ne of the most rewarding procedures we perform is otoplasty
(ear pinning) for patients with abnormally protruding ears. Children are often ridiculed because of their ears, and so timing of the surgery becomes a sensitive issue. Typically, the optimum age for surgery is between 5 and 7 years of age before children are involved in school activities and also before cruel remarks affect the child’s self esteem. In these younger years, the ear cartilages are very easily manipulated and adjust well to the new position of the ear after surgery. Otoplasty is an extremely safe procedure designed to achieve natural appearing result while preserving the function of the ear.
The most common question that parents have regarding otoplasty is again “when do we do it?” This question becomes easily answered if a child has already been teased about his or her ears. Typically, children don’t start getting remarks about their ears until kindergarten or first grade. Therefore, most parents elect to do the surgery before a child enters these two years. Correcting over protruding ears can save a child from harsh comments from their peers.
During your initial consultation, Dr. Blackledge will discuss all aspects of the surgery with you. Using computer generated pictures, Dr. Blackledge will show you how your new ears should look after the procedure is completed.
We will schedule an appointment for you approximately 10 days prior to surgery. At your preoperative appointment, our patient coordinator and nurse will review all the instructions for you both prior to surgery and after surgery. You will receive prescriptions for your necessary medicines at this time, and we will review any of your current medicines that you are taking. This is also an excellent opportunity to ask Dr. Blackledge any questions you may have thought about since the consultation. At the conclusion of your preoperative visit, we want you to feel totally comfortable with your upcoming experience. Remember, we are here to answer your questions and make the preop and recovery process as easy as possible for you. For many of our long-distance patients, the preoperative appointment may be done over the telephone, via e-mail or even on the morning before surgery if possible.
The Morning of…
Upon your arrival, you will be greeted by one of our nurses, and allowed to change into a more comfortable gown. Wear something that is comfortable and slides easily over your head or zips/buttons up the front. You will then be seen by Dr. Blackledge and will discuss any “last minute” questions. We will also draw on you while you are awake and sitting up – as everything tends to change once you lie down. Once you feel comfortable and all questions are answered, we will give you a cup of pills that should make you much more relaxed.
While we want you to be most comfortable during the procedure, the majority of patients undergo otoplasty with what is called a twilight anesthesia. In the case of children, Dr. Blackledge talks to the children during the entire procedure to assure them. He will also sit the children up during the procedure to examine the ears and also to ensure symmetry, so it is important that the children are not completely asleep. This technique of anesthesia is also much safer.
The Recovery Period
Even though the recovery period technically starts immediately after surgery, there are several things that you can do before your surgery day to make the recovery period smoother. During your consultation, we will talk to you about the importance of being physically and mentally prepared for surgery to ensure that we get the best results possible. Now back to the recovery period. Immediately after surgery, a compression dressing is placed over the ears to protect them. This dressing is removed the following day. Most patients go home the day of surgery and rest comfortably for the remainder of the day. You will be shown how to keep the incisions on your ears clean with peroxide swabs and then moist with ointments. All of these measurers allow for a more pleasing scar. The first day after surgery is strictly a “bed rest” day. Most patients feel better than expected, so the temptation is to “over do” it on this first day. However, patients have less bruising and swelling if they rest with their head elevated on the first day. Swelling is typically mild to moderate reaching its maximum on the third postoperative day, and then it starts to decline. Typically, there is little “down-time” involved and you may resume normal activities after a few days. Pain is rarely significant after ear surgery. However, it is not uncommon to feel fatigued for a couple of days after surgery.
Post-op Ear Surgery Instructions
Each day during your recovery period, you will probably have a new and different question.
You will be given specific instructions regarding your postoperative care of the ear areas. These instructions are meant to help make your recovery period easier and also to ensure that the results of your surgery are as pleasing as possible.
There is little bruising with ear surgery. Occasionally, the ears will have a slight yellow hue to them for two to three days following surgery; but for the majority of patients, there is little to no bruising.
Patients will have some swelling in the ear area. The day after surgery, swelling will actually increase over the day. Typically, swelling begins to decrease on the third day after surgery.
It is best to sleep in an upright position with your head at least above the level of your heart for the first week after surgery. This helps to reduced swelling and also bruising. The best beds are usually either a recliner or an incline pillow. Both of these keep the head and shoulders in a natural position. If you try to sleep with your head elevated with pillows, you wind up sleeping in an unnatural position and develop muscle spasms in your shoulders.
You may begin light walking on the fourth day after surgery. In fact, we usually encourage this because it helps to improve your circulation, which in turn gets rid of bruising and swelling quicker. Children are usually playing full speed by the third to fourth day.
A popular question is “how much pain will I have after ear surgery?” Most patients will tell you that they had little to no pain after surgery. The common response is that everything felt “tight.” This is usually due to swelling and the tight sensation begins to subside after about 2 – 3 weeks. Patients are given prescriptions prior to surgery for pain medicine and are encouraged to take theme as directed for discomfort. However, most patients switch to Tylenol soon after surgery.
When Will I Look Presentable?
Obviously, this is a very individualized answer. The average patient is able to go back in public without being obviously swollen or bruised by about 5 – 7 days.