Otoplasty - Risks & Potential Complications
Otoplasty is a surgical process to reshape the ear. A variety of different techniques and approaches may be used to
reshape congenital prominence in the ears or to restore damaged ears. Each individual seeking Otoplasty is unique both in
terms of the appearance of their ears and expectations for results following Otoplasty surgery. In addition, every procedure
has limitations. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential
benefit. Although the majority of patients do not experience the following complications, you should discuss each of them
with your plastic surgeon to make sure you understand the risks, potential complications, and consequences of Otoplasty surgery;
as well as your expectations and goals.
The following are the Risks and Complications of Otoplasty as defined by the
American Society of Plastic Surgeons:
Bleeding
It is possible, though unusual, to experience a bleeding episode during or after surgery. Intraoperative blood transfusions
may be required. Should post-operative bleeding occur, it may require an emergency treatment to drain the accumulated blood
or blood transfusion. Accumulations of blood under the skin may delay healing and cause scarring.
 Do not take any aspirin
or anti-inflammatory medications for ten days before surgery, as this may increase the risk of bleeding. Non-prescription
"herbs" and dietary supplements can increase the risk of surgical bleeding. If blood transfusions are needed to treat blood
loss, there is a risk of blood related infections such as hepatitis and the HIV (AIDS). Heparin medications that are used to
prevent blood clots in veins can produce bleeding and decreased blood platelets.
Infection
Infection is unusual after surgery. Should an infection occur, additional treatment including antibiotics,
hospitalization, or additional surgery may be necessary.
Change in Skin Sensation
It is common to experience diminished (or loss) of skin sensation in areas that have had surgery. Diminished
(or complete loss of skin sensation) may not totally resolve after otoplasty surgery.
Ear Trauma
Physical injury after the otoplasty procedure would disrupt the results of surgery. Care must be given to protect
the ear(s) from injury during the healing process. Additional surgery may be necessary to correct damage.
Skin Contour Irregularities
Contour irregularities and depressions may occur after otoplasty. Visible and palpable wrinkling of skin and ear
cartilage can occur. Residual skin irregularities at the ends of the incisions or "dog ears" are always a possibility
and may require additional surgery. This may improve with time, or it can be surgically corrected.
Scarring
All surgery leaves scars, some more visible than others. Although good wound healing after a surgical procedure is
expected, abnormal scars may occur within the skin and deeper tissues. Scars may be unattractive and of different
color than the surrounding skin tone. Scar appearance may also vary within the same scar. Scars may be asymmetrical
(appear different on the right and left side of the body). There is the possibility of visible marks in the skin
from sutures used during an otoplasty. In some cases scars may require surgical revision or treatment.
Surgical Anesthesia
Both local and general anesthesia involves risk. There is the possibility of complications, injury, and even
death from all forms of surgical anesthesia or sedation.
Asymmetry
The human face is normally asymmetrical. There can be normal differences between ears in terms of shape and size.
There can be a variation from one side to the other in the results obtained from an otoplasty procedure.
Additional surgery may be necessary to attempt to revise asymmetry.
Delayed Healing
Wound disruption or delayed wound healing is possible. Some areas of the ear may heal abnormally or may take a
long time to heal. Areas of skin may die. This may require frequent dressing changes or further surgery to remove
the non-healed tissue. Smokers have a greater risk of skin loss and wound healing complications.
Allergic Reactions
In rare cases, local allergies to tape, suture materials and glues, blood products, topical preparations or
injected agents have been reported. Serious systemic reactions including shock (anaphylaxis) may occur to drugs
used during surgery and prescription medications. Allergic reactions may require additional treatment.
Shock
In rare circumstances, your surgical procedure can cause severe trauma, particularly when multiple or extensive
procedures are performed. Although serious complications are infrequent, infections or excessive fluid loss can
lead to severe illness and even death. If surgical shock occurs, hospitalization and additional treatment would be necessary.
