Otoplasty, commonly known as ear pinning surgery, is a cosmetic or reconstructive procedure designed to correct the shape, size, or position of the outer ear, or auricle. The primary goal is to address ears that protrude significantly from the head, which is often caused by an underdeveloped antihelical fold or an overly deep conchal bowl. By surgically modifying the underlying cartilage framework, the ear is repositioned closer to the side of the head to achieve a more balanced and proportionate appearance.
Determining Suitability
A patient’s suitability for ear pinning is determined by physical maturity and the specific anatomical concern being addressed. For children, the procedure is most often performed after the age of five or six, when the ear cartilage has reached approximately 90% of its adult size and is stable enough to be reshaped. Operating at this stage can be psychologically beneficial, often preventing the emotional distress that can arise from peer teasing.
Adults are also suitable candidates, though their cartilage is firmer and less pliable than a child’s, which may influence the specific surgical technique chosen. Otoplasty addresses prominent ears, including deformities like a lack of a defined antihelical fold or an excessive projection of the conchal bowl. A consultation is necessary to assess the individual ear anatomy and align the patient’s aesthetic goals with realistic surgical outcomes.
The Surgical Procedure
The ear pinning procedure typically begins with the administration of anesthesia, often general for young children or local with sedation for older teens and adults. The surgeon makes a discrete incision, almost universally placed in the postauricular sulcus, which is the natural crease on the back surface of the ear. This strategic placement ensures the resulting scar is hidden from view.
Through this incision, the surgeon accesses the auricular cartilage. Reshaping the cartilage involves two primary approaches: the suture-only technique or the cartilage-modifying technique. Techniques like the Mustardé method use permanent sutures placed through the cartilage to create or enhance the antihelical fold.
Alternatively, for cases with a very deep conchal bowl or excessively firm cartilage, the surgeon may remove a small, crescent-shaped portion of the conchal cartilage. This removal, sometimes combined with light scoring, weakens the cartilage’s spring mechanism, allowing the ear to bend closer to the mastoid bone. Once the desired contour is achieved, the internal sutures are secured, and the external incision is closed using fine sutures.
Post-Operative Care and Healing
Immediately following surgery, a bulky head dressing is applied to provide compression, minimize swelling, and support the new ear position. This initial bandage remains in place for several days. Patients are prescribed pain medication for the discomfort experienced in the first 48 hours and are instructed to keep their head elevated to reduce swelling and bruising.
After the initial dressing is removed, typically within a week, the patient transitions to wearing a lighter, soft headband. The headband is worn continuously for one to two weeks, and then only at night for several weeks afterward. The primary purpose of the headband is to protect the healing cartilage from accidental bending or trauma, especially while sleeping.
Most patients, including children, can return to school or work within five to seven days. However, restrictions on physical activity are strict; strenuous exercise and contact sports must be avoided for four to six weeks to prevent injury. Although results are often apparent quickly, the ears continue to heal and refine over several months as residual swelling resolves.