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Otoplasty is surgery to correct deformities or imperfections of the external ear. These imperfections may range from “Bat” ears or prominent ears, to “Cup” ears or constricted ears. Very severe congenital deformities like microtia or anotia is occasionally seen as well. Depending on the extent and type of deformity you may be concerned about; various techniques can be used to correct them.
Simply pinning back the ear cartilage may be all that is required for patient lacking an anti-helical fold and this procedure is typically performed under local anaesthestic in our clinic. More extensive deformities requiring rib grafting or cartilage resection is typically performed under general anaesthesia.
For patients with microtia, the benefit of working with an Ear, Nose and Throat surgeon familiar with ear reconstruction would be that your hearing function would be evaluated and can potentially be corrected as part of the whole reconstructive effort.
Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve birth defects or traumatic injuries may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.
“Ear surgery can offer a big increase in self esteem for most patients which is why it continues to be a popular procedure,” said Robert M. Kellman, MD, President of the American Academy of Facial Plastic and Reconstructive Surgery.
You may have heard some mean comments like “Dumbo” ears or “Mickey Mouse” ears. These comments can have a significant impact on a child’s or your own self esteem with even more severe ear deformities like microtia attracting unwanted stares and social awkwardness. Otoplasty in Singapore can be performed at any age after the ears have reached full size, usually around five to six years of age but is typically recommended before a child enters primary school so as to minimize any unwanted teasing or social awkwardness. Locally, we find a second wave of patients who would have ear surgery (Otoplasty) done in their late teens to early twenties when they become more concerned about their image impacting their future career and personal relationship prospects.
If you feel conscious about the appearance of your ears or your child’s ear does not look well formed, otoplasty can be considered. As mentioned before, the ear has to be almost fully grown (approximately 5 to 6 years of age) before otoplasty can be carried out. Having realistic expectations is also important.
Otoplasty is a very broad term encompassing procedures for correcting deformities of the ear. Although this page focuses mainly on otoplasty to pin back prominent ears, there are other forms of otoplasty to correct deformities of the ear due to trauma, injury, following skin cancer surgery, congenital malformations of the ear like microtia or anotia. At Ear Nose Throat, Head & Neck Surgery, our ear specialists are able to manage all types of otoplasty depending on the individual patient’s requirement.
Surgery can be done under local anaesthesia in young adults or teenager. General anaesthesia is required for younger children. The ear doctor surgeon will make markings and measurement to establish the normal contours of the ear and then proceed with an incision behind the ear. He will scour the front of the ear cartilage to weaken it and to allow it to fold more easily and then shape it into a more desirable form before pinning the cartilage back with permanent sutures to secure the cartilage. Excess skin behind the ear is trimmed off and, in some cases,, excess cartilage is also removed. This is a cartilage sparing technique preferred by our surgeon and is sometimes known as the Mustarde technque.
A change in shape will not affect hearing. Although the ears’ folds and convolutions do serve to concentrate and localize sound waves, routine surgery to pin back or reshape ears will not produce a noticeable change in hearing.
A mastoid dressing is then applied to keep the freshly pinned back ear in place.
The risks are fairly minimal, but include very rarely; infections, poor healing or possibility of recurrence of the deformity. Normally, there will only be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential. It is recommended that you contact the ear clinic and speak to the ear specialist surgeon immediately.
Before surgery, a thorough consultation is conducted where your concerns, past medical history and the operative procedure explained in detail. Every patient’s expectation is addressed and generally, it is important that realistic outcomes are discussed and agreed upon. Photos are taken before surgery for reference and consent is subsequently taken.
The mastoid dressing, which is like a bandage that goes around your head covering the ears, is applied immediately after surgery and removed after a few days. A lighter headband and dressing is then applied before another visit to remove the stitches behind the ears in about a week’s time. Most patients experience some mild discomfort and have to be careful not to wet the dressing and bandage in the initial week. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands that can be removed occasionally are then used to hold the ears in the desired position for six weeks after the surgery.
Post-surgery, patients enjoy a new ear shape and position that makes them feel attractive and renews their self-esteem. Due to the naturally hidden position of the incision during otoplasty (in the crease, behind the ears), scarring is minimal and not visible. Hearing is also not affected.
The bandage comes off after a few days and is changed to a lighter headband which the patient has to wear most of the time for the first month. Stiches are removed after about a week from the incision made behind the ear. Complete recovery typically takes about 6 weeks though you may carry on with normal indoor activities almost immediately after surgery. Outdoor activities, sports, swimming and vigorous indoor exercise should be avoided for the first month and ideally, patients should refrain from high risk contact sports like rugby of wrestling after their otoplasty.
Recovery from ear otoplasty is usually quite quick. To ensure a smooth recovery, your surgeon will give you specific care instructions and the dos and don’ts. Dressing and bandages should be kept dry and intact until they are due for changing and whatever medications, ointments and follow ups that have been assigned to you should be closely adhered to. Manipulating and putting pressure on your recently operated ear would be unwise and might cause the procedure to fail.
ENT specialists or Otolaryngologists are trained to assess the internal aspects of the ear and manage all (medical) aspects of the ear such as middle ear infections, outer ear infections, hearing loss, tinnitus and dizziness. ENT specialists who are trained in Facial plastic surgery would in addition be able to analyze and develop the ideal surgical plan to obtain an ideal outward appearance while addressing the functional (medical) aspects of the patient’s ear. It is therefore important to appreciate the approach ENT-Facial Plastic surgeons’ approach to otoplasty, which may be very different from just an outward correction of aesthetics. With proper analysis, realistic patient expectations and the skills of a qualified facial plastic surgeon, otoplasty is a very rewarding procedure for both patient and ear specialist surgeon alike.
In Singapore, only certain specialists are accredited by the Ministry of Health to perform this operation. Otoplasty Singapore specialists would typically spend time overseas honing their skillset with this type of surgery since the training opportunities in Singapore to learn otoplasty can be rather limited. With all these in mind, it would be pertinent to look out for a ear doctor Singapore surgeon with these requisite credentials and training.
At Ear Nose Throat, Head & Neck Surgery, our surgeons are fully accredited Singapore ENT specialist with the Ministry of Health, Singapore. Additionally, Dr Kenneth Oo is on the select list of ENT specialists who is accredited to perform Facial Plastic procedures. Dr Oo spent a year at the University of Virginia, USA subspecializing in Facial Plastic Surgery and Rhinoplasty under his world-renowned mentor Professor Stephen Park. Dr Oo has also been the course director of the facial plastic course at the Singapore General Hospital since 2010. At Ear Nose Throat, Head & Neck Surgery, you can therefore be assured that the specialist performing your otoplasty has the credentials and experience to produce the results that’s the best for you.