Most of the risks of otoplasty surgery are similar to those found in other cosmetic surgeries such as bleeding, infection, scarring, recurrence and unsatisfactory result. For adults, anesthesia is not generally an issue because the procedure is usually done under local anesthesia with or without oral sedation with Valium and a narcotic.
Bleeding and Bruising
Bleeding is always one of the first mentioned risks of surgery and can be reduced by avoiding taking certain medications that can thin the blood for two weeks before surgery. These include aspirin, fish oil, Vitamin E and most over the counter anti-inflammatory medications such as the ibuprofens. In general, because the area of surgery is confined to a small space, bleeding and bruising is usually fairly minimal.
Infection is a risk with any surgery; therefore, it is common to take an oral antibiotic around the time of surgery. Infections, when they do occur are usually relatively mild and are effectively treated with removing a few sutures or taking antibiotics or both. Rarely, one of the permanent sutures will get infected years after the surgery, usually due to a small infection close by. It is typically easily resolved with removing the suture and this does not change the final result of the surgery.
Asymmetry of the ears is common in patients who have prominent ears and is generally well corrected with the surgery. Residual asymmetry is a risk but is usually not very noticeable once the excessive prominence has been corrected. When the ears stick out, it is easy to see both at the same time so that asymmetries are more obvious. Once they are pinned back, you have to look side to side to compare them making any difference much less noticeable.
Abnormal scarring can occur with otoplasty surgery in the form of hypertrophic and keloid scars. Both of these are due to excessive scar formation and are relatively unusual during otoplasty surgery. They are more common in darker-skinned patients and generally require subsequent procedures for correction and local steroid injections. Fortunately, these are relatively rare and are hidden behind the ears so that they cannot be seen from the front.
Loss of sensation to the ears can occur but is usually short-lived as the nerves usually regenerate providing normal sensation over time.
Recurrence is probably the risk that patients are most concerned about and can be minimized by using a combination of techniques to keep the cartilage in its desired position and strictly avoiding trauma after surgery for 6-8 weeks.
To avoid an ‘operated’ look with unnatural folds and curves, it is important to seek out an experienced Plastic Surgeon who is certified by The American Board of Plastic Surgery and who specializes is cosmetic surgery.
The skin behind the ears is very thin requiring small sutures for incision closure. As such, the closure is not particularly strong and the wound edges can separate with something as simple as pulling a tight shirt over your head. Therefore, we recommend that you not wear pull-over shirts for at least three weeks after an otoplasty.