Abnormally protruding ears can make a child of any age
the object of cruel remarks by his or her peers. For any
child whose appearance causes concern, otoplasty, "ear
pinning" should be considered before peer pressure
begins to play a significant role in the child's
self-esteem, typically age five or six. When otoplasty
is performed at about age five the development of the
ear cartilage is at an optimal state of maturity to
accept the modified projection. Otoplasty is a safe,
effective procedure performed to achieve a less
noticeable appearance while maintaining function.
Because of its potential to foster a child's
self-esteem, otoplasty is a most satisfying facial
When discussing otoplasty
and cosmetic surgery the best place to start is by
before and after photos to see just what can be
accomplished. Adults often tell Dr. Lopez that their
protruding ears detract from their beauty and ask to
combine otoplasty with another surgery. Most
rejuvenation and contouring surgery can be combined with
otoplasty including facelift,
blepharoplasty (eyelid surgery), chin implants,
rhinoplasty (nasal surgery), lip surgery and
At your initial
consultation, Dr. Lopez evaluates your cartilage and
soft tissue architecture of your face and ears.
Assessment of the ears provides the basis for what one
may expect from an otoplasty. Skin type, ethnic
background and age, along with the degree of deformity
and function are important factors influencing the
outcome of surgery.
As with all facial plastic
surgery, a thorough health assessment and realistic
expectations are prerequisites. Your understanding of
procedures and the postoperative routine is essential to
a successful final result. Following your consultation,
we continue our discussion at the preoperative
At your preoperative
appointment Dr. Lopez will provide all the instructions
for you to follow before and after surgery. An otoplasty
takes about one to two hours depending on the ear
structure and amount of protrusion prior to surgery. If
you are having a combination of procedures your surgery
will take longer. Recovery time from the anesthetic
takes about an hour and you will be discharged about
four hours from the time of admission.
Please avoid any
aspirin, aspirin-containing products, or
ibuprofen (Advil, Aleve, etc.) for two weeks
prior to and two weeks following your surgery.
See our "Medication
List" for products to avoid prior to
surgery. If you are on any medications that
affect bleeding (such as coumadin or warfarin)
please notify the office immediately.
Please refrain from
tobacco products for six weeks and alcohol for
one week prior and three weeks following
surgery. Along with delayed wound healing,
persistent skin redness and other complications
may persist when tobacco and alcohol are not
Please notify us of
all routine medications and significant health
history. We ask that you remain on your daily
medications unless instructed otherwise. At the
preoperative appointment you will be told which
daily medications to take with just a sip of
water on the morning of surgery.
preoperative appointment you will be given
prescriptions for use following surgery
including an oral antibiotic, antiswelling
medication, antibiotic ointment and pain
medications. Please obtain these prescription
medications before your surgery so you will have
them ready for use when you return home after
We will ask you to
take Arnica, a natural herb that significantly
decreases bruising, before and after surgery. We
will also ask you to take Vitamin C (ascorbic
acid), which helps promote healing, before and
You may not eat or
drink after midnight the evening before the
procedure unless instructed otherwise. You may
brush your teeth. Your procedure will be
cancelled if you do not follow these
Remove all make-up
and nail polish before arriving for your
Someone will need
to drive you home after your surgery and stay
with you that evening. Transportation to the
office for dressing removal the day following
surgery is also required.
When you wake up from
surgery you will notice a soft, bulky head wrap
dressing. Following your otoplasty, the nurses will ask
assist you to meet the discharge criteria: to drink
liquids, walk with a steady gait, void, and manage your
discomfort. For patients who have a combination of
procedures such as an eye lift, your vision may be
cloudy from the ointment we place in your eyes at the
time of surgery. The nurses will review all instructions
you will need for care following your otoplasty.
You will be asked to come
to Dr. Lopez’s office the following day after surgery
for a dressing change. You will be asked to return in
six to eight days for suture removal.
POSTOPERATIVE OTOPLASTY INSTRUCTIONS
Keep dressing dry
and intact the evening after surgery. Notify Dr.
Lopez if the dressing becomes loose or falls
removal the day after surgery, you will wear a
head band for one week that can be taken off to
shower. You can shower 48 hours after the
Cleaning the suture
with a Q-tip dipped in hydrogen peroxide once a
day and then and then applying the antibiotic
ointment three times a day is an essential part
of the healing process.
Sutures that have
been kept lubricated with ointment are less
painful to remove.
Keep elastic wrap
head band in place at all times other than
suture care and showers. Children will be asked
to wear their head bands for 2 months when they
complain of discomfort more than pain. Use pain
medication as directed/as needed. Vicodin and
Percocet contain Tylenol. Do not take additional
Tylenol or acetaminophen while taking Vicodin or
Percocet. Do not drive or drink alcohol while
taking pain medication. Taking pain medication
with food helps minimize nausea sometimes
associated with pain medications.
antibiotic (Keflex) when you get home and one at
bedtime. It is not uncommon to have a low-grade
fever for 24 hours following surgery.
Start swelling medication (Medrol Dosepak) when
you arrive home. Then follow package
directions. Take with food.
