Plastic and Reconstructive Surgeon

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Prominent ears are a congenital abnormality that can often lead to feelings of self-consciousness and embarrassment. Usually this occurs during childhood at the school going age where teasing may result in emotional trauma. Prominent ears can be surgically corrected to avoid this. Although this operation is most commonly done during childhood (between five years and 10 years of age), it is also performed on adults who would like improvement to their ears.

Procedure

You will be admitted the morning of the operation in most cases. This operation is usually performed under general anaesthetic but minor corrections can be done in the older patients under local anaesthetic.
An incision will be placed in the back of the ear (inconspicuous). Through this incision most of the operation will be performed. There may be very small incisions in the front of the ear but these heal well and are generally invisible. The cartilage of the ear will be manipulated and sutures may be placed to hold the ear in its new position. The wounds will then be closed.
The dressing that is applied to the ears after surgery is very important for the success of the operation. This is a type of soft helmet dressing that needs to stay on for approximately 1 week. For this reason, the operation is commonly performed during school holidays. I will remove the dressing in my rooms and the ears will be inspected. At the first dressing change, the ear is often bruised and may have a wrinkled appearance due to the dressing.
This appearance resolves and the ear will start to look normal within another week. After the first dressing is removed, you will be expected to wear a head band which covers the ears and holds them back. This will continue for at least another week. After that week (third week after surgery) the head band must only be worn at night to prevent any injury to the ear during sleep. It is recommended to avoid contact sports for six to eight weeks.

Indications

The ear can be prominent because of three main reasons. Firstly, the angle between the ear and the head may be increased. Secondly, the folds of the ear (scapha) may be poorly developed resulting in folds which are not sharp enough. Thirdly, because the cup of the ear is too large.
It is common that all three of these factors play a role but they can occur individually as well. The actual problem in each patient is addressed to achieve the best results. In addition to this, there are other congenital abnormalities that can occur resulting in an abnormal ear shape. These will be discussed and addressed accordingly.
Other reasons for ear surgery would be an abnormality due to trauma or cancer resection. The ear can be reconstructed in these circumstances and the type of reconstruction is dependent on the part of the ear that is missing or deformed.

Disadvantages / Complications

Fortunately, significant complications are infrequent. Every year, many thousands of people undergo successful ear surgery, experience no major problems and are pleased with the results. It is however important to realize that every surgical procedure has risks.
Some of the potential complications that may be discussed with you include:

Hematoma (blood collection under the skin which may require further drainage)
Infections
Pain and itchiness
Necrosis of skin
Unsightly scars
Stitch problems (stitch can come through the skin or create an abscess)
Decreased feeling in the ear which is usually transient
Recurrence of the prominence
Protruding lobule
Irregularities of the ear folds
These complications are very rare but it is important for you to be completely informed about your operation.
These complications may require further surgery

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