Protruding ears are the most common aesthetic deformity of the external ear. Otoplasty is the operation for correction and is largely done in children and teenagers. While some may consider ears that stick out as a minor problem, children that have them do not as they are often exposed to teasing by others. This emotional stress can negatively effect their self-image leading initially to poor school performance and self-confidence possibly springboarding to other more lifelong life issues.
Does otoplasty just make an aesthetic difference or does it have other benefits as well? This very issue was reported on in the September 2010 issue of Plastic and Reconstructive Surgery where findings about the effect of otoplasty on health-related quality of life issues was published. In this study, 84 patients who had otoplasty were evaluated by questionnaires about their results. Of those that returned the questionnaires, 100% of adults were satisfied with the result and 91% of adults would again decide in favor of having otoplasty again. In children, 95% were satisfied with the result and 93% would again decide in favor of surgery again. The health-related quality of life was elevated in both 95% of adults and children.
This study confirms what all plastic surgeons know who perform otoplasty with some regularity…the satisfaction rate is quite high. This is not surprising given the often dramatic change that is evident in the ears as can be seen in any before and after photos of the surgery. While both children and adults benefit alike, the study reports that it is not to the same degree. Children appear to get greater lifelong benefits, both socially and in physical health, than that of adults. This is really no surprise in that correction of a congenital defect earlier allows for the benefits of an improved self-image and confidence for a longer period of time. Conversely, adults have lived with the deformity longer and the impact of correction, while significant, is not as great as the time length of the benefit is less.
One of the other interesting aspects of the study was the incidence of complications and the need for revisional surgery after an otoplasty using a suture technique. Relapse, asymmetry of the ears, and suture extrusion were the most common reasons for secondary surgery. The incidence was around 10%. Some adverse scarring and persistent pain were reported but it did not result in the need for surgical treatment.
Otoplasty done through cartilage reshaping with sutures is both highly beneficial and a satisfying experience for patients. The earlier in life protruding ears are corrected, the longer the benefits of the operation are enjoyed and the more significant those benefits will be.
Dr. Barry Eppley