PROTRUDING EAR SURGERY

Protruding Ear Surgery (Otoplasty)

There’s a phrase often heard when talking about protruding ear surgery:
“The ideal age for this surgery is 5-7.”
When I first heard this, I questioned it too. Yes, cartilage development is
largely completed at these ages. But how accurate is it to say “the ideal
age is 5-7”?
Over time, I realized this: Children, especially those in primary school,
can be very cruel.
Peer bullying is one of the most important problems of childhood. And in
the children who come to me for this surgery, I often see that their
awareness is higher than their peers.

Child Patients and Approach

I had a patient, 7 years old. She had grown her hair long so that her ears
wouldn’t show.
This is also common in adults.
Before the surgery, she asked me: “You won’t cut my hair, right?”
“How do you know that?” I asked, “There’s a risk of infection and all
that… They don’t even cut hair during brain surgery, so you probably
wouldn’t either.” This reminded me again: When talking to children, you
must always treat them seriously.

Causes of Protruding Ears

Protruding ears are usually caused by two anatomical reasons:
Size of the concha (ear cup)
The part of the ear closest to the skull being wide
1. Absence of the antihelix fold
The natural fold of the ear not being prominent
2. In most patients, these two conditions are seen together.

Surgical Approach

While I advocate conservative techniques in rhinoplasty, in otoplasty I
am more in favor of the open technique.
In the open technique, the incision is made behind the ear, inside the
natural folds.
Therefore, it is quite difficult to notice from the outside. For a person to
realize that they have had surgery, they need to pull their ear forward
and specifically look for the incision line.

What is done during the surgery?

During the surgery:
If the concha is wide, it is brought closer to the skull with special sutures.
If there is no antihelix, the natural curve of the ear is recreated.
In other words:
The excess structure is reduced.
The missing structure is created.
The possibility of these sutures opening is slightly higher in closed
techniques.
In open techniques, this risk is more controlled.

Post-operative process

For about 1 week after the surgery, a bandage similar to a volleyball
player’s bandage is used.
This bandage is removed in the 1st week. Afterwards, we ask our
patients to wear the bandage only while sleeping for 2 weeks.
The purpose of this bandage is not to reshape, but to protect the ear. It
does not need to be very tight.

Pain and Recovery

There is a common perception that this surgery is painful.
However, in reality: It is not a painful surgery.
Our patients generally experience a comfortable recovery process.

Long Term

There may be slight loosening over time. In these rare cases, correction
can be done with a small stitch under local anesthesia.
Also, it is not correct to expect 100% symmetry between the two ears.
Generally, around 90% symmetry is achieved, and this is natural.

Note

Ear atresia (absence of an ear or serious developmental disorders) is a
different matter.
These surgeries are more complex and require different techniques.
Today, thanks to biomedical advancements (e.g., bionic ear prostheses),
more comfortable solutions are possible. However, I do not perform
surgeries in this group.