FAQ

Men who have a chest that is disproportionately large from some combination of fat or glandular tissue. This process can be normal in adolescents and subside by the late teens. But surgery can be done on mid-teens if the deformity is so severe that in consultation with the patient's pediatrician it is agreed that the patient would benefit from male breast reduction surgery.

The key issue is whether it bothers a patient enough to be worth undergoing surgery. Usually men will talk about being embarrassed to take their shirt off at the beach, their shirt clinging too tightly to their chest and looking odd when working out, and puffiness developing in the nipples, particularly when their nipples are warm.

True gynecomastia is caused from hormones causing a growth of breast tissue in the male chest. This can be from normal hormones made within the body or from steroids such as those taken by body builders. Being overweight can sometimes lead to a disproportionate amount of chest growth, and even after weight loss this can remain in some men.

Losing weight can help overweight men, though it doesn't necessarily cure gynecomastia. But for men that are thin, surgery is the only option for reducing gynecomastia.

A patient can be put to sleep, given IV sedation, or be given just local anesthesia. It depends on patient preference and the nature of their problem. One or two ¼ inch incisions are made in each side of the chest. A long acting anesthetic is placed. After waiting for it to distribute and take effect, small tubes are placed through those incisions and fat is removed and the shape of the chest contoured. Those incisions are closed with just several small sutures that are removed after about five days.

Excision means cutting out tissue. This can be done with general anesthesia, IV sedation, or local anesthesia. That decision will be based upon a patient's particular anatomy and preference. A small incision is made from about 5-8 O'Clock on the areola and the excess tissue is removed. Stitches are placed that will dissolve.

Some patients just need one procedure and some need a combination of the two. There are two types of tissue that can be responsible for the enlargement of male chests. In true gynecomastia, the cause of the chest enlargement is purely glandular tissue. This is a very firm and rubbery tissue, and it cannot be removed by liposuction; it must be excised. On the other extreme there can be just a localized excess of fat. Fat is easily removed with liposuction and thus liposuction is the choice. Some patients have a combination of both. Men that are very thin will rarely have fat and thus won't need liposuction. Men that are overweight will invariably need liposuction. Steroid use causes the development of firm tissue that requires excision.

Whether fat or gland, the goal of good gynecomastia surgery is the restoration or creation of a nice contour to the chest. While there is often the desire by both the patient and surgeon to remove as much as possible, in actuality it is normal for there to be some glandular tissue beneath the areola and some fat throughout the chest. The goal should be to create just a normal configuration, which means removal of the bulge and creation of a smooth contour. A complicating issue is that the chest looks different when the arms are at the sides than when they are raised above the head. Just try raising your arms now and you will look a lot flatter. Sometimes when the chest is made to look flat with the arms at the side there can be a bit of a depression deep to the areola when the arms are raised above the head.

Gynecomastia patients are warned about the possibility of it coming back. But after performing a great number of gynecomastia cases, the only cases Dr. Teitelbaum has seen reoccur were in men who went onto anabolic steroids after surgery. There have been cases in which a decision was made to just do liposuction and not excision in which the patient later wished that excision would have been done. That is why a careful preoperative assessment and discussion with the patient are so important.

It is always possible to redo gynecomastia – if the problem is to remove more. But if the problem is a depression or an irregularity then that is a much more difficult problem to deal with. It is a problem that is best avoided.

It is safe and common to perform other procedures at the same time as gynecomastia. The most common would be liposuction of the stomach or love handles.

Other plastic surgery procedures such as otoplasty (for prominent ears) and rhinoplasty are also common.

The biggest drawback is that there can be some amount of contour irregularity. For men who need a lot of liposuction, particularly out towards the under arm area, there can be some irregularity in contour if the skin isn't tight enough to snap back. If there is a lot of fat in the chest itself, there can also be a risk of contour irregularity and waviness, particularly if the skin isn't particularly tight. The most common area in which men will notice problems is a depression deep to the areola when raising arms above the head. The overwhelming majority of men do not notice these problems and are thrilled with their result. And even if they do notice something, it is usually relatively minor compared with the dramatic improvement that was made for them.

