Prominent and abnormally shaped ears occur in up to five percent of the population.

Otoplasty is a surgical technique to correct them. There are many types of subtle differences between each abnormality, so different techniques to suit each problem are used. I operate on both adults and children with this problem.

Children and otoplasty

Children can be operated on around the time they start school, as the ear is usually fully grown by the age of four. However, most people would agree that the ideal time is when the child is able to take part in the discussion and be involved in the consent.

Operating early can avoid a lot of teasing and self-confidence issues that can develop. Conversely, delaying surgery till the child is older may be better in some cases as the child is more aware of the problem and can understand and be involved in the care required after surgery. If you or your child are not concerned or bothered by the problem, then clearly no surgery is necessary or can be considered later.

What to expect from the procedure

I aim to create a natural, non-distracting ear. Not all ears are symmetrical, and there may be slight differences between the two after surgery. The usual angle between the head and the ear is between 15 and 30 degrees. Angles bigger than this make the ear more prominent and there can be specific folds missing in the cartilage of the ear that I may need to recreate or accentuate to make the ear look more normal.

Surgery is geared to hide the small incisions so that they are almost invisible, and we try and preserve all cartilage. I have moved away from permanent sutures, which can be associated with late complications. We only use absorbable sutures. Other sutures and softening of the cartilage in specific areas can create the normal folds of the ear if they are not present.

Surgery is performed under general or local anaesthesia and can take between 1-2 hours depending on the complexity of the case. A head bandage is often worn for one week then changed to a lighter ear wrap or head band. Digital photographs are taken before and after surgery to document the changes I make.

Complications are rare, but examples such as haematoma (blood clot) and infection of the cartilage can occur. Subtle imperfections can possibly develop years later as the ear ages and can be remedied by minor surgery if required.