Otoplasty, commonly known as ear pinning, is a cosmetic surgical procedure designed to correct prominent ears by repositioning them closer to the side of the head. This operation alters the shape and angle of the external ear (auricle) to achieve a more balanced appearance. People pursue this surgery to address ears that protrude significantly and improve self-confidence. The process involves careful planning, precise surgical technique, and a structured recovery period.
Candidate Selection and Preparation
The decision to undergo ear pinning surgery depends on several factors, including the patient’s physical maturity and general health. The procedure is typically performed on children once their ears have reached near-adult size, which usually occurs by age five or six, as the cartilage is stable and ready for reshaping. Adults of any age can also be candidates, provided they meet the necessary health requirements.
Ideal candidates must be in good overall health, without medical conditions that could impair healing, such as uncontrolled diabetes or bleeding disorders. Patients must also have realistic expectations about the achievable outcomes of the surgery. For all patients, especially children, the desire for correction must originate from the individual, not from external pressure.
Preparation for the procedure involves a detailed consultation where the surgeon reviews the patient’s medical history and current medications. Patients are often instructed to stop taking blood-thinning medications and certain supplements for a period before the surgery to minimize the risk of bleeding. Smokers are generally required to quit several weeks before and after the operation, since tobacco use can significantly compromise the healing process.
The Surgical Procedure Explained
The surgical process begins with the administration of anesthesia, which is tailored to the patient’s age and the surgeon’s preference. Younger children typically receive general anesthesia to ensure they remain completely still and comfortable throughout the procedure. Older teens and adults often undergo the surgery using local anesthesia combined with intravenous sedation, allowing them to be relaxed but responsive.
The surgeon then creates an incision, most commonly positioned on the back of the ear in the natural fold where the ear meets the head. This strategic placement ensures that any resulting scar is discreetly hidden from view after the healing process is complete. Once the cartilage is exposed, the main goal is to reduce the angle of protrusion by modifying the ear’s structure.
Two primary methods are used to reshape the cartilage and achieve the desired “pinning” effect. The suture technique involves using permanent internal stitches to fold the cartilage and secure it closer to the head. This method is preferred when the main issue is a poorly defined antihelical fold (the curved ridge inside the outer rim of the ear). The sutures are placed deeply to create the missing fold without altering the cartilage directly.
The second method involves direct modification of the cartilage, often called the scoring or removal technique. In this approach, a small amount of skin or cartilage may be removed, and the remaining cartilage is reshaped by scoring or thinning it to make it more pliable. The surgeon manipulates the cartilage to create the desired contour and decrease the depth of the conchal bowl. Permanent sutures hold the newly shaped cartilage framework in place.
The choice between the suture-only technique and the cartilage modification technique depends entirely on the specific anatomical issue causing the prominence. Some procedures may even combine aspects of both methods to achieve the most natural and symmetrical result. After the reshaping is complete, the external incision is closed with fine sutures, and a protective dressing is applied to the ear.
Immediate Recovery and Long-Term Results
Immediately following the procedure, a bulky head dressing is wrapped around the head to protect the ears and help maintain their new position during the initial healing phase. Patients should expect some mild discomfort, swelling, and bruising around the ears for the first few days. Pain medication is typically prescribed to manage any post-operative soreness.
The initial compression dressing is usually removed by the surgeon within a few days to a week. The patient is then instructed to wear a lighter, headband-like garment continuously for several weeks, and then only at night for several months. This headband provides support and prevents the ears from being accidentally bent or folded while sleeping. Non-dissolvable stitches are typically removed about one week after the operation.
Patients are advised to avoid any activities that could put stress on the ears, including contact sports, for at least six weeks. While temporary numbness or sensitivity in the ears is common, these sensations typically fade over time as the nerves recover. Slight asymmetry between the two ears is possible, as perfect symmetry is rarely found in nature.
The final results become progressively apparent as swelling subsides over the following weeks. Although the ears appear closer to the head immediately, the final contour and position are usually visible around three months post-surgery. The results are considered permanent, as the cartilage is surgically reshaped and secured in its new location.