Otoplasty (Ear Reshaping)

Pinnaplasty is a common procedure to pin back prominent, protruding ears. 

Common causes of sticking out ears include an underdeveloped antihelical fold, excessive cartilage in the concha or a combination of both. 

This straightforward procedure sees the surgeon make an incision (cut) at the back of the ear before removing some skin from the cartilage. This cartilage is reshaped so the ear sits closer to the head. The wound is closed with stitches and a dressing is applied to the area.

During pinnaplasty, a surgeon can also correct ears which are not evenly shaped on both sides (asymmetrical).

It is a straightforward procedure and helps to restore a patient’s self-confidence if they are self-conscious about the size, shape or prominent appearance of their ears.

Ear pinning surgery is usually completed in less than an hour.

Pinnaplasty is usually carried out on children and young teenagers, although adults can also undergo ear pinning surgery. Pinnaplasty can be performed on children as young as six years old.  This is often the ideal age to correct the ears as they have reached their adult size.

Ear pinning is not suitable for under fives as the ear cartilage is too soft to hold the stitches in place.

Ear reduction, as the name suggests, is a cosmetic procedure to reduce the size of the ears. Oversized ears, which are out of proportion with the rest of the face, can result in considerable anxiety and low self-esteem, which is why many people opt for this particular form of otoplasty.The medical term for disproportionally large ears is macrotia. 

In ear reduction surgery, the surgeon will remove excess skin and cartilage to reshape and reduce the size of the upper or lower half of the ear, or the whole ear. Ear reduction surgery can be used to reduce the height and width of the ear. Ear reduction will help make oversized ears smaller, restoring a balanced appearance to the face.

Neurofibromatosis, a genetic disorder of the nervous system, can leave ears enlarged and sitting in the wrong place on the side of the head. Some lymph tissue growths can also alter the size of the ear, resulting in the need for ear reduction.

Ear reduction surgery can also help with the problem of stretched earlobes, a common problem caused by the frequent wearing of heavy jewellery, or so-called skin tunnels, large holes in the lobes created as a form of body modification. 

Ear reduction surgery only focuses on the size of the ears. The procedure can be carried out alongside pinnaplasty if the ears are also protruding.

Ear reduction surgery delivers natural-looking results and can transform a patient’s self-confidence. This type of otoplasty can be performed on both adults and children.

Ear correction is the catch-all term used to describe surgery to correct deformities of the ear which have either been present from birth or caused by trauma.

Babies born with small or absent ears (microtia) will require ear correction surgery as the condition can affect their hearing. This can be done by using the child’s own tissue to reconstruct the ear, by placing a prosthetic framework under the skin or a prosthesis used above the skin.

Most ear-trauma injuries are caused by lacerations or biting, and such injuries require emergency treatment. The damaged ear is left to heal before reconstructive surgery is carried out. The techniques used are similar to those used to treat microtia.

‘Cauliflower ear’, caused by a pooling of blood in the outer ear, is a common ear problem which can benefit from ear correction surgery. If left untreated, the blood can become scarred and calcified, resulting in a thickened cauliflower ear. This condition is common among rugby players and boxers. A surgeon will treat a cauliflower ear by lifting the skin from the front of the ear, thinning out the thickened tissue to recreate the original shape of the ear.

A surgeon will have to carry out ear correction surgery in a case of skin cancer of the ear. This issue is dealt with by way of surgical excision and reconstruction.

Infections caused by ear piercings through the cartilage, such as a helix piercing, can cause a loss of ear structure. In some cases the surgeon may need to reconstruct the ear using cartilage taken from the ribs.

Surgery is typically performed under local anaesthetic, and can be completed in an hour or less.

There are many different techniques depending on whether your ear is being reshaped, resized or repositioned.

If your surgeon is aiming to pin your ears back closer to your head, your surgeon will start by making an incision along the crease-line behind your ear and remove any excess cartilage that is causing it to protrude. The ear is then pinned back along the fold to its new position, closer to the head.

Following the surgery, the area will be stitched up and a dressing wrapped around your head to support the cartilage in its new place.

Ear reshaping surgery is carried out under local anaesthetic, meaning you will not feel any pain during the procedure itself.

There will be minimal pain or discomfort in the days after the surgery, but this can be controlled using over-the-counter painkillers. The stitches may come to the surface of the skin which may make the ear feel tender. Any pain or discomfort should have disappeared by two weeks post-surgery. You will be fully recovered from your ear reshaping procedure by four weeks.

It is vital that you follow all the aftercare instructions issued by your surgeon. Failure to do so may hamper the healing process.

Ear shaping results are permanent, so long as you follow the post-surgery care instructions issued by your surgeon, such as wearing a head bandage for several days if required  to help your ears heal in their new position.

