congenital ear deformity correctionRare congenital ear deformity of the well of the right ear in a 33-year-old woman, corrected by reversing the cartilage of the deformed area. Left: Right ear for comparison/Centre: Pre-op/ Right: Post-op result (at 6 weeks)

This case has been published in European Journal of Plastic Surgery: ‘An original technique for the correction of congenital inverted bowl deformity in an adult’, Omer Osmani & Richard Matthews, Eur J Plast Surg (2016) 39:449-452.

In some societies, ears which stick out a lot are considered a sign of wisdom. More often, in Western society, prominent ears are the butt of teasing, unpleasantness and even bullying. This can carry on into adult life, making life a misery for children and adults alike.

Correction by pinnaplasty (also called otoplasty) involves changing the shape of the cartilage (the semi-solid substance within the skin of the ear) so that the ear is brought in closer to the side of the head. It is by altering the shape of the cartilage that the correction is achieved, not by removing skin.

Surgery can be carried out from the age of 5: the ear is well formed by this stage and teasing has not usually started before this. In children, a general anaesthetic (asleep) is needed but from the early teenage years and increasing into the adult age group, surgery can be carried out under local anaesthetic with or without sedation. The sedation can be administered either by mouth (tablets) or intravenously (given by an Anaesthetist). A general anaesthetic can still be used for teenagers and adults, if preferred. Surgery is usually carried out as a day case.
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A special dressing is applied to each ear to keep the new shape and a bandage, held with tape, is then wound round the head to hold it all in place. After going home, it is very important to leave the bandage alone: if it comes off, it is best re-applied at the Hospital. The bandage stays on for about 8 days when it is removed at the Hospital.

There is some bruising and swelling at this stage which settles quickly. The bandage is worn at home at night for a further 3 weeks. The stitches behind the ear take about 4 weeks to fall out. Contact sports should be avoided during this time.

Exact symmetry of the ears is not guaranteed (most people’s ears are a bit different from each other). Very occasionally, the initial result requires slight alteration and, if required, this would normally be done after about 6 months.

Prominent ear correction may avoid much misery for children if carried out at about 5 or 6 years old and can relieve older children, teenagers and adults of significant torment, providing a great boost to self-confidence. The surgery does not affect hearing.