Pain
You will experience pain after your surgery. Pain of varying intensity and duration may occur and persist after
otoplasty surgery. Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after an otoplasty.
Damage to Deeper Structures
There is the potential for injury to deeper structures including nerves, blood vessels, muscles, and lungs (pneumothorax)
during any surgical procedure. The potential for this to occur varies according to the type of procedure being performed.
Injury to deeper structures may be temporary or permanent.
Sutures
Some surgical techniques use deep non-absorbable sutures. You may notice these sutures after your surgery.
Sutures may spontaneously poke through the skin, become visible or produce irritation that requires removal.
Skin Discoloration / Swelling
Some bruising and swelling normally occurs following otoplasty. The skin in or near the surgical site can appear either
lighter or darker than surrounding skin. Although uncommon, swelling and skin discoloration may persist for long periods
of time and, in rare situations, may be permanent.
Skin Sensitivity
Itching, tenderness, or exaggerated responses to hot or cold temperatures may occur after surgery. Usually this
resolves during healing, but in rare situations it may be chronic.
Cardiac and Pulmonary Complications
Surgery, especially longer procedures, may be associated with the formation of, or increase
in, blood clots in the venous system. Pulmonary complications may occur secondarily to both blood clots (pulmonary emboli),
fat deposits (fat emboli) or partial collapse of the lungs after general anesthesia. Pulmonary and fat emboli can be
life-threatening or fatal in some circumstances. Air travel, inactivity and other conditions may increase the incidence of
blood clots traveling to the lungs causing a major blood clot that may result in death. It is important to discuss with your
physician any past history of blood clots or swollen legs that may contribute to this condition. Cardiac complications are
a risk with any surgery and anesthesia, even in patients without symptoms. If you experience shortness of breath, chest
pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may
require hospitalization and additional treatment.
ADDITIONAL ADVISORIES
Unsatisfactory Result
Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be
obtained. You may be disappointed with the results of otoplasty surgery. This would include risks such as asymmetry,
unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (dog ears), loss of
facial movement, poor healing, wound disruption, and loss of sensation. It may be necessary to perform additional surgery
to improve your results.
Long-Term Results
Subsequent alterations in ear appearance may occur as the result of aging, sun exposure, pregnancy, menopause, or other
circumstances not related to otoplasty surgery. Due to the resilient nature of ear cartilage, revisionary surgery may be
necessary in order to improve or maintain the results following otoplasty surgery.
Female Patient Information
It is important to inform your plastic surgeon if you use birth control pills, estrogen replacement, or if you believe
you may be pregnant. Many medications including antibiotics may neutralize the preventive effect of birth control pills,
allowing for conception and pregnancy.
Smoking, Second-Hand Smoke Exposure, Nicotine Products (Patch, Gum, Nasal Spray)
Patients who are currently smoking, use tobacco products, or nicotine products (patch, gum, or nasal spray) are at a greater
risk for significant surgical complications of skin dying, delayed healing, and additional scarring. Individuals exposed to
second-hand smoke are also at potential risk for similar complications attributable to nicotine exposure. Additionally,
smokers may have a significant negative effect on anesthesia and recovery from anesthesia, with coughing and possibly
increased bleeding. Individuals who are not exposed to tobacco smoke or nicotine-containing products have a significantly
lower risk of this type of complication.
It is important to refrain from smoking at least 6 weeks before surgery and until your physician states it is safe
to return, if desired.
Mental Health Disorders and Elective Surgery
It is important that all patients seeking to undergo elective surgery have realistic expectations that focus on improvement
rather than perfection. Complications or less than satisfactory results are sometimes unavoidable, may require additional
surgery and often are stressful. Please openly discuss with your surgeon, prior to surgery, any history that you may have
of significant emotional depression or mental health disorders. Although many individuals may benefit psychologically from
the results of elective surgery, effects on mental health cannot be accurately predicted.