Many patients undergoing gynecomastia surgery are overweight. Obviously it is much healthier and contour is better if a patient loses weight on their own. Surgery cannot make someone look as good as they would look with their own weight loss. But even with weight loss, oftentimes some excess chest fat remains, and so overweight men often still want to have surgery on their chest after they have lost weight. Finally, it is important that when men are overweight that only enough is removed from their chest to make it proportional with the abdomen. There is a tendency among patients and plastic surgeons to remove as much as possible, but when the chest is made much less prominent than the abdomen, this does not look good. And this can become even worse if the patient loses weight after their gynecomastia surgery.

If your problem was glandular, then gaining weight will not be a problem. If the problem was fat, then it is possible that some of it will come back, if you gain a lot of weight back. But whatever was removed is forever gone.

Most patients prefer to go totally to sleep. But there are situations in which IV sedation or even pure local anesthetic work equally well. This is something that Dr. Teitelbaum will discuss with each patient.

There are often two very small incisions that are used for the liposuction portion of the procedure. If an excision needs to be done, there will be a scar at the border of the areola from between 5 and 8 o'clock. Dr. Teitelbaum is very careful with how he closes the incisions and usually the scars are quite excellent. It seems many patients today shave the hair on their chest. If you can grow chest hair, it is good to let it grow before surgery so that it can help conceal the scars during the early healing process before the scars have had a chance to fade.

It is always possible to lose sensation but it is very uncommon to do so.

Insurance companies vary widely in what they will cover. In recent years Dr. Teitelbaum has only seen insurance companies cover gynecomastia surgery when it is extremely disfiguring and the man's chest has a very female breast-like appearance.

Patients can go home after gynecomastia surgery so long as someone is there to help look after them. But some gynecomastia patients are very private and may go to an aftercare facility if they want no one to know.

Dr. Teitelbaum calls all of his gynecomastia patients the night of surgery to check on how they are doing. Equally important is for patients to call him if they have any concerns.

Men will say that it will feel very sore such as after a big work out or getting punched in the chest. Patients will be given narcotic pain pills, but most men do not need to take them after gynecomastia surgery. It is safe to say that the pain is relatively minor and manageable, even for teenage boys.

So long as your work doesn't involve straining and heavy lifting, you can expect to be back to work about three days after gynecomastia surgery. Some people go back even sooner, and many work from home the next day.

You can drive when you are off of all narcotic pain medication and feel totally unrestricted by your discomfort such that you could make any movement you might need to safely drive your car. That is ultimately a decision that I cannot make for you.

It is best to wait about three weeks to go back to the gym, but if you only had liposuction it is okay to work out after about ten days.

It is okay to go out in the sun within days after surgery, provided that the incision is protected by something that will totally block the sun, and it is a good idea to keep the incision totally blocked from sun for a year or so.

Dr. Teitelbaum wants you to keep your initial post surgical garment on for two days. At that point you can take it off and shower. You should put your compression vest back on after that.

Swelling increases after surgery, usually peaking about 5-6 days after gynecomastia surgery. After that, the swelling will subside, rapidly at first, and then gradually. After one month, you'll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.

You will have a vest with foam underneath it put on in the OR. Remove this after two days, throw away the foam, and just wear the vest. When you are around the house, wear the vest. When you want to leave, put on a tight Under Armour type of shirt or vest. There is no absolute period of time that you need to wear compression, but the more you wear it the faster your swelling will go away. In general men will wear this for about a month.

Gynecomastia is breast development in boys and men. It happens in up to 80% of adolescents and usually goes away on its own. But there are millions of young men in whom it did not go away. In its mild form it can allow for a little bit of protrusion of the nipples when the nipples are warm, and in its most severe form the male chest can almost look like female breasts. It is very embarrassing to men, limiting their willingness to take their shirts off at the beach, leading many to always wear an undershirt and an overshirt, and it causes their jackets to hang off of their chest making them look heavy when they really are not. Fortunately this is almost entirely correctable with surgery.

Gynecomastia refers to a growth of the glandular cells of the chest. It tends to be firm and sometimes painful. Pseudogynecomastia is not a pure enlargement of the glandular cells. Rather, it means that there is a disproportionate deposit of fat in the chest, occasionally alongside some increase in the glandular tissue. Overweight men and boys will often have a disproportionate amount of fat in their chests. When they lose weight, for some reason that fat is extremely stubborn. That is the most typical form of pseudogynecomastia.

Liposuction works beautifully to remove extra fat in the chest and sculpt a nice shape. But it only can tease away soft fat cells. If there is a firm mass in the chest, then that needs to be removed through a small incision along the lower border of the areola.

