Macrotia Surgery / Ear Reduction

What is Macrotia?

Macrotia is excessive enlargement of the external ear. This refers to the vertical height and width of the ear. The average vertical height for a female ear is 5.9cm and for a male ear 6.2 cm. Usually when the vertical height exceeds 6.5 cm the ear can appear enlarged and out of proportion to the head. Age, sex, height and head size all play a part in how large the ear may appear. Excessively large ears can be a significant cause of concern for many people as they can attract excessive attention and unbalance the harmony of the face.

In the majority of cases the enlargement is in the upper third of the ear as a result of a wide scapha. The scapha is the flattened area between the helical rim and the antihelix. This is the part of the ear that is most commonly reduced in ear reduction surgery. This gives more balance to the ear and better harmony to the face.

Macrotia Causes and Symptoms

There are several pathological conditions that are associated with increased ear size but these are very rare. Age is also a contributing factor with ear circumference increasing marginally as people get older as well as elongation in the earlobes. However, nearly all cases presenting for aesthetic reasons have no specific cause with developmental and genetic factors being primarily responsible. There are no specific symptoms attributed to an increase in ear size. Patients may complain ears are sensitive and uncomfortable wearing certain type of helmets. The main problem is that Macrotia can have a negative effect on confidence and social interaction.

Am I suitable for Macrotia Reduction Surgery?

Nearly all macrotia ears can be reduced in size. Some limiting factors include previous surgery and scarring that can compromise the blood supply to the ear. In such cases ear reduction surgery can still be undertaken by a surgeon who is experienced in ear surgery. Ear reduction in smokers is associated with increased risks in wound healing and it is recommended to stop smoking for 6 weeks before ear reduction surgery.

How is Macrotia Surgery performed?

Different parts of the ear can be enlarged disproportionally and surgical treatment is individually tailored.  Macrotia surgery is usually performed by removing a crescent of skin and cartilage from the scapha on the front of the ear. Skin on the back of the ear is not removed. The width of the crescent will dictate how much the ear is reduced. The outer arc of the crescent is then advanced towards the inner arc to close the gap. This usually necessitates removal of a small segment of the helical rim. The resulting scar is just within the helical rim a small horizontal scar on the rim itself. These scars heal extremely well that they are almost invisible after a few months.

The surgery can be performed under local anaesthetic and all the stitches are dissolvable. A bandage is worn overnight but can be removed after 24 hours.

Is Ear Reduction Safe?

Ear reduction surgery is a very safe operation when performed by an ear specialist as it requires experience and appreciation in how the ear alters its shape during the reduction process. When the operation is performed with focus on precision, meticulous technique and appreciation of ear skin blood supply complications are negligible. In addition, by performing the procedure under local anaesthetic risks from a general anaesthetic, although extremely rare, are also eliminated.   

Ear Reduction Surgery Risks

Complications that can occur following ear reduction are rare and minor. There is a minor degree of swelling which usually resolves by the second week. In the first 24 hours minor bleeding from the wound may occur which is of no consequence. Infection risk is very small (1%) and responds well to antibiotics. Scars can be slightly red in first 3 months but always settle down.

There is an increase risk complication in smokers and it is recommended to stop smoking for 6 weeks before surgery as nicotine constricts the blood vessels decreasing the blood supply.