Ear Correction (Otopexy)

What is Ear Correction?

Ear correction is a surgical treatment to attach protruding ears. Depending on how far the ears protrude from the head, different surgical methods are used. Ear correction, medically, also called otopexy or otoplasty, is among the most common aesthetic surgeries.

Usually, the ears lie close to the head. When the ears protrude more than 30 degrees from the head, they are called protruding ears or "jug ears." Affected patients who find their ear position disturbing also often have to struggle with inferiority complexes and self-confidence disorders. Teasing at school because of protruding ears is a severe psychological burden for children.

Causes for Protruding Ears

Protruding ears are usually a congenital deformation of the cartilaginous parts of the ears, or the cartilaginous parts of both ears have grown asymmetrically to each other. The surgery is for restoring the harmony and symmetry of both ears. Typically, an ENT physician or a specialist in plastic and aesthetic surgery will carry out this surgery.

Ear Correction Methods

Ear cartilage is modified and sutured in the desired position with the classic method of ear correction. The ear correction is accessed via an incision in the auricle, which allows the ear cartilage to be exposed and worked on. The desired size and inclination can be created before the ear is fixed in the desired position. A significant advantage of this method is the gentle access at the back of the ear, with hardly any visible scars after the procedure. However, the healing process must be awaited, and an ear bandage is worn before the results become visible.

EarFold Method

A new method in ear correction is the EarFold method, in which implants are inserted into the auricle. This involves using implants made of nitinol with a gold coating, which have been approved in the EU since 2015. This method is suitable for people who want to undergo surgery because of a missing antihelix or for whom other ear surgeries to correct the shape are not possible. The implants allow quick treatment under local anesthesia and excellent compensation of ear asymmetries.

The expected result can already be simulated before the surgery. This method requires only a small skin incision of approx. 5mm and is carried out minimal invasive. Therefore, no visible scars are expected after the surgery. A further advantage is that the implants can be changed or repositioned if necessary. The costs are also lower, as this procedure is much faster than the classical method. The result is immediately visible after the surgery, as no significant healing process has to be awaited, and no eye-catching ear dressing has to be worn.

The Procedure of Ear-Correction

The surgical procedure is preceded by the surgeon's detailed study of the anatomy of the patient's ear cartilage tissue. The surgery will take about one to two hours and is usually carried out under local anesthesia. If desired, the patient can also be given a sedative and sleep through the surgery. General anesthesia is only used for very young children.

The patient lies in a dorsal position with the head slightly raised. First, the surgeon makes an incision behind the ears at the junction from the ear to the head. He can remove skin and cartilage tissue through this incision until he has brought the ears into the correct position and angle. To remove excess cartilage, the surgeon uses a special trephine. However, the removal of cartilage is not always necessary. In some cases, the surgeon can even bend the cartilage into its desired position and fix it there. The surgery is secured with tape patches, the skin incisions are stitched together, and the patient receives a dressing around the head.

When reducing the size of the ears (otoplasty), the surgeon makes a small incision at the upper edge of the auricles, detaches the skin from the front at the same time, and reduced the cartilage through specific incisions. In a final step, the surgeon removes the excess skin and stitches the edges of the cartilage together. During this process, the surgeon can also reduce the size of the earlobes.

During the operation, both ears - if both are affected - are reshaped and repositioned. In many patients, the protrusion in the edge area of the ear (anthelix) is rather weak or almost non-existent. It has to be reshaped from the ear cartilage and fixed in this area.

What Is the Right Age for a Set Back Ears Surgery?

In general, the patient decides whether he is satisfied with the shape of his ears. The surgeon advises and can show the patient options but also limitations. It is recommended that the procedure is carried out in children at the age of five years to protect them from possible teasing and exclusion. If the child agrees to the surgery, the cooperation is usually significantly better. By far, not all ear corrections are carried out at this age; in many cases, patients do not seek advice until puberty or adulthood.

What Should Be Paid Attention to Before an Ear Surgery?

Some medications, especially blood-thinning ones such as aspirin or ASS, must be discontinued before the procedure. If the surgery is carried out under general anesthesia, the standard guidelines apply: The patient should neither eat nor drink for six hours before the surgery. If the patient regularly takes medication in the morning, it should be discussed with the surgeon or anesthetist before the surgery, whether to stop or continue taking them. Patients who smoke are best advised to stop smoking in the period before and after the operation to support wound healing and prevent wound healing disorders.

