Prominent ears are a congenital abnormality that can often lead to feelings of self consciousness and embarrassment. Usually this occurs during childhood at the school going age where teasing may result in emotional trauma. Prominent ears can be surgically corrected to avoid this type of teasing at school. Although this operation is most commonly done during childhood (between five years and 10 years of age), it is also performed on adults who would like improvement to their ears.

INDICATIONS
 
The ear can be prominent because of three main reasons. Firstly, the angle between the ear and the head may be increased. Secondly, the folds of the ear (scapha) may be poorly developed resulting in folds which are not sharp enough, and thirdly because the cup of the ear is too large.
It is common that all three of these factors play a role but they can occur in combinations as well. The actual problem in each individual is addressed to achieve the best results. In addition to this, there are other congenital abnormalities that can occur resulting in an abnormal ear shape. These will be discussed and addressed accordingly.

Other reasons for ear surgery would be an abnormality due to trauma or cancer resection. The ear can be reconstructed in these circumstances and the type of reconstruction is dependent on the part of the ear that is missing.

PROCEDURE

You will be admitted the morning of the operation in most cases. As with all other operations, you will not have eaten or had anything to drink for at least 6 hours (anaesthetic safety reasons). I prefer to perform this operation under general anaesthetic but minor corrections can be done in the older patient under local anaesthetic.
An incision will be placed in the back (inconspicuous) of the ear through which most of the operation will be performed. There may be very small incisions in the front of the ear but these heal well and are generally invisible. The cartilage of the ear will be manipulated and sutures may be placed to hold the ear in its new position. The wounds will then be closed.
The dressing that is applied to the ears after surgery are very important to the success of the operation. This is a type of soft helmet dressing that needs to stay on for approximately 1 week. For this reason, the operation is commonly performed during the school holidays. I will remove the dressing in my rooms and the ears will be inspected. At the first dressing change, the ear is often bruised and may have a wrinkled appearance due to the dressing. This appearance resolves andf the ear will start to look normal within another week. After the first dressing is removed, you will be expected to wear a head band which covers the ears and holds them back. This will continue for at least another week. After that week (third week after surgery) the head band must only be worn at night to prevent any injury to the ear during sleep.

DISADVANTAGES / COMPLICATIONS

Fortunately, significant complications are infrequent. Every year, many thousands of people undergo successful ear surgery, experience no major problems and are pleased with the results. It is however important that every surgical procedure has risks.
Some of the potential complications that may be discussed with you include:

-    Haematoma (blood collection under the skin which may require further drainage)
-    Infections
-    Pain and itchiness
-    Necrosis of skin
-    Unsightly scars
-    Stitch problems which can come through the skin or create an abscess
-    Decreased feeling in the ear which is usually transient
-    Recurrence of the prominence
-    Protruding lobule
-    Irregularities of the ear folds

These complications are very rare but it is important for you to be completely informed about your operation.

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