You should see results from your surgery almost immediately, but typically we recommend waiting for between one and two weeks to allow any bruising or swelling to subside, before you can expect to see your full results. You should expect a full recovery from otoplasty by four weeks.

We regard the healing cartilage like a healing bone and need to splint the ear in its new position as it heals.

We therefore provide all patients with a head bandage after surgery that must be worn for between 5 – 7 days.

If the surgery does not involve the cartilage, then a head bandage is not a requirement and the stitches can be masked with simple tape.

There is very little downtime after ear reshaping surgery.

We recommend you take a week off work, during which time you will need to wear a head bandage day and night to support the wound.

Your ears may be a little bruised and swollen during this time, and you will need to keep wearing the bandage support at night for at least 3 weeks.

Any discomfort is easily managed with painkillers, and normal washing and bathing is possible within a week.

You should make a full recovery anywhere between 4 to 6 weeks after surgery.

The most common place for an otoplasty scar is behind the ear. Although some scarring is inevitable, our skilled surgeons make the required incisions in the natural folds and lines of the ears, meaning these scars will not be visible. The scars will fade naturally over time.

Occasionally the scars become raised and pink in colour (hypertrophic), but this will settle over the following months. Patients who have undergone otoplasty may develop keloid scars. This is more common in people with darker skin. But it is rare to develop this type of scar after ear reshaping surgery.

Otoplasty and Pinnaplasty are two technical names that are used interchangeably to reference cosmetic ear reshaping surgery.

You will need to wear a headband for 5 to 7 days to ensure your ears are maintained in the correct position post-surgery, and for up to a month at night after surgery whilst you are sleeping.

You can therefore expect to be wearing your glasses after 3 weeks after surgery, but can take longer. You should therefore consider buying prescription contact lenses for this time period.

It is extremely unlikely that an otoplasty procedure will negatively affect your hearing. Ear pinning will not improve your hearing either. 

The ear is made up of three parts: the outer ear (the pinna), the middle ear and the inner ear. All three parts contribute to hearing, but this is mainly down to the middle and inner ear. As otoplasty surgery only concerns the outer ear, it is very unlikely that surgery to this area will affect your hearing. 

Ear correction surgery may be possible on the NHS, particularly for children who need it for therapeutic (medical) reasons.

Cosmetic ear reshaping surgery is not possible on the NHS, except in very rare circumstances where severe psychological distress can be evidenced.

Although prominent or abnormal ears do not cause any hearing difficulties, they can be a source of bullying for children. It is therefore quite common for children to have an ear pinning.

Children should be 6 years of age or older since at this point the ears have fully matured. It is also preferable to wait for an age when a child is able to express their unhappiness with their appearance, and personally wish to have the position or shape of their ears corrected.

There are no differences in the surgical techniques used for children and adults, although children are more likely to have the procedure done under a general anaesthetic.

Yes, it is possible to get surgery to repair stretched ears and stretched earlobes. The success of the surgery depends on how much the earlobe has stretched out of its natural position. Stretched ears typically develop with the onset of age but wearing heavy ear jewellery for long periods of time can also cause stretching.

Ear surgery is a quick and effective procedure to reverse stretched ears and can be carried out within an hour.

Otoplasty is minor surgery and complications are typically those associated with such surgery. This can include:

• Asymmetry
• Bleeding and bruising is the most common risk and there is always some swelling. The purpose of the head bandage is to reduce this risk and speed healing.
• Scarring - scars are typically behind the ear and not visilbe, but on occasions, these scars can become hypertrophic, that is raised and pink, gradually resolving over some months, or even keloid with scars that continue to grow to the point where they may become visible. We can mitigate this with the Cadogan Clinic scar treatment
• Infection and necrosis (loss of tissue)
• Numbness
• Re-protrusion
• Stiffness of the ear

Ear augmentation is a procedure to enlarge small ears. This particular type of otoplasty can help to rectify asymmetry of the ears.

Ear augmentation will require synthetic or autologous implants. When a synthetic implant is used, it is covered with a skin graft. The autologous method involves using the patient’s own cartilage, taken from the ribs, which will eventually fuse with the ear. This method is less likely to result in rejection.

Ear augmentation is used to treat microtia, a defect present from birth in which the patient has an abnormally small or malformed ear. This condition can vary in severity. 

Ear augmentation is also used to treat a condition called constricted ear, otherwise known as a cupped or lop ear, in which the top rim of the ear is folded over. This condition is caused by a shortage of skin, cartilage or sometimes both.

Ear augmentation surgery is typically carried out on children. The method used depends on the age of the child. Book a consultation with one of our expert surgeons to discuss the available options.