Hart Cosmetic & Reconstructive Surgery Institute
621 S New Ballas Road
Suite 676A
St. Louis, MO 63141
Phone: (314) 251-6250
Fax: (314) 251-6822

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Ear Surgery

Ear Modification

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Are You a Candidate for Otoplasty?

      Ear surgery can correct protruding ears (excessive ear cartilage), large or otherwise deformed earlobes, "lop ear" (where the ear tip bends down and forward), and "cupped" or "shell ear" (which could be a very tiny ear or an ear without natural creases).

      Malformed ears is a broad term that includes cupped ears, shelled ears, or ears that are otherwise not visible due to a birth defect. The ears are assessed for excessive cartilage, malformed cartilage, mal-positioned cartilage, and soft-tissue (skin and fat) deformity.



When Is the Best Time for Otoplasty?

      Children's ears are most often fully developed by age 4. There are no additional risks associated with age. The procedure is usually performed to improve the appearance of the ears so that the child would not have to endure ridicule from peers throughout their childhood.

      Firmer cartilage of fully developed ears in adults does not provide the same molding capacity as in children. Having the procedure at a young age is highly desirable for two reasons:

  • The cartilage is extremely pliable, thereby permitting greater ease of shaping.
  • The child will experience psychological benefits earlier from the cosmetic improvement.


The Procedure

      Dr. Hart will typically suggest a general anesthesia for young patients and a local anesthetic combined with a mild sedative for older children and adults. For certain general anesthesia cases, an overnight hospital stay may be appropriate. Otherwise, patients return home within hours of the procedure on the same day. Under normal conditions, time in surgery is about two hours.

      Techniques vary among surgeons and patients. Factors that may impact the choice of technique include the general anatomy of the ears, the extent of the ear cartilage, excessive skin in the surrounding area, or level of deformity in other areas of the ears.

There are two common otoplasty techniques:

  • Dr. Hart first determines the incision location by finding the most inconspicuous site on the back of the ear. Once the incision is made, Dr. Hart will sculpt the exposed ear cartilage and re-position it closer to the head for a more natural-looking appearance. Dr. Hart may use non-removable stitches to help the cartilage maintain its position. In some cases, Dr. Hart will remove more excessive cartilage in order to enhance the ultimate appearance of the ear.
  • In the second common technique, skin is removed and the ear cartilage is folded back. There is no cartilage removed in this technique. Non-removable stitches are used to help the cartilage maintain its position. Dissolvable or removable stitches are used for the incision location, which are removed or dissolve within seven days.

      For total ear reconstruction, otherwise known as congenital microtia (ear absence), a common approach begins with developing a framework from the ribs, then elevating the back, and placing a skin graft. The ear canal is then carved out often it is necessary to rotate the lobule. Ears that are malformed due to trauma (including burns) may undergo a variation of the reconstruction process, possibly with more extensive skin grafting, depending upon the extent of the tissue damage.





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