Complications of Otoplasty - An Overview

What Is Otoplasty?

Otoplasty is external ear surgery. It is a cosmetic surgical procedure that corrects the ear or reshapes the ear cartilage and enhances the appearance of the ear. It does not improve functioning by enhancing hearing ability. A plastic surgeon may perform otoplasty in both children and adults to correct the following types of external ear esthetic problems:

• Congenital external ear problems like large earlobes, contracted or small-sized ears, wrinkled earlobes, the altered shape of the earlobes, over-projected ears, missing ear cartilage, or missing ears.

• Missing ears due to accidents or injuries.

• Downwardly folded ear tips give rise to lop ears.

• Smooth crease and wrinkle-less ears give rise to a shell-like appearance- shell ears.

• Ear injuries.

• Macrotia or large ears.

• Microtia or small ears.

Surgeons recommend otoplasty between the ages of four and fourteen as the cartilage will be soft and easily moldable. But adults also opt for such surgeries when their ears get affected due to accidents, sports injuries, or other traumatic conditions.

What Are the Types of Otoplasty?

Otoplasty may be performed in three different ways. They are:

• Ear Pinning: Ear pinning is performed on the ear angles to make the ear less prominent. The procedure will be done under general anesthesia or sedation, and the incisions will be made on the back of the ear. Ear pinning enhances the shape of the cartilage and reduces the over-projection or protrusion of the ears by bringing them closer to the head.

• Ear Augmentation: Ear augmentation is the procedure performed to increase the size of the ears in candidates having smaller ear sizes or partially developed ears. The size and shape of the ears will be enhanced with the help of tissue grafting procedures.

• Ear Reduction: Ear reduction is the removal of excess tissues from the ears to reduce their size. It is performed in candidates having macrotia or large ear size.

How Is Otoplasty Done?

Initially, the candidate should prepare for the surgery. The candidate should not be a smoker or should have quit the habit of smoking before the surgery. In addition, the candidate should be healthy. The presence of underlying conditions can sometimes worsen the healing process and the outcome of the surgery.

• Choosing the Surgeon: Choosing a well-qualified and experienced surgeon is essential. In addition, the clinical setup or the hospital where the procedure will be carried out should be neat and hygienic.

• Preparatory Steps: The surgeon will take a detailed medical history. Sharing with the surgeon the type of physical and mental illness that the candidate has, the types of medication currently consumed, and medical allergies are essential. The patients will be asked to quit smoking and maintain a healthy lifestyle.

• The Procedure: The surgeon will explain the whole procedure to the patient. The patient will be given general or local anesthesia with sedation to make the procedure comfortable and painless. The surgeon will then make an incision, usually on the back of the ear. After raising the flap, excess tissue will be removed, tissues will be added, or required reshaping will be done. The surgeon will close the incision and place sutures.

What Are the Complications of Otoplasty?

Even though otoplasty is a safe procedure, complications can happen immediately after the surgery or later. Immediately after the surgery, the patient may experience one or more of the following:

• Numbness.

• Reaction to anesthesia.

• Bleeding.

• Bruising.

• Swelling.

• Nausea.

• Pain or discomfort.

• Tingling sensation.

• Soreness.

• Redness.

• Itchiness.

• A chest infection may develop after giving general anesthesia to the patient.

The other potential complications of otoplasty are:

• Infection: Rarely, the surgical site may get infected after the procedure.

• Hematoma: Hematoma is the collection of blood. Hematoma may develop in the ears after otoplasty. A hematoma that develops around the ear cartilage is known as an auricular hematoma.

• Scar Tissue Formation: The cartilage may get infected and lead to the development of scar tissue.

• Perichondritis: Perichondritis is the infection of the cartilage.

• Over-Correction: The surgery may lead to over-correction of the ears, making the ears pulled abnormally close to the head region.

• Asymmetry: After healing, the ears may look asymmetrical or develop abnormal contours. The surgeon will usually do surgical alterations on both ears to prevent asymmetry.

• Under-Correction: Sometimes, the surgery may fail to deliver the required results and lead to under-correction of the anomaly. Such cases can be managed by doing further surgeries.

• Recurrence: The ear cartilage has elastic properties and naturally tends to gradually revert to its original condition. Due to this reason, the abnormal external features may recur for years after ear correction surgery. The recurrence rate increases according to the health status and the individual's lifestyle.

• Allergic Reactions: The patient may develop allergic reactions to antiseptic solutions or suture materials.

• Healing Duration: Delayed healing can be noticed in the case of smokers.

• Sore Throat: Using a breathing tube may cause a sore throat.

• Loss of Balance: Fluid may accumulate within the treated ear and lead to balance issues.

• Ulcer: Some areas of the skin may die after the surgery, leading to ulcers that may take a prolonged period to heal.

How to Take Care After Otoplasty?

Following the surgeon's guidelines is extremely important to reduce complications and promote healing. Some of the self-care tips are:

• Applying the topical medications and taking oral medicines prescribed by the surgeon is necessary.

• Keeping the surgical site clean and hygienic is also important.

• Performing strenuous exercises should be avoided for a week after the surgery.

• Refraining from smoking and following a healthy lifestyle will help in rapid healing.

• Follow-up appointments should be taken with the doctor, which will help assess the progress and outcome.

• In case of severe complications, the patient should visit the doctor and get the required treatment.

Conclusion

Otoplasty is an ear correction surgical procedure usually performed by a cosmetic or plastic surgeon. It is a relatively effective and safe procedure. But, like any surgical procedure, otoplasty also leads to complications and side effects. Choosing an experienced and well-qualified surgeon and following the surgeon’s suggestions and advice will help reduce the complications to an extent.