Ear Pinning (Otoplasty)

Otoplasty, also known as ear pinning surgery, is a procedure in which your surgeon makes adjustments to the ears in order to create a more aesthetically pleasing profile. The procedure involves making strategic incisions, often behind the ears, to access and reshape the cartilage; sutures are used to secure the ears in the desired position.

Some patients may be candidates for “scarless” otoplasty, in which the incisions are even more limited. Otoplasty is often performed on children as well as adults, providing a long-lasting solution that can reduce bullying, enhance self-esteem and alleviate concerns about ear appearance.

There are two primary causes for prominent ears: a lack of an appropriate “antihelical” fold in the upper part of the ear that causes the outer rim to stick out, and prominent cartilage in the center of the ear, known as the “conchal bowl.” This cartilage can also cause the ear to appear more perpendicular to the face.

Novel otoplasty techniques focus on addressing undesired ear prominence by using sutures to create a natural-looking contour in the ear’s cartilage, effectively reducing protrusion and pinning back the ear to bring it closer to the head. The procedure may be required in one or both ears to ensure a balanced appearance. Having an otoplasty will not affect your ability to hear.

This surgery is technical and requires finesse to achieve optimal results. It is imperative to work with a surgeon who understands the artistic and personalized nature of otoplasty; every procedure must be tailored to address your specific anatomical concerns. Be sure to discuss all possible benefits and risks of an otoplasty in a consultation with a board-certified plastic surgeon or facial plastic surgeon.

The ideal time for an otoplasty, or ear surgery, often depends on your or your child’s individual needs and circumstances. While some individuals are born with genetics that cause their ears to stick out or to appear large in relation to their head, other individuals may have ear-related issues due to a traumatic injury.

When possible, it is recommended to consider this procedure during early childhood or adolescence as soon as the ears are fully developed — around the age of five or six — to  minimize potential psychological impacts associated with ear appearance, including teasing and bullying.

Otoplasty can, however, be performed successfully in adulthood as well, providing individuals the opportunity to enhance their ear aesthetics at any stage of life. Even if done later, there is typically little if any visible scarring in a standard procedure because the incision is hidden behind or within the creases of the ears.

Once the ear has fully formed, there are few alternatives to surgery. However, if identified early, ear molding for newborns with prominent ears has a high success rate in correcting ear shape and can often prevent the need for surgery later on. This non-surgical approach involves using a custom-fitted mold to reshape the pliable ear cartilage and is typically started within the first few weeks of life.

Individuals may also have ears that appear small or are not properly formed. Microtia is a congenital ear deformity in which the external ear is underdeveloped or absent; however, this condition differs significantly from a prominent ear that requires otoplasty. Microtia repair involves complex reconstructive surgery to create or rebuild the ear, often using ear cartilage or synthetic material, and is performed in multiple stages.

Ultimately, consulting with a qualified surgeon can help determine the most suitable surgery and timing based on your individual anatomy and goals.

While the majority of patients are satisfied with the results of otoplasty, there is a small chance of needing revision surgery to address asymmetry or achieve your desired outcome. Additionally, there are limited risks of infection, scarring, and changes in skin sensation.

Before you go

An otoplasty consultation and preoperative process involve a detailed discussion with your surgeon about your goals and expectations. Your surgeon will examine your ears, discuss your medical history, and determine the most suitable surgical approach.

Key topics to discuss include the surgeon’s experience, the type of anesthesia used, potential risks, and the expected recovery time. Reviewing before-and-after photos of previous patients is crucial to understanding potential outcomes. Your surgeon will also explain preoperative instructions, such as avoiding certain medications and arranging for post-surgery care. This thorough preparation helps ensure a successful otoplasty procedure.

During the procedure

Otoplasty can be performed under local anesthesia or general anesthesia, depending on the complexity of the surgery and personal preference. For young children, general anesthesia is preferable. In any case, you or your child will be pain-free.

The duration of the procedure typically ranges from one to two hours, although this can vary based on the specific adjustments needed. Otoplasty is often performed on an outpatient basis, allowing patients to go home on the same day.

During the procedure, your surgeon will make strategic incisions, often behind the ears and sometimes within the creases of the ears, to access and reshape the cartilage; sutures will then be used to secure the ears in the desired position.

Scarless percutaneous otoplasty is performed using small needles and specialized sutures to reshape and pin back the ears without visible incisions. This minimally invasive technique allows for precise adjustments while minimizing scarring and reducing recovery time.

Ear Pinning (Otoplasty) Aftercare 

After otoplasty, wearing a protective headband is recommended to support the ears and maintain their new position. Typically, the headband should be worn continuously for the first week and then nightly for several weeks, as advised by your surgeon. Strenuous activities and those that pose a risk of injury to the ears should be avoided for six to eight weeks. It is also advised to sleep on your side. You may experience some discomfort and itching. Pain is typically managed with over-the-counter medications.

The full results of the otoplasty can take up to several months to become apparent as swelling subsides. It is critical to attend follow-up appointments so that your surgeon can track your progress and ensure an optimal healing process.