The indication for treating gynecomastia is that it is causing you a visual problem. Do you feel your clothes are tight in your chest? If you are sweating does your shirt cling to your nipples? Is the contour of your chest as nice as it should be relative to the rest of your body? Most patients can easily answer for themselves if they have enough of an issue with gynecomastia to investigate whether they want to treat it.

It is obviously best for overweight people to have plastic surgery at their ideal weight. From a practical point of view, that should be refined to mean that surgery should be done at the weight a patient is most comfortable maintaining because it allows the plastic surgeon to contour the chest out to the surrounding areas so that it blends most beautifully. Some later weight gain or weight loss would not noticeably impact the result. Many men who are much more overweight decide to do liposuction of their chests before losing their weight because it gives them a nice jump start. They feel better about wearing tight or clingy athletic clothing and the surgery really can boost their self esteem and get them on their way to perfecting their bodies.

When you raise and lower your arms, you will see that your chest will somewhat smooth out when your arms are up. So if your chest is smooth after surgery when your arms are down, sometimes there can be a bit of a depression when you raise your arms all the way over your head. In some situations – though uncommonly so – there can be a bit of a depression even with the arms down. With gynecomastia surgery, the plastic surgeon is obligated to remove the entire piece of abnormal glandular tissue, no matter how big it is. When large, it may have compressed the normal tissue around it. Dr. Teitelbaum is excellent at sculpting this tissue. Nonetheless, it is possible to have some bit of a depression in that area. If the skin is loose after a large weight loss, or if there are lots of stretch marks, then the skin may not tighten up well after the gynecomastia tissue is removed. These patients still have a big improvement, but they may not get a chest that is as tight as ideal. If a lot of liposuction needs to be done and the skin isn't tight, then sometimes some subtle waviness or irregularity in the contour is possible. All in all, these problems are mild when taken in context of the huge improvement of the surgery, but each patient deserves to know going in the likelihood they may have one of these issues.

Dr. Teitelbaum is dedicated to making his patients happy. If there is anything at all he can do to tweak a result after gynecomastia surgery or any other surgery he will do it. It takes close to a year for the result to totally settle down. It is best to wait as long as possible so that you don't end up chasing your tail, reducing one side to match the other, only to end up over-corrected or under-corrected. The tissue also softens over time which gives Dr. Teitelbaum a greater ability to create a nice contour. It is very unusual for any of Dr. Teitelbaum's patients to ask for a revision, but he does it when it is necessary. Far more often he revises gynecomastia surgery on patients dissatisfied with their previous result elsewhere or who have had several failed attempts at fixing their problem.

All gynecomastia patients are warned that it can come back. But the only gynecomastia patients in whom Dr. Teitelbaum has seen it return were men who took anabolic steroids after having their gynecomastia surgery. Some patients may have had inadequate initial treatment, such as doing liposuction but not an excision. Such patients didn't really have a recurrence of their gynecomastia, but merely need more done.

When the tissue is soft and just fatty, then liposuction is the ideal treatment. But pure glandular breast tissue is too dense to be removed by liposuction and must be surgically cut away. There are some cases in which the problem seems to mostly be fat because no firm mass can be felt before surgery. But after doing the liposuction, gradually the firm area emerges like an almond in the center of a melting chocolate bar. In some situations there is a combination of fat and glandular tissue, but the patient may opt to just do the liposuction, accepting that the result will not be as complete but preferring to have a slightly easier recovery.

Gynecomastia should be considered normal in teenagers. And it goes away most of the time. So when should a teenager consider surgery? Sometimes the severity of the gynecomastia is just too severe to expect the child to live with. Instead of just being a bit full or having a pointy shape, there can be a significant amount of asymmetry or the chest may develop very much of a breast like shape. Parents might tell from their son's behavior that it is affecting their self-esteem. They may not want to take their shirt of and swim or go to a pool party. They may avoid playing a sport because they don't want someone to see their chest in the locker room. Dr. Teitelbaum frequently helps teenagers with their gynecomastia. In all cases he speaks extensively with the boy, his parents, and the child's pediatrician.

No matter the type of anesthesia, you will have had surgery on your chest. Your ability to use your arms safely and avoid an accident will be impaired by the surgery. You must therefore get a ride home. If you just had local anesthesia then you could take a cab home, but if you have general anesthesia then you will need to be taken home by the person who will stay with you and take care of you that day.

