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Most patients who desire otoplasty have ears that are normal or near-normal in shape but are prominent; in short, the ears stick out too far. Prominent ears vary from slightly prominent (just prominent enough to affect the choice of hair style) to profoundly prominent (an obvious deformity to anyone who sees the patient).

The goal of otoplasty is to produce an ear that is normal; that is, to create an ear that is set back sufficiently but not excessively, and one that lacks any visible scars or sharp, artificial edges. Finally, like surgery on the face as a whole, the ear should be setback harmoniously, with each part of the ear in the correct position relative to the other parts, not set back, for example, in the upper two thirds but with a persistently prominent earlobe.

Most otoplasty procedures are performed through an incision in the crease behind the ear where they are completely hidden. The correct contours are created by folding the cartilage using sutures or incising/removing cartilage as necessary. In cases of ears that are also excessively large or unusually shaped, an incision is sometimes made just inside the outer rim of the ear, where it is hidden under the overhang.

I usually place a soft, bulky dressing to protect the ears for a few days post-operatively. When that is removed, no further dressings are required. I suggest that the patient wear a headband at night for a month or so, just to prevent the ear from bending forward during sleep and ruining our hard work!

To see before and after images, please click Ear Surgery Gallery.

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