Healing Process After Set Back Ears

In addition to the general requirements and recommendations after surgery, especially the sensitivity of the ears, must be taken into account. Any stress on the auricles should be avoided in the months after the surgery, among others, exposure to pressure, bending, wearing ear jewelry, and also wearing glasses. The tissue is still sensitive even months after the surgery and the cartilage and skin structures will not have anchored then.

Because the healing phase varies from patient to patient, the final shape of the ear can usually not be finally evaluated until two or three months after the procedure. During this time, the ears may return to their original position due to the elastic restoring forces of the cartilage, and the ears may protrude again, possibly necessitating a second surgery.

Patients usually experience pain, which is normal, and the treating specialist will prescribe painkillers. However, if the (severe) pain persists in the long term or if there is fever or secondary bleeding, the doctor should be informed and consulted. There is also a risk of bacterial infection of the cartilage. Therefore, antibiotics are usually prescribed for the patient.

If the healing process is free of complications, the head bandage can be removed after about one week. However, not until then, as the dressing serves as a compress and supports wound healing. The stitches will be removed after ten days. It is also recommended to wear a headband in the weeks following the removal of the stitches - especially at night, to prevent the ears from bending during sleep.

Usually, children can go back to school after about a week, while adults can carry out their everyday tasks after only four or five days.

Aftercare examinations should be carried out. The treating specialist will decide on the frequency of these examinations according to the healing process.

What Risks And Complications Have to Be Expected After Ear Correction?

In principle, it is important to wait until children are at least five years old when planning such surgery because the auricles have fully developed in their shape as of this age.

In case of intolerance regarding general anesthesia, local anesthesia can be used in consultation with the anesthetist.

Ear correction is usually a low-risk and straightforward procedure, which is safer; the more experienced the surgeon is in this area. Nevertheless, as with any other surgical procedure, complications such as hematomas, infections, wound healing disorders, or failure can occur, about which the treating physician will inform the patient in detail. In some rare cases, a bruise may form, which has to be punctured surgically, but usually, the bruises just disappear. Temporary hypersensitivity of the ears cannot be excluded either but will subside after some time of healing.

Costs for a Set Back Ear Surgery

This surgery is almost always a plain aesthetic procedure without medical necessity, which means that statutory health insurance companies do not cover the 2000-3500 Euro bills. The costs are calculated individually according to the complexity and are difficult to predict.

For children under 14 years of age, the costs of the surgery are, in certain cases, partially or entirely covered by health insurance companies. For this, a medical opinion estimate confirming the psychological impairment of the child must be available.

Which Doctors And Clinics Are Specialists for Ear Correction?

If you are thinking about having your ears set back, you want to be sure that an ear correction will achieve a satisfactory result. Therefore, the patient is wondering where to find the best ear surgeon in Germany or Switzerland. The choice between an ENT specialist or a specialist for plastic and aesthetic surgery has to be made.

Both specialists for plastic and aesthetic surgery and experienced ENT doctors have the necessary training to carry out an ear correction. Whether a doctor is an ear specialist depends on his surgical experience in the field of ear surgery. The more otoplasties a doctor carried out, the more experienced he becomes in his area of expertise. That is why it is important to get a personal impression of several specialists before having an aesthetic procedure carried out.

We will help you find an expert. All listed doctors and clinics have been checked by us for their outstanding specialization in the field of ear surgery and are awaiting your inquiry or treatment request. Currently, you will find experienced doctors for ear correction in Berlin, Eschweiler, Düsseldorf, Munich, Bern, and Lucerne.

Sources:

• www.dgaepc.de/aesthetisch-plastische-chirurgie/gesicht/ohrenkorrektur/
• Kastenbauer, Ernst R ; Tardy, M Eugene ; Schumacher, Katharina ; Aguilar, Eugenio A ; Caroll, William R ; Dellian, Marc: Ästhetische und Plastische Chirurgie an Nase, Gesicht und Ohrmuschel. 3. unveränd. Aufl.. Stuttgart: Georg Thieme Verlag, 2005.
• Prof. Dr. Peter M. Vogt; Klinik für Plastische Chi Medizinische Hochschule Hannover: Praxis der Plastischen Chirurgie : Plastisch-rekonstruktive Operationen - Plastisch-ästhetische Operationen - Handchirurgie - Verbrennungschirurgie. Berlin, Heidelberg: Springer, 2011.