Dr. Teitelbaum only uses drains when he has to take out very large amounts of breast tissue. He will tell you ahead of time if this will be necessary.

You will have a vest with foam underneath it put on in the OR. Remove this after two days, throw away the foam, and just wear the vest. When you are around the house, wear the vest. When you want to leave, put on a tight Under Armour type of shirt or vest. There is no absolute period of time that you need to wear compression, but the more you wear it the faster your swelling will go away. In general men will wear this for about a month.

Liposuction and liposculpture are really one and the same. The point of the term liposculpture is to suggest that the surgeon is artistically sculpting the body rather than just randomly sucking out as much fat as possible without regard to shape. Dr. Teitelbaum is the consummate artist and focuses his attention on sculpting the body.

Nearly half of all of Dr. Teitelbaum's liposuction patients are men. No matter how hard men exercise and work out at the gym, there are some stubborn fat deposits that won't go away, even in the very thinnest and fittest men. Of course men with a more average build, and certainly those with a few pounds to lose have parts of their bodies that would be improved with liposuction. These changes are beneficial when undressed, in a business suit, in workout clothes, or in a bathing suit. And since the scars are hidden, liposculpture leaves little of the telltale sorts of signs of plastic surgery that concern men considering plastic surgery.

Men will most often get liposuction under their chins (submental region), chests, and love handles. The stomach is the next most common. Outer thighs are only very occasionally done. Unlike women, upper backs, arms, inner thighs, and knees are never done.

The results are actually better in men than they are in women. There are two shortcomings in liposuction in women. The first is the ability of the skin to contract. Men have thicker skin and tend to maintain more elasticity than women. The other is that with liposuction there is always a risk of seeing some waviness or irregularity under the surface of the skin. The thicker skin and greater number of hair follicles in men obscure those irregularities more than the skin does in women. Finally, fat deposits in men seem to be much more discrete, with delineated boundaries. This allows better sculpting of the treated areas into the surrounding areas, thereby making the result more natural and attractive.

The fat in men is sometimes more dense and fibrous than it is in women. For this reason, Dr. Teitelbaum has power liposuction and ultrasonic liposuction devices available to use whenever necessary on his male patients. These instruments allow him to more smoothly and gently sculpt his male patients.

How can liposuction of the neck (submental liposuction) benefit men?

It is simply amazing how much better men can look after liposuction of their chest. Whether overweight or of normal weight, many men carry excess fat in this area. Sometimes the fat is just proportional to their being overweight. Though patients who are overweight ideally should lose weight, it turns out that chest fat is often very difficult to lose with weight loss. But even so, reducing the fat in the chest makes clothes fit so much better and makes men look dramatically thinner so many men choose to do this procedure even when losing the weight is an option. Other chest liposuction patients are men who have lost weight whose chest remains prominent. Finally, there are men who have gynecomastia – abnormal breast development. When the tissue is hard, it has to be cut out by the surgeon. But when it is soft it is called pseudogynecomastia and that can be treated by liposuction. The fat in a man's chest is often very fibrous and tenacious, making it resistant to ideal volume removal and sculpturing by standard liposuction techniques. For these reasons Dr. Teitelbaum frequently uses ultrasonic liposuction or power assisted liposuction to help him sculpt the most ideally shaped chest.

Some men have extra fat on the inside around the organs, and some men have extra fat just under the skin. Liposuction only works for the fat that is under the skin. Men that can sit down and pinch a roll of skin and fat probably have fat under the skin (subcutaneous fat), and this is well treated by liposuction. But there are some men with very firm bellies who cannot really pinch a lot of skin and fat. It can be obvious even to them that the fat is on the inside. Surgery cannot do anything for them at present. Their only option is weight loss. But for the countless men who have too much subcutaneous fat, liposuction can work wonders. It works not just to make men thinner, but it is indeed very effective at sculpting a nice contour to their abdomens. Liposculpture can help emphasize a six-pack and the results can be very beautiful.

