The following is a brief overview of the problems of prominent ears and their correction. Sometimes harshly referred to as Bat Ears, Jug Ears.
WHAT CAUSES PROMINENT EARS (BAT EARS)?
The ears are one of the first part of the body to reach adult size and they are therefore often more prominent in children as they are relatively out of proportion. As many as 2% of the population feel that their ears stick out too far, and this might be on one side only. It is often an inherited problem involving the development and lack of the usual cartilage folds in the ear.
WHEN CAN BAT EARS BE TREATED?
The cartilage in a baby's ear is very soft and pliable and can be moulded with the use of splints if prominent ears are obvious from birth. Most cases of prominent ears (bat ears) become a problem in early childhood particularly because of teasing and bullying at school. Children may become very self conscious. Other children may not be bothered by their ears. Most surgeons advise that surgery for prominent ears is not undertaken until the child is old enough to understand what the surgery involves. In most cases it is best that the child feels that their ears are a problem and is able to express a desire for surgery themselves. At this stage the child is more likely to be cooperative and happy with the outcome. For this reason, and the fact that the cartilage is too soft in the early years, the operation is rarely performed under the age of 5 years.
WHAT IS INVOLVED IN THE OPERATION?
The surgery involves a general anaesthetic but may be performed under local anaesthetic in adults. Some centres will perform the procedure as a day case without the need for an overnight stay in hospital. A cut is made behind the ear close to the groove between the ear and the side of the head. It may be necessary to remove some of the cartilage. In other cases the cartilage is reshaped with the aid of stitches.
ARE THERE ANY COMPLICATIONS?
A consent form must be signed before surgery. This must be signed by an adult (parent or legal guardian) on behalf of any child under the age of 16. The form states that you are aware of the risks and complications involved with the procedure. In some patients problems with red, raised and lumpy scars can develop. There can also be prolonged discomfort or numbness associated with the scars. In very rare cases, problems with wound healing might lead to the need for a small skin graft behind the ear. Wound healing can also be delayed if the wounds become infected. Bleeding under the skin, forming a haematoma, occasionally requires a return to the operating theatre for the clot to be removed. Most patients are happy with the outcome but some may feel that there is some asymmetry (the ears don't match) which might involve further surgery for minor adjustments.
WHAT HAPPENS AFTER THE OPERATION?
After the operation the ears will be strapped with a heavy bandage like a large sweat band to provide protection. There will be some discomfort which might require painkillers but it is best to avoid painkillers such as aspirin, ibuprofen (nurofen) and diclofenac as these can increase the risk of bleeding. The bandage can be removed after approximately 10 days at which point any non-dissolvable stitches can be removed. It may be necessary to wear a bandage at night for a couple of weeks.
WHEN CAN NORMAL ACTIVITES BE RESUMED?
Care must be taken when washing hair initially and it is advised to avoid swimming for at least 2 weeks and contact sport for eight weeks.
The British Association of Plastic Surgeons