happens before surgery?

In most cases, the surgery is performed as an outpatient at either the hospital or the surgicenter. An anesthesiologist will monitor you throughout the procedure. The anesthesiologist will review your medical history the night before or the morning of surgery. If preoperative lab studies are ordered, they should be done several days in advance.

Avoid aspirin or products containing aspirin within 10 days of surgery. Non-steroidal anti-inflammatory medications should not be taken within 4-7 days of surgery. Many over-the-counter products contain aspirin or anti-inflammatory drugs. Check all medications carefully. Acetaminophen (Tylenol) is an acceptable pain reliever. Your doctor will give you prescriptions at the preoperative visit. Fill them prior to surgery.

Do not eat or drink anything 6 hours prior to surgery. Smokers should try to stop or reduce smoking to minimize postoperative complications. If you are sick or have a fever the day before surgery, call the office. If you wake up sick the day of surgery, still proceed to the surgical facility as planned. Your doctor will decide if it is safe to proceed.

What happens on the day of surgery?

Check in with the surgical facility at the designated time. Wear comfortable loose-fitting clothes. Remove all jewelry and valuables. Remove all make-up with a cleansing cream and wash your face with soap and water.

Do not take any medication unless instructed by your doctor. In the preoperative holding room, a nurse will start an intravenous line (IV) and you may be given a medication to help you relax.

What happens during surgery?

In the operating room, the anesthesiologist will usually use a mixture of a gas and an intravenous medication to put you to sleep. You will be continuously monitored during the procedure. The surgical team includes the surgeon, anesthesiologist, nurse, and surgical technician.

The surgery may take several hours depending on requirements and additional procedures. Your doctor will speak with any family or friends in the waiting room once you are in the recovery room.

What happens after surgery?

You will be taken to the recovery room where a nurse will monitor you. Once fully recovered from the anesthetic, you will be able to go home the same day. Have a friend or family member pick you up and spend the first night with you. Rest with your head elevated on pillows to minimize swelling. Get up with assistance to use the bathroom. Eat a light, soft, and cool diet. Avoid hot liquids. Follow your doctor’s prescriptions.

What are the general instructions and follow-up care?

In most cases, a bandage will be placed to cover the wound. For otoplasty, a compressive dressing will be placed to hold the ears in the appropriate position. The bandages should remain in place for one week. Wear an ear band-it at night for the next 6 weeks. Avoid facial tanning for 6 months and use sunblock when in the sun.

After bandages are removed, clean the wound with hydrogen peroxide and apply antibiotic ointment. Wash your face and hair. Avoid excessive scrubbing of the wound. Stay out of the pool and wear the ear band-it for the next 6 weeks. Numbness, swelling, itching, and discoloration are normal and should go away with time.

NOTIFY YOUR DOCTOR IF YOU HAVE:

1. A fever greater than 101.5 degrees F.
2. Persistent sharp pain or severe one-sided pain.
3. Increased swelling or redness of the ears.
4. Drainage from the wound.

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

Isaacson, Glenn C., M.D. "Congenital anomalies of the ear." UptoDate. Updated Feb. 4, 2016.