What to Expect on the Day of Otoplasty
We utilize a fully accredited (JCAHO level accreditation) outpatient surgical center that has significant experience in the treatment of pediatric patients. We utilize only board-certified anesthesiologists who are skilled in the treatment of pediatric patients.
In the vast majority of cases, the otoplasty procedure is performed using general anesthesia that is supplemented with local anesthesia. In rare cases, the procedure could be performed using local anesthesia with sedation, but this would be limited to adults or very mature adolescents.
The procedure begins by making marks on the rim of the ear on both sides and then measuring the distance of protrusion of the ear from the skull. This is done to produce a result that is as symmetrical as possible.
We then remove a small strip of skin from the back of the ear. This excision is oriented such that when the incision is closed the scar does not lay in the crease behind the ear, but is up on the back of the ear. In this way, glasses will not put pressure directly onto the scar.
The skin on the back of the ear is then separated from the cartilage of the ear. If the antihelical fold is not well developed, we then come to the front of the ear underneath the skin and use some special files to weaken the cartilage on the front of the ear. We then use some permanent sutures to create and maintain the fold. If the bowl of the ear (concha) is overdeveloped, we then plan for an excision of a small piece of the cartilage and the remaining cartilage is then sutured back together. Additional sutures may be used to suture the concha to the skull to reduce any further protrusion (concha-mastoid sutures). The skin is then sutured together and a well-padded head wrap is applied.
If a single ear is treated the procedure typically takes 1 ½ hour to perform. If both ears are treated it typically takes 2 ½ hours to perform.