Liposuction of the love handles is one of the best areas for liposuction in men. Many guys have shredded six packs yet still cannot get rid of their love handles. The skin is thick, the area contracts nicely, and the results are amazing. It is important to recognize that the ideal male physique does have some sense of love handles – just look at a photo of Michaelangelo's David or other similar work of art. If the love handles are entirely removed the man can become overly "hourglassed" appearing which is both feminizing and unattractive. Dr. Teitelbaum uses liposuction not simply to make you thinner, but to make you look better.

Fat is stored when food is consumed and not burned. So if you have a relatively stable weight, then this is simply not an issue. If you are going to gain weight, then you will have fewer fat cells in any areas that were treated, so proportionately fat will go more to other areas. When liposuction is done to put someone into better balance, then this isn't a problem, because they will gain or lose weight in a more proportional manner. The people who have trouble with fat going elsewhere were people who were overweight and had liposuction in one or two areas that weren't necessarily disproportionate. When those folks gain weight, then the fat does seem to go somewhere else.

Dr. Teitelbaum checks regularly with his abdominoplasty patients' nurses at an aftercare facility. He and his nurse will stop in to visit you the evening of your surgery and again the next day. On the second day after surgery patients will be driven to Dr. Teitelbaum's office.

Men who ask for a tummy tuck have either lost a lot of weight or they have always had a "pregnant" look no matter what weight they have been at. These last patients often have what is called a "rectus diastasis," which is a separation between the muscles that would otherwise create a "six-pack." When those muscles separate, they can look like they are trying to push their stomachs out as far as possible.

The skin can only snap back part way after being stretched. When a man loses a large amount of weight, significant amounts of residual skin remain. It can fold over his underwear and even over his penis. It can create a roll just beneath his beltline within his pants. Despite all of the very hard work to lose weight, he may still not be enjoying the appearance he has earned. A tummy tuck can remove this redundant skin and fat and tighten the remaining tissues to create a dramatic enhancement to his appearance.

It is actually unusual to do a tummy tuck on a man at his true goal weight. The procedure is usually done when a man's weight loss has slowed or come to a halt, even if he would like to still weigh a bit less. Oftentimes operating at that point creates a big enough improvement that the boost to his self-esteem helps him to go the rest of the way after the surgery. It is highly unusual for any remaining weight loss to require any sort of a revision.

A typical tummy tuck in a man who has lost a lot of weight requires a scar that goes just within the underwear line across his entire lower abdomen. But the scar needs to continue around the sides for as far as the looseness goes which he wishes to correct. There is also usually a scar around the belly button.

If the looseness extends all the way around the waist to the back, and if your buttocks and thighs are loose or deflated, then a lower body lift may be the ideal procedure. Though it involves a scar all the way around the waist, it can significantly tighten the buttock and thighs and for the patients who need it the results are tremendous.

The distinction between a "lower body lift" and a "belt lipectomy" is subjective and will be answered differently by various doctors. Essentially however a belt lipectomy involves a relatively straight incision all the way around the waist, removing loose skin in both the abdomen and lower back. But the belt lipectomy does not work to lift the buttock and thighs. The lower body lift (also known as a thigh/buttock lift) actually has a scar that for technical reasons is located a bit higher on the back than is the belt lipectomy. While the belt lipectomy just removes the pinch of skin and fat around the waist, the lower body lift involves dissection down under the thigh and buttock and is primarily focused upon raising and lifting those tissues. The scars are very similar but will be different. The lower body lift is a longer procedure with a longer recovery because more work is done on the thigh and buttocks and the tissues need to be pulled a lot tighter in order to produce a durable lift of the thighs and buttocks.

The muscles that go from the rib cage to the pubic bone are the rectus abdominis muscles. These are the muscles that enable you to do a sit up, and they are the muscles that can create a six pack. They are supposed to be fused in the center, but after children in women and sometimes congenitally in men they are separated. It is common to reconnect these when doing a tummy tuck in women after babies, but it is not common that a rectus diastasis occurs simply from obesity in either men or women. But there is a subset of men who seem to be born with a weak attachment between the rectus muscles, and they develop a "congenital rectus diastasis." These men will say that they have never been able to hold their stomach their whole lives and that people may have teased them that they even looked pregnant.

An endoscopic abdominoplasty involves a small incision in the pubic hair and another around the belly button. Through those incisions, and endoscopic camera is placed and the rectus muscles are sewn back together in order to create a flatter stomach. Sometimes liposuction is done at the same time to help further thin the stomach.

