The goal of any good plastic surgeon is for their patients to look normal after surgery. It is preferable to provide patients with a natural, un-operated look after a cosmetic procedure. Most patients who are having otoplasty surgery feel that other people veiw them as not looking normal because of the shape, size or projection of their ears.
Starting with Abnormal
One would naturally assume that, going into an otoplasty procedure, the patient does not have a 'normal' appearance to begin with. The ears are either too big, stick out too far, have unnatural contour some other abnormality or a combination of one or more of these. The challenge for the surgeon is to correct these problems and create a natural or 'normal' appearance to the ears as well as improved symmetry.
One way to do that is to hide the surgical scars as much as possible. Most otoplasty procedures involve removing an ellipse of skin from the back of the ear in order to obtain access to the underlying cartilage for reshaping. These scars usually heal as very fine lines and are generally quite well hidden from view once the ear is pinned back closer to the scalp. Although the ears can be prone to keloid scars, especially in some ethnic patients, even these can be hard to see behind the ears.
Smooth, Rounded Contours
Another important thing to do during otoplasty surgery to create a normal appearing ear is to avoid creating unnatural folds and contours, which can make it obvious that a surgery was performed. A normal ear has gently curved rounded folds and contours, not sharp angles and straight lines. An experienced otoplasty surgeon will take the time necessary to recreate these natural aesthetic shapes and folds to a pleasant appearance. Some of the older otoplasty techniques created sharp folds with straight lines resulting in an unnatural 'operated' look. These methods should be avoided.
Subtle Appearance Change
Many patients think that they will look drastically different after an otoplasty because they focus on their ears so much in photographs and when looking in the mirror. Although the ears themselves may look quite different after surgery if there is a lot of correction performed with surgery, most patients are surprised that they still look like themselves after surgery. The best part is, they are no longer concerned with the appearance of their ears.
It is common for patients who seek aesthetic ear surgery to have more symmetry problems than others. Although differences in shape and size occasionally occur, the most common cause of ear asymmetry is a differential in projection of the helical rim from the side of the head. When both ears stick out excessively, it is easier to observe different ear size, shape or contour because both ears can be visualized at the same time. Once the excess projection is corrected, it is almost impossible to see a difference in the ears so asymmetry is less noticeable.