Surgery Instructions – Otoplasty
WHO IS A CANDIDATE:
If you have ears that stick out too far from the side of the head. If the ears have an unusual or undesirable shape.
Ears that have normal folds and shape with normal protrusion from the side of the head.
The operation is usually performed on an outpatient basis under sedation and local or general anesthesia. The ears are usually bandaged with a dressing that wraps around the head in a turban-like fashion for several days.
Initial mild postoperative discomfort is easily controlled with oral medication. The procedure is appropriate beginning at age 5 or 6 or at any time thereafter.
RECUPERATION AND HEALING:
The ears usually look “normal” within 10-20 days.
Usually headband is worn at night for 3 weeks after the first dressing is removed to protect the ears. Contact sports should be avoided for about 3 months.
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.
A hematoma (collection of blood) is rare but possible. It could cause delayed healing or an infection.
A relapse of the protruding ear(s) is possible if there is subsequent injury or if stitches loosen postoperatively.
Scars behind the ear are usually unnoticeable, in the unlikely event the scars widen or become too thick,
The ears may be slightly different in size and shape (most ears are somewhat different to begin with).
Infection or even abscess formation (collection of pus) may occur.
Fluid collections rarely accumulate under the skin and may require drainage or aspiration (withdrawal by needle).
Otoplasty is an elective procedure. The only realistic alternative is to not have the surgery.
Post Operative Instructions
If you have excessive bleeding or pain, call the office at (214) 363-4444, day or night.
YOUR FIRST 24 HOURS:
If you are going home, a family member or friend must drive you because you have been sedated. Someone should stay overnight with you. If you have any questions about these matters, please ask one of our nursing staff.
Keep your dressings as clean and dry as possible. Do not remove them unless instructed to do so. Your dressings will stay on for 72 hours.
Take it easy and pamper yourself. Try to avoid straining. You may go to the bathroom, sit and watch TV, etc., but NO MATTER HOW GOOD YOU FEEL, DO NOT CLEAN THE HOUSE, REARRANGE THE
ATTIC, ETC.! We do not want you to bleed and cause any more swelling and bruising than is unavoidable.
If you have any postoperative nausea, carbonated sodas and dry crackers may settle the stomach. If nausea is severe, use the suppository. If you feel normal, start with liquids and bland foods, and if those are well tolerated, progress to a regular diet.
Smoking or nicotine use (chewing tobacco, nicotine gum, snuff) can have a severe detrimental effect on wound healing. The nicotine decreases the vital blood supply to the skin and can cause poor healing or even skin death. STOP ALL NICOTINE PRODUCTS 2 MONTHS BEFORE AND AFTER SURGERY.
Excessive use of products with caffeine such as coffee, tea, or soft drinks, especially Diet Coke, can have similar effects as nicotine.
STOP ALL CAFFEINE PRODUCTS 2 WEEKS BEFORE AND AFTER SURGERY.
Hormone replacement therapy and birth control pills increase the incidence of blood clots. STOP 2 WEEKS BEFORE AND AFTER SURGERY.
Please don’t drive for at least 2 days after general anesthesia or intravenous sedation or while taking prescription pain pills.
POST OPERATIVE APPOINTMENTS:
It is very important that you follow the schedule of appointments we establish after the surgery.
Specific Post Operative Instructions
Elevate your head to decrease the swelling. Do not lie on your sides for 7-10 days after surgery. Sleep on a soft pillow with a cutout for the ears for 1 month. If you wear glasses, modify the temple pieces of the glasses to avoid putting pressure on your ears.
Do not remove the dressings. Your surgeon or a nurse will do this 3-5 days after surgery. Once the dressings are removed, avoid pulling on the stitches or bending the ear forward. Another yellow gauze is sutured to the ears and cannot get wet in shower. This gauze is removed in 7-10 days. Wear the headband at night for 3 weeks after the gauze is removed.
