Since the ears are about 85% grown by the age of six, otoplasty surgery is often done on children before they reach school age in an effort to prevent the psychological trauma and embarrassment associated with kidding from other children about their condition. As patients of this age are too young to perform the procedure with just a local anesthetic, the surgery must be done under general anesthesia in a hospital or surgery center that is equipped to treat small children.
Underdeveloped Ear Folds
It is common for ears that project out too far to be missing normal folds, have underdeveloped folds or other abnormal folds that should not be present. All of these can be improved upon or completely corrected using the scoring (incomplete cutting of the cartilage), permanent suturing and/or resection techniques normally performed during otoplasty surgery.
Some infants are born with extra or abnormal folds in the cartilage. Many of these can be removed or corrected with the techniques described above.
Very often, patients with over-projecting ears have significant asymmetry of their ears with respect to shape and the amount of projection. It is generally much easier to spot ear asymmetries when the ears project out too far as they can both be seen at a single glance. Once they have been ‘pinned back’ to their normal position, the differences are much more difficult to observe as both ears cannot be seen at the same time.
Other Ear Abnormalities
Other ear deformities, which can be treated during otoplasty surgery, include repairing partially torn or cleft earlobes, reducing the size of excessively large earlobes (usually in older patients), removing abnormal bumps of cartilage along the rim of the ear and correcting deformities due to ‘cauliflower’ ears.
The latter develops from trauma to the ears where the layer on top of the cartilage (perichondrium) gets separated from the cartilage because of bleeding brought on by the trauma. This results in excessive cartilage growth causing the normal contour of the ear to become deformed. During this type of surgery, the ear skin is elevated off of the deformed cartilage and the excess misshapen cartilage is removed resulting in a much more natural appearing ear form is carved out of the remaining cartilage.
As the skin on the ears is often unprotected from the damaging rays of the sun even when wearing a golf or baseball cap, the ears are a common place for skin cancers to develop. Some creativity is often required to removed these cancers and not create too much of an ear deformity, which is why the job is frequently given to an experience plastic surgeon to perform a skin graft or local flap. Prevention, of course, is best; which is why you should protect your ears when out in the sun.