Ear reconstruction, also known as otoplasty, employs a variety of surgical procedures to change the size and shape of the ear, make the ears proportionally similar, pin protruding ears back, rebuild deformed, absent or noticeably smaller ears, or repair an injured ear. Most of the surgical procedures take from two to five hours or are performed in stages involving several small surgeries with healing time in between. Surgery for ear reconstruction is usually done as an out-patient procedure with a local anesthetic and sedation or general anesthesia. Otoplasty is typically performed by an oral and maxillofacial surgeon, plastic surgeon, or ear nose and throat surgeon.
Procedures to pin protruding ears back, make small changes to the ear shape, and fix severe cuts or torn piercings are typically done using either the cartilage scoring or cartilage sparing technique. With cartilage scoring, small incisions are made in the ear cartilage so that cartilage can be extracted, moved around, or added to the ear. This technique sometimes produces scaring, but the scars are typically hidden in the skin folds of the ear. Cartilage sparing involves using sutures to manipulate the ear shape and often results in less scaring.
Surgery to completely rebuild or reshape an absent ear, highly deformed ear, or to fix a badly burned ear is usually done in four steps. In the first procedure, which takes about four to five hours and is the only surgery which requires at least an overnight stay in the hospital, cartilage is harvested from the ribs and placed under the skin of the deformed ear. Ear lobe construction takes place in the second procedure, which takes about an hour. The third procedure involves grafting skin, typically taken from the buttocks, to the rebuilt ear cartilage and finishing the earlobe, which lasts about two hours. In the last procedure, the new ear is given an opening to look like an ear canal, and the ear is reworked to make it look like the other ear.
While adults can have ear reconstruction, the best candidates for ear reconstruction are older children once their ears are fully grown because the cartilage is easier to manipulate and reshape. Ear reconstruction is typically done to improve physical appearance, and doing this early in life can spare children the hardship of feeling different. In general, ear reconstruction procedures are fairly safe, easy to recover from, and complications, such as a reaction to anesthesia and infection, are rare.