Otoplasty or surgery for protruding ears

The first step for Dr Christelle Santini is to understand the cause of protruding ears in children and adults, with three types of malformation that are often more or less associated with each other:

• Valgus de conque: excessive angulation between the auricle and the skull, resulting in true "detachment" (Helix Valgus).
• Excessive size of the concha cartilage projects the ear forward, accentuating the protruding appearance (concha hypertrophy).
• Defects in the folding of the cartilage's usual reliefs, so that the auricle looks too smooth, as if "unfolded" (defect in the folding of the anthelix).

This clinical analysis will be coupled with an aesthetic analysis of the face to determine the type of surgical procedure to be applied.

The complexes associated with protruding ears are often such that surgery is most often performed on young adults entering the professional world, or minors in their school or university careers.

For otoplasty in children, Dr. Christelle Santini advises waiting until the age of 7, to ensure both anatomical and "psychological" maturation. It's important that the request comes from the child and not just the parents, especially as the child will need to be involved in the post-operative follow-up.

In most cases, this type of earplasty is covered by the French health insurance system for children. In adults, treatment is only available for severe forms of ear detachment.

The first appointment with Dr. Santini is essential for a clinical, aesthetic and psychological assessment. It is essential to understand expectations and any fears, especially in the case of children.

Dr. Santini always takes the time to listen to the child, which is a must for her.

This is also what will determine the choice of anaesthesia, with an appointment with the anaesthetist if necessary. This may depend as much on the technique used as on the patient's level of anxiety.

In the event of anaesthesia other than local, the anaesthetist must be consulted at least 48 hours before the operation.
No medication containing aspirin should be taken in the 10 days preceding the operation.

You'll need to wash your head the day before or the same day.

The procedure is generally performed on an outpatient basis, meaning that the patient is discharged the same day after a few hours of monitoring.

Surgery takes an average of 60 to 90 minutes.

Three types of anesthesia are available:

• Pure local anesthesia, where an analgesic product is injected locally to ensure that the ears remain insensitive, if necessary after first applying an anesthetic cream so as not to feel anything.
• In-depth local anesthesia with intravenous tranquilizers (neuroleptanalgesia-type "vigilant" anesthesia).
• General anesthesia during which you sleep completely.

Each surgery to correct protruding ears is tailor-made, and can combine different technical procedures.

The incision lines, corresponding to the location of the future scars, are usually hidden in the retroauricular fold, i.e. the natural crease behind the ear. This ensures a virtually invisible scar.

Dr Santini then accesses the cartilage by slightly cleaving the skin.

The principle of otoplasty is to remove excess skin or cartilage, recreating a harmonious, balanced plication.
This can be done by resection or by suturing the cartilage with very fine, non-absorbable stitches, before closing the skin.
Skin suturing is performed with a fine, absorbable thread, so there's no need to remove the stitches.

A light dressing is applied, along with a contention bandage.

Monitoring takes place in the recovery room for around 1.5 hours, then in your room, before discharge, usually the same day.

A "helmet" bandage holds the ears in position for the first 24 hours. It is removed the day after surgery. Its purpose is to compress the detached areas during the first few hours, combating tissue detachment.

The ears may then appear swollen, with relief masked by edema (swelling). More or less significant bruising may also be present. This possible appearance is nothing to worry about: it's normal, only transitory, and in no way compromises the final result.

Once the dressing has been removed, the sutures can be left in the open air, and any glasses worn can be resumed. However, it is essential to systematically wear a headband over the ears for 7 to 10 days (day and night), and for 1 month at night only. The purpose of this headband is to prevent the ear from turning over unintentionally. For children, this can be done during school vacations. Similarly, contact sports or violent sports that could traumatize the ears should be avoided for two months.

Pain is usually moderate.

For children, Dr Santini systematically proposes a pain-relieving treatment, perfectly adapted to each individual's sensitivity.

Exposure to extreme cold is not recommended for at least two months, given the risk of frostbite due to the transient reduction in ear sensitivity.

Although the first results are clear at around 2/3 weeks, it will take 2 to 4 months before the final result can be appreciated.

• Local anesthesia possible.
• Ear surgery from age 7.
• Discharged the same day as otoplasty.
• 3 to 7 days of professional downtime.
• Final result between 2 and 4 months.

Otoplasty corrects protruding or misshapen ears, enhancing facial harmony. Results are visible as soon as the bandages are removed, after a few days. The final result is usually achieved within 2 to 3 months, once the healing process is complete.

This procedure offers permanent results. See examples of transformations before and after this subtle procedure.

What to do before surgery for protruding ears?

• 1 to 2 consultations with your plastic surgeon, including the taking of medical photographs
• A consultation with the anaesthetist if necessary.
• Delivery and signature of the estimate, respecting the 15-day legal deadline between the first consultation and the surgery for protruding ears.

How is otoplasty performed to correct protruding ears?

• Local anesthesia, neuroleptanalgesia or general anesthesia.
• 1h30 of intervention.
• Absorbable threads with the otoplasty scar hidden in the crease of the ear.
• Same-day return home after ear surgery.

What is the post-operative course of surgery for protruding ears?

• Wear a blindfold during the day for a week, and at night for 1 month.
• Follow-up visit with your plastic surgeon 10 days before surgery.
• The threads used to correct ear detachment are absorbable.
• Plan to take 3 to 7 days off work after otoplasty surgery.
• Stopping sport after ear surgery for 2 months.
• Final results in 2 to 4 months.