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Ear correction

Ear correction

There are many different abnormalities of the ears of which bat ears are the most common. Bat ears are congenital and do not affect your hearing. However, it can be cosmetically disturbing and make you insecure. Bat ears can be corrected with the aid of plastic surgery. For adults, the operation usually takes place under local anesthesia and for children under general anesthesia. The surgery takes about an hour and you can go home the same day.

During a first consultation, the doctor will look at the anatomy of your protruding ears. The correction of your ears must be attuned to that. During this consultation we will discuss the possibilities and your expectations of the operation

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There are many different abnormalities of the ear, but a prominent ear, sometimes referred to as bat ear, is the most common one. A prominent ear is the result of a congenital deformation of the cartilaginous framework of the external ear. Hearing is generally not affected, but cosmetically it can be disturbing. Children with prominent ears may be teased at school and as a result of this their self-confidence can be undermined. Often at a later age they seek correction of the ears, which shows that it has been an issue for years. Prominent ears can be corrected with plastic surgery and the medical term is an otoplasty. After birth the ear continues to grow and around the age of five the ears will be about 80 % of their adult size. Therefore, a correction can be done from the age of five, just before they go to primary school.

There are different anatomical reasons for ears to be prominent and the correction should be focused on these. During the first consultation the anatomy of the ear is assessed and possible correction is explained. The surgical risks, the possible complications and the course of the correction are also discussed.

In adults, the procedure normally takes place under local anesthesia and in children under general anesthesia, however, a general anesthesia will add to the cost of the procedure. The correction is performed on the back of the ear. A small strip of skin will be removed and the cartilage can be remodeled through the incision but no cartilage will be removed. The shape of the cartilage will be adjusted and fixed with stitches to obtain the desired shape. The skin will be stitched with dissolvable stitches and a head bandage will be put in place to protect the ears and the operation. The procedure takes approximately one hour and you or your child can go home the same day.

In adults the bandage is removed the next day and in children approximately after a week. It is important that at night a bandage is worn for protection and for ease of sleeping. Normal showering and washing of hair can proceed after a week and any dried blood scabs can gently be removed with water. Do not use a hair drier for two weeks and keep it on the coolest setting for six weeks. During sleep it is best to keep your head a little elevated with an extra pillow or by elevating the head end of the bed. Furthermore, it is advisable to sleep on your back to prevent any pressure on your ears. In the first couple of days it is important to rest. Avoid bending down during the first couple of weeks and don’t do any strenuous exercise for four weeks. Between a couple of days to a week after you can go back to work as long as you don’t do any heavy labor.

The results of otoplasties are generally good. In the first week the ears will be swollen with some bruising, the bruising will disappear fairly quickly but residual swelling may take longer to subside. Often the ears may appear red, swollen and sensitive for some time. As the swelling goes down, the ears take on their final shape. In the beginning the scar behind the ear will be red and in time will become the usual color of the skin. The final result can be judged after approximately six weeks. Complete symmetry is always pursued, but a small difference may be present which lies within the spectrum of the general population. Generally, most patients are very happy with the results.

After every operation there is a possibility of developing bleeding or an infection. These present themselves through pain, swelling, redness and in case of infection; pus seeping through the wound. Bruising can occur, usually in combination with swelling. Long term hypersensitive ears in cold weather can occur which eventually disappears. Some people heal better than others, some of which may develop hypertrophic scars. These thick scars need to be treated with steroid injections. Nevertheless, the scars are not noticeable because of their position behind the ear. On a rare occasion, the memory of the cartilage is so strong that the ears return more or less to their original shape. A second correction is then needed whereby a more aggressive approach is taken to remodel the cartilage. It is important to have realistic expectations. You can expect a clear improvement but not perfection. Absolute symmetry is virtually impossible, but if the difference is significant a second procedure maybe necessary.

Before and after (Dr Karel Taams)
Before and after (Dr Karel Taams)