Wear a headband over the ears for 6-8 weeks after surgery when sleeping or during sports activities. Resume exercise and sports in 3 weeks. AVOID ANY ACTIVITY THAT MAY TRAUMATIZE THE EARS FOR 3 MONTHS. Contact sports, wrestling, football helmets, diving in water, etc.
If there is crusting along the suture lines behind the ears, apply antibiotic ointment (Polysporin or Bacitracin) after cleansing with soap and water.
Specific As You Heal Information
We want you to avoid straining or any aerobic activity for at least 3 weeks after surgery. This is to avoid bleeding, bruising, and swelling. Do not resume strenuous exercise for 3 to 4 weeks.
You may resume driving when you feel you are able, but wait at least 2 days after surgery. Keep in mind that you must have full use of your reflexes. If pain will inhibit them, don’t drive!
You may enjoy sexual activity as your body allows with the following restriction: please reread Activity/Sports above and apply the same concept to sex.
If fresh scars are exposed to the sun, they will tend to become darker and take longer to fade. Sunscreen can help. Take extra care and precautions if the area operated on is slightly numb — you might not “feel” a sunburn developing.
Possible problems and complications
No surgical procedure is without risk. Most complications associated with otoplasty, however, are minor. Here are some possible problems:
Collection of blood or serum under the skin (hematoma), or (seroma). This can be removed and the reason for the drain and postoperative compression.
Temporary crusting which forms on the incision.
Numbness or loss of sensation in the area of operation is normal.
Extraordinary sensitivity in the surgical area. This occurs with some patients, but disappears in time.
Depression. With aesthetic surgery, as with other surgical procedures, this sometimes occurs postoperatively. This is generally attributed to the normal response of the body to surgery and anesthesia.
Asymmetry. No patient is identical from side to side. Small differences exist in all patients. In the occasional patient with a major difference, this can usually be improved with a secondary procedure.
Hypertrophy or keloid scarring – this can be treated with cortisone injections, tape, or possibly scar revisions. This problem is frequently seen in dark pigmented individuals.
Poor scarring is the single biggest drawback to this surgery. Scars will stay red for months. These will eventually fade unless you have a dark complexion.
Poor healing of skin.
Potential but unlikely complications:
Infection and/or abscess under the skin – can be treated.
Loss of a small area of skin (necrosis); this usually occurs in smokers, caffeine addicts and obese people.
Deep venous thrombosis (blood clots) affects mainly the veins in the lower leg and the thigh. This clot may interfere with circulation of the area, and it may break off and travel through the blood stream. This clot can then lodge in the brain, lungs, heart, or other area, causing severe damage to that organ or even death. This is the reasons we have you stop hormones, wear TED hose, and walk every 3 hours the night of surgery.
Other complications of a severe nature, which could be life threatening
There is evidence of an increased incidence of MRSA (methicillin-resistant Staphylococcus aureus) and other antibiotic resistant bacteria in our community. In the past, these resistant bacteria were typically found only in hospitals, but they are now found everywhere. Frequently people can be a carrier of the bacteria without their knowledge. An infection with this bacteria can cause severe damage to the skin and even death. We are diligent in cleaning and sterilizing our facility and try to limit the exposure of outside bacteria from patients into our surgery center. We therefore have implemented the following hygiene steps to help prevent the contamination of our facility and therefore decrease your post operative infection risk.
Bathe your entire body with CLn body wash the 2 nights prior to surgery and again the morning of surgery. CLn body wash is an anti-bacterial, antiseptic liquid soap. Sleep on clean sheets the night before surgery and wear clean clothes to your surgery.
YOU MUST ENTER INTO SURGERY FULLY UNDERSTANDING NOT ONLY THE BENEFITS, BUT ALSO THE POSSIBLE PROBLEMS. ON RARE OCCASIONS, MINOR REVISIONS MAY BE NECESSARY TO ENHANCE THE FINAL RESULTS.
The instructions above are general and some portions may not apply to all patients. Changes in the instructions depend on your medical history, number and type of procedures and type of anesthesia.