Vitamin C (ascorbic
acid) helps promote healing. Take 1000 mg three
times a day for two weeks following surgery.
Arnica, a natural
herb that significantly decreases bruising, is
used under the tongue three tabs three times a
day before meals for two weeks.
Advance diet from liquids
to soft food (oatmeal, French toast, yogurt, soup,
pasta) to your regular diet as tolerated. You have no
diet restrictions. Often the anesthesia you received
can make your stomach feel uneasy for the first 24 hours
so avoid large meals.
Rest for entire day after
surgery. Sleep with head of the bed elevated or use two
to three pillows for one week after surgery. Absolutely
no bending, lifting or straining. If you have little
children, bend at the knees or sit on the floor and let
them climb on to your lap. No driving for one week
following surgery. Two weeks off work is recommended.
Bruising can be camouflaged
at one week postoperatively with make-up. Always protect
your face from the sun. At this point, a hat and
sunglasses are a good idea. It is ok to apply sunscreen,
cosmetics or facial creams two weeks after surgery.
Avoid unprotected prolonged sun exposure for three
months following a otoplasty to prevent pigmentation of
Following an otoplasty, it
takes time for the swelling to subside and for the skin
to heal. Most patients return to work one to two weeks
following surgery, depending on the degree of privacy
one is trying to maintain. At two weeks postoperatively,
swelling and bruising may be apparent to you but not to
many of your coworkers and closest friends.
Final results following an
otoplasty are not apparent for one full year following
surgery Dr. Lopez will want to see you 3, 6 and 12
months after the surgery to ensure that you’re healing
1) I don’t like that
my ears stick out.
Ears that protrude significantly from the skull can draw
attention to them. Teasing can occur at any age;
especially young children like to point out aspects of
our appearance that stand out. Otoplasty is a safe,
outpatient procedure that allows Dr. Lopez to place the
ears closer to the skull so that they don’t stick out as
well as give them a more normal shape.
2) At what age
should my child have an otoplasty?
Typically Dr. Lopez likes to see the child when he is
around 5 years old. By this age ear development has
neared maturity. Another important factor is the
psychological effect of teasing, which can start as
early as 4 to 5 years old. If the otoplasty is performed
prior to the onset of peer pressure yet timed when the
cartilage is mature enough to be reshaped, your child is
not as adversely affected by the teasing of unknowing
classmates. The child also needs to have matured enough
to participate in the postoperative healing. A
noncompliant child can cause suboptimal results.
3) Will I still look like
"me" after surgery?
Many of Dr. Lopez’s patients report that when
they return to their normal life, their friends comment,
“You look great. Are you getting more sleep?”, “Did you
change your hairstyle” or "You look less stressed and
tired”. Dr. Lopez will not change the way you look, just
enhance it. Ultimately the preoperative degree of
protrusion of the ears will determine how much of a
4) How long does my surgery
The length of surgery depends on several factors
including the complexity of each person's ears. In
general the surgery takes one to two hours. Revision
otoplasty can take a little longer because of
corrections that need to be made as a result of the
5) How much pain will I
Fortunately, most procedures on the face cause mild
discomfort. However, Dr. Lopez does provide all patients
with prescriptions for pain medication. Most patients
may use the prescription medication for one to two days
after surgery and then switch to Extra Strength Tylenol.
6) Will I be awake during
You will have the choice to have general anesthesia or
IV sedation (medicine administered through an IV) and a
local anesthetic (numbing medication administered in the
operating room). In both situations, patients are asleep
during surgery. Patients do not hear or feel anything
and are comfortable during the operation. Patients wake
up very soon after the surgery is completed.
7) Do I go home after the
Yes, most facelifts are done on an outpatient basis.
Because you will go home after receiving sedation, you
will need to make arrangements for a responsible adult
to drive you home, to stay with you overnight and to
drive you to our office for your first postoperative
appointment. Your first appointment is usually the day
after surgery. Patients having surgery must stay in the
immediate San Antonio area overnight.
8) How long should I stay
in San Antonio following surgery?
Most patients stay in San Antonio about seven to ten
days following surgery. After that it's ok to fly or
travel long distances.
9) When can I exercise?
Dr. Lopez prefers that aerobic activities be avoided for
two weeks after surgery. In addition, heavy
weightlifting or more strenuous workouts should be
avoided for three weeks postoperatively. It' is
extremely important to avoid bending, lifting or
straining during the early postoperative period as these
activities can increase swelling and delay healing.
10) Will I bruise and swell
afterwards and how long will it last?
Unfortunately it is impossible to do surgery without
causing swelling. Dr. Lopez does everything possible to
minimize the amount of swelling that occurs. Generally,
postoperative swelling begins to resolve at the end of
the first week. Bruising is extremely variable. Patients
that have a tendency to bruise will generally bruise for
about 10 days. Patients that don’t tend to bruise may
have minimal if any bruising. Complete resolution of
bruising and swelling may take two to three weeks.
However, bruises may be camouflaged fairly easily at
seven to ten days with a concealer stick.
