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 plastic surgery.
When discussing otoplasty and cosmetic surgery the best place to start is by looking at 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, browlift, blepharoplasty (eyelid surgery), chin implants, rhinoplasty (nasal surgery), lip surgery and facial resurfacing.
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 appointment.
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.
PREOPERATIVE OTOPLASTY INSTRUCTIONS
- 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 discontinued.
- 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.
- At your 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 surgery.
- 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 after surgery.
- 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 instructions.
- Remove all make-up and nail polish before arriving for your procedure.
- 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 off.
- Following dressing 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 surgery.
- 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 sleep.
- Most patients 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.
- Start your 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.
- 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 incision lines.
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 as anticipated.