Medications
There are many adverse reactions that occur as the result of taking over-the-counter, herbal, and/or prescription medications.
Be sure to check with your physician about any drug interactions that may exist with medications which you are already taking.
If you have an adverse reaction, stop the drugs immediately and call your plastic surgeon for further instructions. If the
reaction is severe, go immediately to the nearest emergency room. When taking the prescribed pain medications after surgery,
realize that they can affect your thought process. Do not drive, do not operate complex equipment, do not make any important
decisions, and do not drink any alcohol while taking these medications. Be sure to take your prescribed medication only as directed.
ADDITIONAL SURGERY NECESSARY
There are many variable conditions that may influence the long-term result of otoplasty. Secondary surgery may be necessary
to obtain optimal results. Should complications occur, additional surgery or other treatments may be necessary. Even though
risks and complications occur infrequently, the risks cited are particularly associated with otoplasty surgery. Other
complications and risks can occur but are even more uncommon. The practice of medicine and surgery is not an exact science.
Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained.
In some situations, it may not be possible to achieve optimal results with a single surgical procedure.
PATIENT COMPLIANCE
Follow all physician instructions carefully; this is essential for the success of your outcome. It is important that the
surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Personal
and vocational activity needs to be restricted. Protective dressings and drains should not be removed unless instructed by
your plastic surgeon. Successful post-operative function depends on both surgery and subsequent care. Physical activity
that increases your pulse or heart rate may cause bruising, swelling, fluid accumulation and the need for return to surgery.
It is wise to refrain from intimate physical activities after surgery until your physician states it is safe. It is
important that you participate in follow-up care, return for aftercare, and promote your recovery after surgery.
HEALTH INSURANCE
Most health insurance companies exclude coverage for cosmetic surgical operations such as otoplasty surgery or any
complications that might occur from surgery. Please carefully review your health insurance subscriber information pamphlet.
Most insurance plans exclude coverage for secondary or reversionary surgery.
FINANCIAL RESPONSIBILITIES
The cost of surgery involves several charges for the services provided. The total includes fees charged by your surgeon,
the cost of surgical supplies, anesthesia, laboratory tests, and possible outpatient hospital charges, depending on where the
surgery is performed. Depending on whether the cost of surgery is covered by an insurance plan, you will be responsible for
necessary co-payments, deductibles, and charges not covered. The fees charged for this procedure do not include any potential
future costs for additional procedures that you elect to have or require in order to revise, optimize, or complete your outcome.
Additional costs may occur should complications develop from the surgery. Secondary surgery or hospital day-surgery charges
involved with revision surgery will also be your responsibility. In signing the consent for this surgery/procedure,
you acknowledge that your have been informed about its risk and consequences and accept responsibility for the clinical decisions
that were made along with the financial costs of all future treatments.
Dr. Younai is a Board Certified Plastic & Reconstructive Surgeon with experience in all aspects of
Facial Cosmetic Surgery including that of the Ears. He is skilled and experienced in all
techniques of Otoplasty and strives to create ears that are natural and normal looking. During your consultation
he will discuss all details including: if you are a good candidate, surgical options and techniques, potential risks
and complications of surgery, pre- and post-operative instructions, recovery course, as well as what to expect after
surgery. At that time Dr. Younai will also show you before-and-after pictures of other patients with
Otoplasty, who might be similar to you.
Dr. Younai performs Otoplasty on both children and adults who come to the California Center for Plastic Surgery
from the Northern as well as the Southern California region. Some of these cities include Beverly Hills, Los Angeles, Santa
Monica, Hollywood, Burbank, Pasadena, Glendale, Valencia, Palmdale, Fresno, and Oxnard.
Dr. Younai performs his surgeries at the Regency Surgery Center which is certified by Medicare,
AAAHC, and AAAASF. This state-of-the-art facility is located in Encino, and near Sherman Oaks, Calabasas, Woodland
Hills, Thousand Oaks, and Westlake Village.
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