Ear pinning surgery, formally known as otoplasty, is a cosmetic procedure designed to reshape and reposition the external ear (auricle). This surgery brings prominent ears closer to the head, creating a less noticeable profile and improving facial balance. Otoplasty can also address ears that are disproportionately large or those with congenital deformities. It is a common procedure performed on both children and adults seeking to correct the appearance of their ears without affecting hearing.
Candidacy and Anatomical Goals
The procedure is frequently performed on children, often between the ages of five and six, when the ear cartilage is sufficiently developed and pliable. Operating at this age can help a child avoid potential psychological distress from teasing. Adults are also candidates for otoplasty, provided they are in good general health and have realistic expectations.
Prominent ears usually result from two main anatomical issues. The first is an underdeveloped antihelical fold, the inner ridge that helps keep the ear folded toward the head. The second is an excessive or enlarged conchal bowl, the deep, cup-shaped portion of the ear. The anatomical goal is to reduce the distance between the ear and the side of the head, ideally to less than two centimeters, and to recreate the natural contours.
The Surgical Process
Otoplasty is generally an outpatient procedure, allowing the patient to return home the same day. Anesthesia varies: adults often receive local anesthesia with sedation, while general anesthesia is used for children to ensure they remain still. The surgeon makes a small incision on the back surface of the ear, concealing the resulting scar once the ear is repositioned.
The two primary techniques for reshaping the cartilage are cartilage scoring and permanent internal sutures. The cartilage-sparing method, such as the Mustardé technique, involves placing non-absorbable mattress sutures to fold the cartilage and recreate the antihelical fold. This technique is effective when the cartilage is soft and pliable, particularly in younger patients.
For patients with stiffer or thicker cartilage, or an overly large conchal bowl, the surgeon may use cartilage scoring. This involves making precise incisions to weaken the cartilage, allowing it to bend into the desired shape. In cases of excessive conchal cartilage, a small amount of tissue may be trimmed before sutures are placed. The incisions behind the ear are then closed with fine sutures. The procedure typically takes one to three hours, depending on complexity.
Post-Procedure Care and Expected Recovery
Immediately following surgery, the ears are covered with a thick, protective head dressing to promote healing and maintain the new position. This initial dressing is usually worn continuously for about one week. Patients may experience mild discomfort, swelling, or throbbing, managed with prescribed pain medication.
After the initial dressing is removed, patients transition to wearing a soft headband. This headband is worn full-time for several days, then primarily at night for four to six weeks to protect the ears while sleeping. Most adults and children can return to normal activities within five to seven days as swelling subsides. Strenuous activities and contact sports must be avoided for four to six weeks to prevent injury.
Potential Complications and Long-Term Results
While otoplasty is safe, potential complications can occur. Specific risks include infection of the skin or cartilage, and hematoma, a collection of blood that may require drainage. There is also a risk of suture exposure, where internal stitches become visible, or a recurrence of prominence if the cartilage pulls the ear forward.
Changes in skin sensation, such as temporary numbness, are common but usually resolve over a few months. Possible outcomes include asymmetry between the ears or an overcorrection, where the ears are pulled too close to the head, creating a “pinned-back” look. The final aesthetic result is considered permanent because the reshaped cartilage maintains its new form after healing.