Too much skin in the upper eyelids makes men look older and tired. When severe it can even interfere with vision. When the skin "crowds" the eye socket the color of the eyes becomes lost and the expressiveness of the eyes gets lost. Extra fat in the upper and lower eyelids can make the eyes look puffy, tired, and old. Eyelifts do not simply make men look more youthful and vibrant, but they make men look handsome.

The problem with facelifts is that we only know the bad ones. We all see men with great facelifts every day, but they are simply not obvious. If you want a facelift but are hesitant because you think that all men with facelifts have to look fake and feminized, please do not worry. With the right surgeon and techniques a facelift can make you look much better without looking as if you have had surgery.

Men can look extremely handsome even with some sagging in their cheeks and with prominent nasolabial folds. The key ingredient in maintaining a man's appearance is the jawline and neck. On the other hand deep nasolabial folds and looser cheeks are more problematic for women. It is thus very important that a man considering facial surgery be assessed with a different mindset than is used with a woman. There are many circumstances when a necklift without a facelift is ideal for men.

A weak chin suggests a weak personality. Cartoons of tough guys always are caricatured with excessively large chins. Weak men are satirized with small chins. The point of a chin implant is only to give a man a normal chin. When this is done, men look stronger, more athletic, younger, and sexier. There are many different shapes of chin implants. While women tend to look better with more rounded chin implants, men often look better with more square shaped chin implants. One of the most wonderful things about chin implants in men is that no one ever thinks about whether someone has had a chin implant. Restoring a small chin to become a normal size makes men look dramatically better and the fact that he had surgery is usually undetectable.

Looking lean and athletic are important characteristics for men to possess. When looking at a clothed man, no part of the body suggests that as much as the visibility of the jawline and the presence or absence of a double chin. Submental liposuction works phenomenally well on men. Their thicker skin and beard probably helps to enhance the tightening of skin after liposuction. Just making the neck a bit thinner and the jawline a bit cleaner will make men with just a bit excess of fat in those areas look much better.

Liposuction under the chin – submental liposuction – works well to thin the neck. But liposuction of the face does not work. However there are two marble shaped pieces of fat in the cheek called "buccal fat" which can easily be reduced. Buccal fat is the fat that gives babies their chipmunk appearance. But that look can exist even in thin adults. With a small incision inside of the mouth, a small amount of this fat can be removed through a procedure called "buccal fat excision." By removing the bulge in the lower cheek, the face can be made to look much leaner. Because facial fat is lost as we age, plastic surgeons must be careful not to remove buccal fat without careful consideration as to whether that person has so thin of a face that they may look too thin after face is lost in the future. For the many patients who undergo buccal fat excision, they enjoy a much leaner appearance, and the surgery leaves no tell tale signs that anything was ever done.

Indeed there is a problem of men looking "done" or "feminized" after plastic surgery. The cause is applying the same procedures as done on women to men without stopping to assess whether they should be done or how they should be modified to fix a particular man's aesthetic needs. Another problem is simply doing too much of something surgically, the end result of which means that it will look surgical. As long as the cheek component of a facelift is not pulled to tight, then there is little concern of a facelift feminizing a man. Injecting too much filler – and sometimes any at all - into the nasolabial fold or lips can feminize a man. Browlifts can be done in men, but they must be done with extreme caution because men are supposed to have lower brows than women, and men's eyebrows should be lower and more horizontal in shape as compared to the arched shape of the ideal female brow. Men benefit all the time from rhinoplasties, but the nose mustn't be made too small or narrow. To the contrary, plastic surgery can actually give men a greater degree of masculinity and handsomeness.

Dr. Teitelbaum performs many more otoplasties on men than on women. While women can at least cover their ears with hair, frequently this is not possible for men. It is amazing how much less handsome a man looks when his ears stick out even a little. Have you ever thought Stephen Colbert looks a little…different? Look at his ears, particularly the one on the right; that might work for a comedian, but there is no doubt that it makes him look far less handsome. And it is almost never a matter of handsomeness per se for otoplasty patients; some retardation syndromes such as Down's are associated with malformed ears. As unfair and wrong as it is, the shape of our ears create impressions as to our intelligence. That is perhaps why otoplasty patients are often embarrassed about their problem or secretive about having it corrected. But the good news is that otoplasty is one of the most time-tested procedures in plastic surgery and the operation has evolved to a very high level of safety and effectiveness.