11) Should I do anything
before to prepare for surgery?
You will have a preoperative appointment with Dr. Lopez
and his staff to go over the preoperative instructions.
12) Why do I need a
This is an essential appointment to prepare you for your
upcoming surgery. Dr. Lopez will take preoperative
photographs at the visit as well as go over the
procedure again to ensure that everyone is on the same
page. All questions that you have will be answered on
that visit as well. You will often times be given your
prescriptions on the preoperative visit day.
13) What else can I do to
do to prepare for surgery?
Dr. Lopez likes to have patients that have well
controlled blood sugar to drink three eight ounce
glasses of pineapple juice for at least one week before
surgery. Pineapple juice can help minimize the
postoperative swelling. Patients that use tobacco will
be asked to stop for six weeks before and six weeks
following surgery. Tobacco has properties that impede
wounds from healing. Dr. Lopez will encourage tobacco
users to not resume smoking at all after surgery; in
fact many of his patients have used the surgery as their
motivation to quit smoking.
14) What about my daily
medications before surgery?
In general you will be allowed to take most of your
daily medications. Medications that thin the blood such
as ibuprofen, vitamin E, and herbal supplements need to
be stopped two weeks before surgery. You can continue to
take a multivitamin. Aspirin needs to be stopped three
weeks before surgery. Dr. Lopez will provide a
"Medication List" that reviews all medications and
supplements to avoid prior to surgery.
15) Do I need any special
prescriptions before surgery?
Dr. Lopez will generally give you a prescription for an
antibiotic, a pain medicine, antibiotic ointment, as
well as an anti-swelling medication. He also asks you to
start taking Vitamin C 1 gram per day for 1 week before
surgery to continue for 2 weeks after surgery.
16) What will I feel when I
wake up from surgery?
Most patients report only mild to moderate discomfort
associated with some tightness or pulling. This pulling
sensation, most noticeable under the chin, subsides
after about three weeks. Dr. Lopez will make sure you
are not nauseated or queasy.
17) How will I look like
when I wake up from surgery?
Following the procedure, you will have a soft head wrap
around your head and under your chin. This helps
minimize swelling. The head wrap will be removed in the
office the following morning. A second dressing may be
gently applied for 48 hours to minimize swelling. You
may have some bruising, however, this typically is more
pronounced 24-48 hours after the procedure.
18) How can I prevent
Most patents will have a little bruising. We can try to
minimize bruising by using Arnica before and after the
procedure. Arnica is a natural "herb" that helps prevent
19) How do I take care of
The areas that are sutured will require some simple
care. Dr. Lopez asks that you use a Q-tip to cleanse the
sutures with peroxide once a day and apply an antibiotic
ointment three times a day to keep the sutures soft. In
six to eight days, when the time arrives for suture
removal, sutures that have been cared for will slide out
20) When can I shower?
You can shower 48 hours after the surgery. Make sure
that you pat dry the incisions well after the shower and
apply the antibiotic ointment.
21) What medications do I
take following surgery?
Dr. Lopez will ask you to take the following medications
starting the day of surgery:
1- An antibiotic - generally Keflex for one week
2- Pain medicine - Vicodin or Percocet to take as
3- Antibiotic ointment- to place on the incision sites
at least three times a day
4- Antiswelling medication- for patients that are not
diabetic a Medrol dosepak will be given
5- Vitamin C 1 gram for 1 week before and two weeks
following surgery to promote healing
6- Arnica- place under the tongue three tabs three
times a day before meals for two weeks.
22) When do I start taking
Patients take their pain medication as needed. Begin
taking vitamin C 1 week before surgery. You can begin
taking Arnica the day before surgery. The antibiotic and
swelling medications begin when you arrive home
following surgery. Unless you are notified otherwise,
resume all daily medications when you arrive home from
23) Are there any foods to
avoid following surgery?
No. Dr. Lopez encourages you to eat a well-balanced
diet. You may notice that saltier foods can cause you to
swell for a longer period of time.
24) When is my first
You will be asked to see Dr. Lopez on the first day
following an otoplasty for removal of head wrap
dressing. You will need someone to drive you to this
25) What about my regular
Sleep with head of the bed elevated or use two to three
pillows for one week. Absolutely no bending, lifting or
straining for two weeks. If you have little children,
bend at the knees or sit on the floor and let them climb
on to your lap.
26) How can I minimize the
swelling and bruising?
Most of Dr. Lopez’s patents will have a little bruising.
He minimizes bruising by having patients stop all blood
thinners well ahead of surgery as well as using Arnica
before and after the procedure. A good night’s sleep is
vital to healthy healing. Patients are also asked to
sleep with their head at least at 45 degrees to minimize
27) When will I look
You will be presentable at two to three weeks. You will
look great at six weeks and even better at six months as
things settle and expressions become more natural. At
three weeks you know you are well on the way to recovery
and most patients resume routine activities around two
to three weeks following surgery. Final results are
evaluated at one year.
28) How often do I need to
return for postoperative visits?
Dr. Lopez likes to see his patients 3, 6, and 12 months
after the procedure to ensure that the healing is going